It seems everyone is looking for a non-surgical way to reduce the signs of aging. Some of the most popular treatments are neurotoxin injections and dermal fillers. But how do you decide which product, where to inject and how much is enough? Mark Elliott MD, a board certified plastic surgeon from Meridian, Mississippi says, determining which product and how much can mean the difference between looking great and looking overdone.
By: Carolynn Grimes
How to reap the benefits of injectables without looking overdone
“A lot of people come in and don’t really know what they need. They want to apply Botox to all of the problems on their face, or fillers to all of the problems on their face. You have to explain to patients why Botox might work well in some areas of the face and fillers won’t—and vice versa,” says Elliott.
The Combo Injection
Pat Sullivan MD, a board certified plastic surgeon from Providence, Rhode Island says there’s a variety of dermal fillers and neuro-modulators (Botox-type injections) to choose from. He says while it can be confusing to the patient, it allows the doctor to “tailor” the procedure to fit the patient’s needs. Sullivan says he matches the filler or neurotoxin to the patient based on their lifestyle and their goals. For example, it’s not unusual for a patient to have Botox injected on the forehead, Dysport around the eyes, and a dermal filler, such as Restylane or Juvederm injected at the jawline.
Here is an easy way of initially sorting out which type of injection goes where. If you’re looking to relax frown lines and smooth crow’s feet around the eyes, a Botox-type injection is probably the best solution. A neurotoxin works by temporarily weakening specific muscles on your face. The relaxed muscle is then unable to produce the movement that results in wrinkling of the skin “Any wrinkle on your face that’s caused by a muscle contracting, and if it’s a wrinkle that you don’t like, whether it be on the side of your eyes, between your eyebrows that’s where Botox is going to work,” says Elliott.
A dermal filler, on the other hand, is going to take care of the areas that are recessed or not as full as you would like them to be. Fillers can help eliminate wrinkles by adding volume to the dermal layer. Elliott explains, “Anywhere that you have a depression, for instance in the nasolabial folds (the vertical lines that run from your nose to your mouth) or at the corner of your mouth or in your lips; that’s where a filler like Juvederm or Restylane is going to work best.”
How to Avoid Over-Injecting
“The way to avoid the overdone look is to be careful not to put too much product in a noticeable area,” says Elliott. He says, “The classic place you see the overdone look is where women have an excess of filler placed in their upper lip, which gives them an abnormal fullness. That’s either because they’ve had too much total injected or too much injected in a specific area.” Botox, can be overdone as well. “The classic overdone Botox look is when somebody has too much placed in the vertical lines between their eyebrows. When the muscles that hold your eyebrows together become weak, your eyebrows will start to spread a little wider and you’ll have this flat empty look on your forehead—that’s a giveaway of too much Botox,” says Elliott.
Studies show the popularity of injectable fillers and neurotoxins continues to rise and may be a good fit for many patients looking to buy some time before considering surgery. Elliott says, “There’s a certain amount of maintenance you can do to put off surgery for a little while and I think for a lot of people it’s a good fit.” He also acknowledges the patient needs to have reasonable goals in mind and go to a trusted source for their injections. As for avoiding the overdone look— “If I’m uncomfortable doing something because I don’t think they need it or think they’ve had too much of it already, I’ve got to express my feelings and be honest with them,” says Elliott.