Facial Injections: Info, Prices, Photos, Reviews, Q&A

Botox and Restylane work in very different ways, together or alone

Botox and Restylane work in very different ways. Botox and its newer competitor Dysport are neuromuscular blocking agents that stop the movement of muscles that result in wrinkle formation.

On the other hand, Restylane is a “tissue-filler” that may be used to fill in any depression in the skin, whether this is caused by wrinkles, post-acne scars, or loss of soft tissue for any reason.

Certain areas of the face do benefit from use of both Botox or Dysport and a tissue-filler such as Restylane at the same time, particularly if the goal is elimination of very deep wrinkles or folds.

When used together, the effectiveness is often synergistic so that the sum of the two treatment effects is greater than each of their individual effectiveness (i.e. 1+1=3). When used in combination, each influences the longevity and the effectiveness of the other.

Nonetheless, when the correct choice of treatment is made for the particular problem to be corrected, a single agent is often all that is required. (Michael R. Macdonald, MD, Bay Area Facial Plastic Surgeon)

Botox + Restylane = Better results!

Remember that Botox is a muscle paralyzer; it does not “lift” or fill-in. What is does do well is to prevent frown muscles, for example, from causing or deepening those lines between our brows.

It is also effective in other areas. If you don’t frown much, if your skin is youthful and tight with good elasticity and collagen content (genetics), and if you haven’t been in the sun too much or smoked cigarettes, then Botox may be all you need.

Simply paralyzing the frown muscles allows the skin to remain smooth and furrow-free! Unfortunately, not all of us fall in that category above; some of us may have frowned for many years before Botox was available, have thin skin with poor tone and elasticity, or have too much sun exposure over our lifetimes.

In these cases (and that fits a lot of us!) even with the muscles properly paralyzed, there still are residual lines or furrows that make some patients think their Botox isn’t working. (Using more Botox won’t work–you can’t paralyze a muscle more if it is already paralyzed.)

It is if you can’t contract the muscle or deepen the furrows, but if they’re still visible after effective Botox injection by a competent injector using fresh Botox, then a filler such as Restylane, Perlane, Juvederm Ultra, or Juvederm Ultra Plus (all hyaluronic acids, or HAs) can be added to fill up the lines and smooth them out.

Patients who require fillers often ask why they shouldn’t have just a filler, and spare the cost of the Botox. The answer is that if the muscle still is functional (not paralyzed by Botox), the filler can be pushed out of place by the mucle action, making the improvement much less long-lived.

Too many patients who wish to scrimp on their treatment costs decide on “just the filler” and then complain that “It doesn’t last as long as you said it would!” The filler can’t do its intended job if it has been moved out of proper position by continued mucsular action.

So, if Botox is enough to eliminate your lines, good for you! if, after a week or two to see how the Botox makes your lines look, they are still visible, then add a filler for the best results.

Remember, since Botox lasts for 2-6 months for most individuals (3-4 is average), and fillers last 6-9 months on average, you must re-do your Botox to get the longest effectiveness out of your fillers. If you follow a proper timetable, your results will be the best possible, and last the longest, for the lowest cost. (Richard H. Tholen, MD, FACS, Minneapolis Plastic Surgeon)

Botox and Restylane are different entities…. but can work together!

Wrinkles are caused by 4 reasons: muscle action, volume loss, loss of elasicity and gravity. Botox influences your muscle activity it reduces the strength, so it works best for wrinkles predominantly caused by muscles. Good example forehead wrinkle) Restylane (=Hyaluronic acid =HA) is a filler.

Gives back volume where you lost it. There are many location where you loose volume and you can use HA. Nasolabial folds and marionet grooves being frequent locations. So different products, both for wrinkles so you look better (anti aging effect) For skin improvement: retinoids, peels and laser are better options (allthough Restylane Vital is used as well). (Ivar van Heijningen, MD, Belgium Plastic Surgeon)

Botox and fillers work well together.

Botox Cosmetic and fillers such as Restylane and Juvederm work well together, but remember, they do not do the same thing, and are used for different issues or concerns. Botox Cosmetic works by temporarily paralyzing certain muscles of the face that we often use (and overuse).

For example, when we squint or frown, we use the muscles around the outer aspect of the eyes and between the forehead (glabella). Over time, wrinkles appear. Juvederm and Restylane and a host of other injectibles called “Fillers” are meant to literally fill in deep creases, furrows and lines.

The nasolabial folds (smile lines), deep glabellar creases and hallowed-out eyes are often the target of fillers. (Peter Schmid, DO, FAACS, Longmont Facial Plastic Surgeon)

BOTOX and FIllers Yield Better Results

Deep line sin the face represent a breakdown of the supporting layers of the skin. Botulinum toxin can help rest the skin, but fillers will help “fill” the wrinkle. Areas that are particularly suited for this are; lip lines frown lines crows feet in thick skin patients-patients with normal to thin skin the filler may be visible as lumps Studies have shown the combination of the two lasts longer than either one alone. (Brian Maloney, MD, FACS, Atlanta Facial Plastic Surgeon)

Botox and Restylane combination

In a word: yes. But remember they are treating different issues. Restylane is a soft tissue filler, great for treating prominent deep forehead or glabellar wrinkles, while Botox (or it’s competitor, Dysport) minimizes motion, and is great for furrowed brows and crows feet.

There are pleny of other brands and options that address these typical aging issues and I encourage you to consider all your options. (Douglas J. Key, MD, Portland Dermatologic Surgeon)

Botox and Restylane (or Juvederm) can work well together–but it depends on what you need

Botox and Dysport work in a manner very diferent from fillers (Restylane, Juvederm, Radiesse). Botox works by weakening a muscle that creates “active” wrinkles/crinkles: crows feet, vertical lines between your eyebrows, and horizontal forehead lines.

Fillers, on the other hand, are used to plump up of fill out deeper folds and wrinkles that tend to get etched into the face, or to add more volume to areas of your face that have hollowed out.

Using both types of products can certainly give you a more comprehensive result. There are certain cases, though, where you can use both products to treat the same problem. For example, if the “11’s” between your brows are so deep and etched in, Botox can soften the creases, but you may also benefit from having some Restylane injected as well to further correct the deep wrinkle. (Haresh Yalamanchili, MD, Houston Facial Plastic Surgeon)

Botox and Restylane

A rule of thumb for botox and dysport is that they treat the area of the face from the outer corner of the eyes and up. They treat dynamic lines (lines that change with facial expression or deepen with expression).

In the lower two thirds of the face are the nasolabial folds and marionette lines, which don’t change very much and best treated with fillers. One exception is the nasojugal crease, which is just below the eyes and responds very well to restylane. (Roy A. David, MD, San Diego Facial Plastic Surgeon)

There is no one formula that works with all patients. Combinations can at times be better than single agent treatments. It depends upon the problem. (John P. Di Saia, MD, Orange Plastic Surgeon)

Yes, but they may be better if Botox is given first.

Botox will quiet the muscles but in patients who have deep furrows this will not be sufficient. Our routine is to give the Botox and then see the patient at two weeks. The furrow is then filled as needed.

This has two advantages:

1. Usually less filler is needed
2. The filler and botox will both last longer because of the synergy between the products (Nathan Mayl, MD (retired), Fort Lauderdale Plastic Surgeon)

Botox and Restylane

Botox is most commonly used on the upper face, while facial fillers are used on the lower two thirds of the face. While they can be used together, both work via different mechanism. Botox is used to relax the facial muscles.

Fillers are used to add volume to the face. (Anil R. Shah, MD, Chicago Facial Plastic Surgeon)