Dermal Fillers: The Basics

In a previous entry I reviewed the two types of facial wrinkles, static and dynamic. Dynamic wrinkles occur when facial muscles contract and static wrinkles are present when the face is at rest.

Botox works well for dynamic wrinkles because it relaxes the muscles that cause them. Botox has no effect on static wrinkles because static wrinkles are not related to muscle contraction.

As we age, certain substances (collagen and elastin) within the deep layer of our skin (dermis) begin to deteriorate. Furrows form within the dermis as collagen and elastin disappear. Static wrinkles form when the overlying skin falls into these furrows.

Dermal fillers like Juvederm, Restylane and Belotero are made of a compound (hyaluronic acid... not really an “acid”) that naturally occurs in the dermis. Dermal fillers smooth out wrinkles by filling the furrows between the overlying skin and underlying dermis.

Deep static wrinkles are commonly found on the lower half of the face. Wrinkles that are particularly amenable to treatment with dermal fillers include wrinkles around and below the nose (nasolabial folds), jaw wrinkles (marionette lines) and the lines around the mouth (cigarette lines.)

Botox: Where it Works Best

Most people know that Botox smoothes facial wrinkles by relaxing the muscles that cause them. Few people, however, are aware of the areas of the face that represent danger zones when it comes to Botox injections.

Botox is routinely used to treat wrinkles involving the upper half of the face. Crow's feet, forehead wrinkles and the lines between the eyebrows (the "11" lines) are prime targets. In trained hands, full doses are given with few complications.

Less frequently, Botox is used to treat wrinkling in the lower half of the face. Wrinkling around the mouth and lips are the most frequent target areas.

Lower doses of Botox are utilized in the lower half of the face due to the increased risk of side effects. Slurred speech, difficulty drinking through a straw and an impaired ability to kiss can occur where muscles around the mouth are relaxed with Botox injections.

Before undergoing any medical procedures, it is important to understand the risks and benefits. If you are contemplating Botox injections to the lower half of your face, be sure to discuss these specific risks with your injector before undergoing treatment.