Injectables: The Needling Questions
Any time a doctor or nurse heads towards you with a syringe, you are about to meet with an ‘injectable’. In the cosmetic world, the term injectables usually encompasses Botox and what are called ‘ dermal fillers’, such as collagen. Many people get confused as to what type of injectable they need.
The main difference is one type is a muscle relaxer (Botox) and the other is a substance designed to remain suspended, for a certain amount of time, in the skin. Anyone who has watched a crease elongate and deepen, and thought ‘if we can spackle the wall, why can’t we do that for the skin?’ has described a filler’s role.
Most people want to know which would be better - Botox or a filler? It depends a lot on the depth and the location of the wrinkle. A general rule of thumb is: Botox for the eyes up, fillers for the nose down. This is a general rule - fillers and small amounts of Botox are used all over the face. But – generally - Botox works very well for the line between the brows, horizontal lines on the forehead and crow’s feet, and - generally - doctors don’t use it as much around the mouth, cheek and chin area because relaxing certain muscles in the lower face will result in a very unpleasing look.
Fillers are probably most commonly used for ‘naso-labial’ lines, the lines that go from the nose to the corners of the mouth, and the marionette lines, which drop down from the corners of the mouth. They are also used to prop up the corners of the lip, which can tend to pull downward as we age. “Smoker’s Lines”, the bane of many a woman who has never taken a puff, can be diminished by fillers, or a combination of fillers. Fillers are also answerable for the big lip phenomenon (see associated article Fillers - Giving You Lip).
Often, doctors will opt for a combination of Botox and dermal fillers. If the crease in the forehead is deep, Botox alone may not diminish it to the patient’s satisfaction. Smoker’s lines as well commonly get a dual approach.
In my experience, people are generally very happy with Botox for the forehead and eye area, but the lip and mouth area are another story. Usually - although it can relax smoker’s lines – using Botox alone won’t achieve the look the patient is after, and a filler is required. Patient satisfaction with dermal fillers, though, is more elusive – for reasons we will explore in the next few articles.
