Confused About Botox and Fillers?

Confused About Botox and Fillers?

Most everyone has heard of Botox, even though most don’t really know what it is.

“It’s something that doctors inject into people’s faces to make them look younger,” says 39-year-old Kelley from Dallas.  Close… but there’s so much more. “What about fillers, do they do the same thing as Botox?”

These are common questions from many people who aren’t quite sure what these products do and where to go to have them administered. Botox is the flagship product of a group of materials utilized by physicians to restore youthfulness to the face without surgery. “Botox and fillers” is what the lay person might hear them referred to as, yet “fillers” is really an umbrella term covering an impressive (and growing) array of materials suited for different facial areas.

Dr. Shaun Parson of Scottsdale, Arizona and Dr. Brad Calobrace of Lousiville, Kentucky – two board certified plastic surgeons – offer their opinions of the new trend, discussing the effectiveness of the materials, and their uses and longevity. Parson and Calobrace clear up a common misunderstanding of these products: for these products to work, you need to have the injections performed by an expert.

By Shaun Parson, MD and Brad Calobrace, MD
The Plastic Surgery Channel

Which filler to choose for certain problems?

Sculptra, Restylane, Voluma, Radiesse. All of these fancy names are fillers, yet each does something different. “As a consumer, it’s tough to know which is best for your needs,” explains Dr. Parson. “There are so many fillers and there are all these different agents… When do we use which ones as plastic surgeons?”

“I talk about this with my patients a lot,” answers Dr. Calobrace. “I think with Botox, mostly I use in the upper half of the face…forehead, crow’s feet, and the glabella or what’s often called the 11’s, between the eyes. I use fillers in the lower part of the face, around the mouth, in the parenthesis, etc.”

Even so, these rules are more guidelines than anything else. The main (and huge) advantage to having your injections done by a board certified plastic surgeon is their deep understanding of facial anatomy. It may seem obvious, but who would you trust to get a better result? Your family doctor or a plastic surgeon?

Here we have three patients of Calobrace who underwent injections. Based upon their unique facial anatomy and the wear and tear from age, Calobrace formulated an individualized plan with a variety of selected fillers to achieve the patient’s goals.

Patient 1



With this patient, Calobrace utilized both Botox and a filler. “In this situation, I used Botox around the lips to soften the dynamic lines you find with the muscles around the mouth, as well as adding a filler,” explains Calobrace. “With the combination of Botox plus a filler, you can soften the lips very nicely and give a youthful look.”

Patient 2

“We’ve found that as we age,” notes Dr. Parson,  “we lose volume in the face.”


The patient looking to restore volume to the face is Calobrace himself! “As I was turning 50, I needed some global volume – a little bit of volume everywhere to make everything look a little softer and younger,” says Calobrace. “I decided to use Sculptra, which is a collagen stimulator. It softens the lines and gives a fuller look.”

Patient 3



The ability to utilize fillers in patients who aren’t ready for a facelift or eyelid surgery is huge. “Another point is we don’t always have to reach for the knife,” says Parson. “We sometimes can camouflage.”

For this patient, Calobrace utilized materials to help eliminate bags under the patient’s eyes. “Many patients come in and say they want lower eyelid surgery,” says Calobrace. “Sometimes surgery is the right thing to do, but some people don’t want surgery, or it’s not convenient at that point in their life. In that situation, you can offer fillers. Here, I used Restylane in the lower eyelids to camouflage the bags and give a more rested look without surgery.”

Trusting an Expert

As you can tell from the patients above, the answer wasn’t just Botox alone, nor was it a specific filler. Great results come from a broad understanding of both the products and facial anatomy, expertise that only board certified plastic surgeons can offer. When considering a quick injection to take a few years off your face, consider the importance of choosing where you go. It may be cheaper to get some Botox from someplace other than a board certified plastic surgeon or dermatologist, but the results may mirror your investments.

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