Botulinum toxins (Botox and Dysport) are frequently used in conjunction with hyaluronic acid fillers (Restylane, Juvederm, Perlane).
They act as a one-two punch on facial lines: Botox reduces muscle activity, which is the root cause of many lines, particularly those in the glabella (between the eyes), forehead, and crows’ feet.
Restylane is a soft tissue filler, filling lines, adding volume, add improving areas of concavity. Because they work on lines in completely different ways, their actions are complementary. (Ronald Friedman, MD, Plano Plastic Surgeon)
Botox and Restylane are safe and effective treatments for non surgical facial rejuvenation. However, they work differently.
Botox works by weakening the injected muscles. If the prominent facial lines or strong expression lines are mostly due to the action of the underlying muscles, Botox treatments should reduce their appearance.
36 Year Old Woman Treated With Restylane By Dr. John J. Martin, Jr., MD, Coral Gables Oculoplastic Surgeon
For example, some patients are concerned about prominent verticle lines between the eyebrows. Some women refer to these as their “11s.” Even in younger women, the deepening of these lines with facial expression can create an undesired angry expression.
Botox is very effective in reducing the appearance of these lines by weakening the underlying muscles that pull the skin in that area.
Restylane is a oft tissue filler that when injected into the skin, camouflages the appearance of the underlying lines or wrinkles by filling the area and smoothing out the contour.
It is most useful in the lower face, around the smile lines or corners of the mouth. It is also useful to enhance the fullness of the lips. Before a treatment is offered, the physician assesses the areas of concern to determine the main cause of the problem.
41 Year Old Woman Treated With Restylane With Doctor Robert W. Sheffield, MD, Santa Barbara Plastic Surgeon
When muscle hyperactivity is the main culprit, Botox is used. When the features are more related to anatomic features or loss of facial fullness, Restylane or other soft tissue fillers are used.
In some areas, like the glabella between the eyebrows, if the lines are reduced in appearance but remain slightly visible, soft tissue fillers can be used to supplement the result, acting in synergy with the Botox, and enhancing the results.
In the lower face, when Restylane is used around the corner of the mouth to reduce the appearance of the downturning of the lips, Botox can also be used carefully to weaken a facial muscle that pulls downward on the corners of the mouth, enhancing the results of the soft tissue fillers. (Stephen U. Harris, MD, Long Island Plastic Surgeon)
Achieve longer lasting results with Botox and Juvederm
You can get longer lasting and more youthful results when you get Botox and Juvederm injections together. For example, Botox is injected to prevent movement and Juvederm is injected to fill in the wrinkle. This is commonly referred to as a SoftLift treatment.
Each patient is different and an assesment would be required. (David A. F. Ellis, MD, Toronto Facial Plastic Surgeon)
Anti-aging and the injectables
The two injectables that you asked about Botox and Restylane work in different ways. Botox paralyzes muscles. This may have a preventative aging effect over time because if the muscle is paralyzed over long periods of times, it may reduce the appearance of fine lines and wrinkles.
This has been confirmed with studies. Restylane fills wrinkles that are already there. It is a “filler” so to speak. I dont believe there is a mechanism for the restylane to prevent wrinkle development in anyway.
Restylane Vs Botox For Forehead
The fillers and Botox can be used at the same time to have a great effect.
The filler can work to fill in deep wrinkles and the botox can be used to soften more shallow wrinkles near areas where the muscle works to create them. (crows feet, glabellar area, forehead etc..) Something to think about for sure. (Chris Thiagarajah, MD, Denver Oculoplastic Surgeon)
Botox and restylane (or other fillers) are commonly used together.
Botox paralyzes selective muscles to soften or eliminate expression lines while fillers, such as restylane, add volume to areas for the purpose of restoring a youthful appearance. Although their mechanisms are different, they both target facial aging and therefore are commonly used in tandem. (Vincent N. Zubowicz, MD, Atlanta Plastic Surgeon)
We commonly use Botox together with wrinkle fillers like Restylane or Juvederm.
Restylane Vs Botox Injections
We commonly use Botox together with wrinkle fillers like Restylane or Juvederm. Botox helps wrinkles caused by muscle contractions, while the fillers smooth out wrinkles caused by loss of tissue. (William P. Coleman III, MD, Metairie Dermatologic Surgeon)
Botox And Fillers Used Together
The one area that you might consider Botox and a filler in combination is the glabella – the area in between the eyebrows.
