Facial injectables have long been popular anti-aging treatments for the face. Botox and dermal fillers work so well and push off facelifts and other facial surgical procedures for so many, it’s no wonder they are now a go-to tool in aesthetic surgery. In recent years, plastic surgeons have seen the average age of patients seeking injectables dropping steadily.
The products’ success has many realizing that they actually work (and work really well) and wonder if they may work for them. “Younger and younger people are getting injected these days,” shares Charlotte-based board certified plastic surgeon Dr. Stephan J. Finical.
Preventing Wrinkles As Opposed to Treating Wrinkles
Squint in the mirror and you will see the skin at the corners of your eyes crinkle. Scowl in the mirror and you may notice the furrows that show up between your eyebrows. Women in their 20’s and 30’s are often just beginning to notice the many different wrinkles that form when they smile, frown, squint or scowl. Usually, in youth, those wrinkles disappear when the facial muscle action stops.
Over time, the continued action of our facial muscles begins to crease our skin into visible wrinkles, even when the muscles are at rest. “It’s just like if you fold the page of a book over and over again,” explains Dr. Finical. “It will cause a wrinkle in the page.”
Botox works by relaxing the muscles that are causing the skin to wrinkle with muscle movement. By preventing strong muscle motion, the resulting wrinkles are diminished. Botox’s use over it’s history has mostly been countering already established wrinkles – but what if it were to be used as preventative maintenance?
“The trend, cosmetically, is people are starting to use Botox in their twenties and thirties. Even if they’re just starting to get a wrinkle – so that they don’t. It is more of a preventative,” says Finical.
Fillers to Keep Youthful Cheeks Looking Young
Wrinkles aren’t the only sign of an aging face; as we age, we also lose volume in the face. Our cheeks become deflated and gravity pulls the deflated skin downward, making visible creases called nasolabial folds appear. The nasolabial folds run from the bottom corners of the nose to the corners of the mouth on each side of the face, also known as the parenthesis.
Since nasolabial folds are primarily due to volume loss and are not usually formed as a result of muscle movement, Botox does not help to help soften those lines. Fillers, however, can do the trick. Specifically some newer options are providing better and longer results.
“The other thing that’s really changed in the last five years, is good fillers have come out for the cheeks,” says Finical. “It changes my entire approach to how I inject. I do a lot less into the nasolabial folds and a lot more into the cheeks now.”
Cheek fillers are a great option to provide volume and lift where aging faces need them most. In some cases, treating the cheeks may significantly improve wrinkle areas like the nasolabial folds. Until recently, the only facial fillers available were too soft to be used deep in the cheeks. The only reliable way to lift cheeks in the past was through facelift surgery. “Now we can do it with a filler,” Finical points out. “It really is a nice thing because it takes tension off the nasolabial fold, and it also helps smooth the surface into the lower lids.”
Recent advances in facial filler technology also means that today’s fillers last longer. “A good cheek filler is going to last a couple years,” says Finical. “It can be very cost-effective.”
Advertising Drives Trends
On October 3rd, 2017, the FDA approved the use of Botox for treating forehead lines. While using Botox to treat forehead lines is nothing new to experienced plastic surgeons, it does mean that the company behind Botox is now free to advertise for that specific indication.
In the past you may have seen advertisements in magazines or on television for Botox as a treatment for crow’s feet or frown lines – the two previously FDA approved facial cosmetic uses. Now, the newly approved indication means a new wave of advertisements will likely raise awareness of Botox for forehead lines and drive new waves of patients into plastic surgeon’s offices for treatment.
FDA Indicates that Botox Cosmetic can be injected to improve the look of:
- Frown lines between the eyebrows (glabellar lines)
- Crow’s feet lines
- Forehead lines
“If you’ve got horizontal wrinkles in the frontalis muscle that raises your eyebrow, those can be injected,” explains Dr. Finical. “Now, you have to be careful with that, because it’s a tug of war. If you inject too much here, you can drop the eyebrow a little bit, and people don’t like that. It’s a good reason to go to somebody who is an experienced injector.”
Fillers and Botox, while sometimes derided for outlier results done by poor injectors, truly are amazing tools. In the right hands, the two can be used as an artist might use oil to paint. The two non-surgical products can offer patients a decade or more of slowed aging before they ever need to consider surgery, and may prevent those days in younger patients for decades and decades to come.