When To Use Botox® And Dermal Fillers

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By Nadiv Shapira, MD

Facial wrinkles and folds are an inevitable consequence of aging. They are the result of repeated activity of the facial muscles and a gradual loss of skin fullness due to the depletion of fat, collagen, and elasticity.

While the skin of the face is still full and only shallow wrinkles are seen, you can preserve the smooth skin by getting periodic Botox® injections.

Existing facial wrinkles and folds however, would most effectively be addressed by three complementary modalities:

  • Injection of Botulinum Toxin (Botox®, Dysport® or Xeomin®) – to weaken and relax the muscles and to slow down the formation of wrinkles.
  • Skin tightening by stimulating collagen by non-invasive, non-painful radiofrequency (Reaction® by Viora)
  • Filling the lost fullness of the face by either the injection of hyaluronic acid based dermal filler (e.g., Juvederm®, Restylane®), or by stimulating the body to re-generate it’s own lost collagen by injecting Sculptra®.

Facial fillers, like Juvederm® or Restylane® are preferable if only a small area is to be treated and immediate results are sought; Sculptra® is more appropriate for the treatment of a large area and if gradual results are preferred.

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