Laugh lines, crow’s feet and wrinkles around the forehead are signs of a life well lived – and a natural part of the aging process. But take heart: While wrinkles are a fact of life, there are safe and effective ways to minimize their appearance and, in some cases, slow their progression.
Botox® and fillers are two of the most common noninvasive procedures to address wrinkles today and have grown in popularity over the last five to ten years. However, many patients still have questions and, sometimes, misconceptions about these approaches.
We often see patients wanting to learn more about how injections and fillers can reduce the appearance of wrinkles and help them look younger. The first thing we do is talk about the difference between these procedures and the benefits of each. Then, together, we can determine which may be the best for you.
Myth #1: Botox and fillers are the same thing
While many confuse Botox and fillers, it’s important to understand they aren’t the same thing.
Botox paralyzes muscles temporarily, which can help prevent the overlying skin from developing wrinkles. Fillers, on the other hand, can soften and fill lines and areas of volume loss like the cheeks or lips.
With Botox injections, small amounts of Botox are injected into these areas to block signals from nerves to the muscles. The muscles are then no longer able to contract so the face doesn’t wrinkle. The most common areas for Botox include forehead lines and crow’s feet.
Fillers, like Juvéderm® and Voluma® XC, use an injectable gel to fill a wrinkle that is already apparent. Juvéderm can be used to target wrinkles around the eyes and lips. Voluma XC can lift and smooth the cheeks.
Another key difference between fillers and Botox is that Botox is a very effective measure to prevent or delay the appearance of wrinkles.
The best time to start Botox is actually in your late 20s or early 30s, before wrinkles become obvious. The less you use the muscles in your face, the slower wrinkles will form. Of course, Botox and fillers need to be part of a comprehensive strategy that includes no smoking, sun protection and other skincare routines.
READ MORE: Understanding your winter skincare routine
Myth 2: My Botox won’t last
The effects of Botox are not permanent but you and your provider can work together on a timeline that works to keep wrinkles at bay.
Typically, we recommend about six months between injections, but that can vary based on your age and preference. The first sign it’s time to come back to the office is when the muscle begins to loosen up and start to move again, which is an indication the paralysis is wearing off.
Fillers, on the other hand, can last up to two years.
Your provider can help you decide what approach is best for you.
You can experiment with fillers and Botox, but you need an experienced provider to guide you through the options that are best for you to ensure that injections are effectively administered.
Just because you can get Botox at a spa or the dentist doesn’t mean you should. You need to see a knowledgeable provider who will create a strategy that addresses your concerns.
Myth #3: My results won’t look natural
One of the biggest misconceptions about Botox is that, because the muscles are paralyzed, you won’t be able to express emotion. But the areas targeted with Botox aren’t really needed to share your thoughts and feelings. For example, you don’t need to express anything with the muscles on your forehead, not being able to squint your eyes isn’t going to keep your family and friends from knowing how you feel and you can still certainly smile, frown and laugh.
Fillers are also a natural, subtle way to reduce the appearance of wrinkles.
Myth #4: Once I start, I can’t stop
Botox and fillers are elective procedures that you can stop at any time, but it’s always best to discuss your plans with your provider to create a schedule that’s right for you. Your provider can also address any concerns you may have about the procedure or recommend a different approach to better meet your goals.
AAMG Plastic Surgery offers nonsurgical and surgical cosmetic procedures to women and men. Choosing cosmetic plastic surgery is a deeply personal choice. To learn more about what’s the best fit for you, check out aahs.org/cosmetic.
Tripp Holton, MD is a plastic surgeon at AAMG Plastic Surgery. Kathryn Sidrow is a certified physician assistant at Anne Arundel Medical Group (AAMG) Plastic Surgery. 