This happens to be one of the most common areas for cosmetic Botox use, which is intended to address the frown lines.
In patients who already have a depression even at rest, a filler may be indicated in addition to the Botox to help soften the unwanted depressed skin crease. Not all patients need this, however. I usually recommend that my patients undergo Botox treatment first.
Botox Collagen Restylane
Wait until several rounds of Botox have been completed (meaning 6-9 months of Botox use) before making the decision (and paying) for a filler. In many cases, the resting crease will resolve with Botox use alone.
If there is a persistent line that bothers you after Botox treatment, then try a filler for further enhancement. (John M. Hilinski, MD, San Diego Facial Plastic Surgeon)
Botox reduces the muscles that cause the creases (wrinkles) in the skin. Restylane is placed into the skin to reduce the crease itself. By using them together, you will treat the cause (muscle activity) with Botox and the result (wrinkle) at the same time.
However, with Botox alone the relaxed skin crease will gradually improve by itself. (Randy J. Buckspan, MD, Austin Plastic Surgeon)
Injectable Anti-aging Treatments
Botox and dermal fillers can be used together to obtain a great aesthetic look. One of the most common areas to combine the two products is in the lower jaw line. Filling the corners of the mouth then adding some Botox to the Depressor muscles create a nice lift to the smile plus extends the length of time the filler will last. (Michael L. Workman, MD, Portland Plastic Surgeon)
Combination treatments for optimal results
Botox is best used for lines from muscle hyperactivity – frown lines, crow’s feet, forehead lines, “smoker’s lines” or lines around the mouth. Fillers, as the name implies, are more for giving volume to the naso-labial fold area or lower face.
Using both can be very effective in gaining a ‘refreshed look’ or more ‘youthful look’ without undergoing the stress and recovery of surgery. Of course, be wary that this non-surgical treatments will not give you the same result as that obtained from surgery. (J. Vicente P. Poblete, MD, Cleveland Plastic Surgeon)
Which Anti-aging Injectable Is Right For You
Synergy Between Treatments
Botox & Dysport reduce wrinkles from repetetive muscle action, while dermal fillers like Restylane or Radiesse or Sculptra add volume where it is needed. If one has need for both, there is undeniable synergy between multiple therapies- leading to a more rejuvenated look.
Certainly not mandatory, but a good idea if your goal is to look better. Add a good skin care regiment to this, and the effect is even more pronounced.
Eyelid surgery or a browlift and even better! Don’t discount the benefit of synergy among cosmetic treatments…the whole is often much greater than the sum of its parts. (Randolph Capone, MD, FACS, Baltimore Facial Plastic Surgeon)
Botox and Dysport relax muscles that cause wrinkles, typically the vertical lines between the eyebrows, horizontal lines in the forehead, and crow’s feet around the eyes. Dermal fillers like Restylane and Juvederm are used to fill in wrinkles, typically in the lower face.
The time to combine them would be for the lines between the eyebrows if they are too deep, or “etched in” to go away with Botox alone. There is a lot of art and finesse to combining them in other areas, so you want to go to an experienced injector. (Richard Baxter, MD, Seattle Plastic Surgeon)
Botox and fillers
Botox is used on wrinkles that are caused by the action of the muscle underneath it, these are DYNAMIC wrinkles. If these wrinkles are very deep the the combination of Botox and a Filler will give you the best results. (Samir Shureih, MD, Baltimore Plastic Surgeon)
Botox and fillers can be used together
It is not unusual to augment the effect of fillers such as perlane and restylane or Juvederm with the use of neuromodulators such as Botox. This is a common practice and certain areas of the face work better for this approach.
Additionally, certain patients will respond better to this approach. This must be assessed on an individual basis by your dermatologist. (Steven Hacker, MD, West Palm Beach Dermatologic Surgeon)
Botox and Restylane can be used synergistically to combat deeply etched wrinkles
Sometimes it’s not enough to paralyze a muscle, which is causing an undesired wrinkle, especially if the line has been deeply etched into the overlying skin. In the “11s” (corrugator) or scowl lines or perioral wrinkles, this combination can be better than either separately.
By putting the muscle to “sleep” for 3-4 months and filling the “trench”, the overall results are superior. (Lavinia K. Chong, MD, Orange County Plastic Surgeon)