Why The Gift of Botox or Fillers Are The Perfect Holiday Gift - Thanks To Cosmetic Injectables Center

Dr. Sherly solemain

rn melody kohagura

It’s that time of the season when we start to think of our loved ones and how each year we try to see if we can top last year’s gift. For the avid beauty lover and fountain of youth believer who do not discriminate against a little botox or fillers, what better way to treat that person than giving them the gift that keeps on giving – a gift card to Cosmetic Injectables. And while you’d probably like to give your own advice on what your friend could choose as an option, we sat down with Dr. Sherly Solemain and RN Melody Kohagura to get a complete course on the pros and cons of botox vs. fillers, the best places to get these injections, and how to best prepare for your treatment if you have sensitive skin or a low pain threshold (like us).

What’s the major difference between Botox and fillers?
DS and MK: Botox and fillers are both cosmetic treatments used to improve the appearance of wrinkles and folds on the face, but they work in different ways. 

Botox, also known as botulinum toxin, works by temporarily relaxing the targeted muscles that cause wrinkles and lines. When injected into specific muscles on the face, it prevents them from contracting. This reduces the scrunching of the skin above, and hence minimizes the formation of wrinkles and lines over time. This relaxation of both muscle and skin also gives time for the skin to heal itself and reverse damage from previous skin folding that has etched in. Botox is commonly used to treat crow's feet, frown lines, and forehead lines.  However, many other off-label areas are treatable as well, as described below.

Fillers differ in that they are injected under the skin to add volume and fill in wrinkles and lines. They can be made from a variety of materials, including hyaluronic acid, PLLA, and calcium hydroxylapatite and are often used to either reverse loss of volume or enhance certain features of the face. Popular treatment areas are the lips, cheeks, and jawline, as well as the finer lines around the mouth and nose.

In summary, Botox works by temporarily relaxing muscles to reduce wrinkles and lines, while fillers work by adding volume to the skin to fill in wrinkles and lines.

What are the best places to use Botox and fillers?
DS and MK: The best places to use Botox and fillers depend on the individual's unique needs and desired results. Some of the commonly used areas for Botox are forehead lines, frown lines (the vertical lines between the brows), crow’s feet (wrinkles around the eyes), natural looking brow lift, bunny lines (wrinkles on the nose), lip flip (for lip pout and for wrinkles), orange peel chin (chin dimpling), neck bands (vertical neck contractions), masseter hypertrophy (TMJ, grinding), migraine, back and shoulder trigger points, and hyperhidrosis (excessive sweating) of the underarms, hands, and feet.

Some of the common areas used for fillers are the lips to add volume and shape or for treating fine lines, nasolabial folds (smile lines around the mouth), marionette lines (lines below mouth corners that give the sad look), cheeks (to restore or enhance volume and contour), chin, temples to restore facial balance, under-eye hollows, earlobes, jawline to restore or enhance definition and contour and neck.

Let’s talk about beauty myths. We’ve heard that getting Botox in your 20’s is actually considered preventative. Is this true and if so, why?
DS and MK: It’s a great idea to start Botox early, before lines etch into the skin and facial features start to descend.  The idea behind preventative Botox is that by starting the treatment early, one can delay and prevent the need for more extensive anti-aging treatments in the future. By utilizing Botox injections to areas in the face that are prone to developing wrinkles before they become permanent one can prevent scar-like tissue that etches in wrinkles into the skin which is harder to improve.

Are there any long-term effects of using either Botox or fillers?
DS and MK: The long-term effects of using Botox and fillers can vary depending on several factors, including the type and amount of product used, the area treated, and how the individual's body reacts to the treatment.

One of the potential long-term effects of Botox is possible muscle weakness in the treated area, which is usually a desired effect. Tolerance, albeit rare can be another possible long term side effect.

For fillers, some of the potential long-term effects are late onset allergic reaction (uncommon) or filler migration. However, these responses can be minimized or resolved through the injection of a reversal agent called hyaluronidase at any time, putting the skin back at baseline. Less commonly, if filler gel blocks arteries/blood supply to a region, permanent scar or even less likely, blindness can occur.  Going to an experienced provider and following proper aftercare instructions is important to prevent side effects from fillers and Botox. These are typically discussed with your healthcare provider before treatment and any questions or concerns are discussed with potential alternative treatments.

And what if, after a treatment, someone realizes that it’s a little much Botox or filler than they expected. What can be done to lessen or minimize the plumped look?
DS and MK: Without any intervention, Botox usually dissipates over 3-4 months. In addition, often we can relax the opposing muscle to the one causing the unwelcomed result and minimize the undesired effect. To reduce this type of complication from occurring in the first place, it’s important to choose a qualified and experienced healthcare provider that will do an assessment of your unique anatomy to anticipate potential mishaps. At our office, we err on the side of caution and take a conservative approach to a plan of action and a long-lasting relationship.  We also encourage a 2-week follow-up for first time patients for any dosage adjustments.

For too much filler causing an undesired cosmetic issue or discomfort, a reversal medication called hyaluronidase, typically called Hylenex or dissolver, is an enzyme that can break down hyaluronic acid-based filler and reverse it within 24 hours. Sometimes several reversal sessions are required, especially with the firmer, longer lasting products. After reversal treatment is complete, the skin goes back to its baseline position.

For us wimps that have sensitive faces, what’s the best way for us to prepare for injections?
DS and MK: This is a question that we get all the time here at Cosmetic Injectables Center. We design our approach to the non-surgical treatments we provide at our office in a manner to be well tolerated. We always ask during and after procedures about the level of discomfort the patient is experiencing to modify and make it more comfortable [for them]. Most patients rate their pain levels between 1 to 3 out of 10.

Some of our pre-treatment recommendations for patients to reduce discomfort are to avoid things that have caffeine or alcohol which can increase sensitivity to pain. Coming to your appointment when you’re tired, stressed or on your period can increase pain sensitivity.

Your injector can also provide you with multiple aids to help minimize discomfort by utilizing numbing cream, cold compress, vibration devices, nitrous gas, or a nerve block similar to at the dentist to alleviate discomfort.  Taking deep breaths during the treatment is also helpful.  Some of the additional techniques we use at our office to enhance comfort are that we typically use the smallest needles available, change them frequently in the same treatment session, use distraction techniques by tapping on the skin, by engaging in conversation during the injection and we have TVs that play soothing music and calming visuals. Lastly, taking pain medication 1 hour before treatment helps with the pain.

Choosing an experienced injector is also important because we can minimize discomfort by using precise and reduced number of injection sites. Certain modifications can result in less downtime as well.