Q: How does Botox® (botulinum toxin A) fight wrinkles?

A: Originally used to treat muscular conditions, Botox, is now among the most well-known cosmetic injections. It works by temporarily weakening the muscles that contract to cause wrinkles. It’s FDA-approved for treating crow’s feet (or laugh lines), the creases between the brows and forehead lines.

There are other FDA-approved medications that work similarly: Dysport® and Xeomin®. But Botox is the market leader with about 90 percent of treatment targeting the upper face. We prefer it because it’s predictable and we know it works.

Q: Can Botox prevent wrinkles?

A: Anyone over the age of 18 can receive these injections, but most patients are between 30 and 60 years old.

Botox is sometimes used as a preventive measure to delay some lines from developing. But I tend to discourage patients from using it for that. When the lines aren’t there yet, it is difficult to gauge its effectiveness.

Q: How do dermal fillers work? How are they different from Botox?

A: As people get older, they tend to lose fat in their faces. Dermal fillers help restore the look of fullness that is common in youth.

On the other hand, Botox prevents the flexing of muscles that eventually cause wrinkling. This is why it makes sense to use it on the forehead and around the eyes.

The lines in the lower part of the face, however, are not due to repeated muscle movement, but from a change in facial structure over time.

Dermal fillers, such as Juvederm® and Restylane®, add volume to the depressions around the corners of the mouth and cheekbones. There are several new fillers introduced over the past year, including Juvederm Vollure®, Refyne®, Defyne®. Sometimes, it’s best to get a combination of different fillers to get optimal correction. Together, Botox and dermal fillers can work together to rejuvenate the face.

Q: How long do cosmetic injection results last?

A: Most dermal fillers last anywhere from nine to 12 months, depending upon the patient and where we’re targeting the injections. Juvederm Vollure, the latest filler introduced, lasts closer to 15-18 months. Botox and other botulinum toxin A injections last for about four to six months.

Q: Are there other, new treatments on the market?

A: The FDA approved Kybella® in 2015 as a nonsurgical treatment for addressing neck fullness or fat, known as the double chin. The advantage of this treatment is you may avoid surgery (liposuction). However, it does take time to take effect.

The treatment consists of receiving two to three injections about four to eight weeks apart. It works best for people with mild to moderate fullness and mild to moderate skin laxity. If the skin is too loose, no injection is going to tighten it.

Q: Do cosmetic injections cause side effects?

A: Any cosmetic injection treatment, including dermal fillers and Botox, has potential side effects. It’s best to talk with your doctor as side effects may vary depending on which injection(s) you receive.

Q: Are patients typically satisfied with the results?

A: Yes. It’s also important to understand that you aren’t going to get facelift results from a non-surgical treatment such as Botox or dermal fillers. It can’t replace surgery but it can improve your appearance. Be sure to have a thorough discussion with your doctor to understand what is realistic in terms of results.