Sunday, August 21, 2011

Filler vs. Neurotoxin (Botox, Dysport)


A common question that I am faced with is which is better for a patient: fillers or Dysport. This is a little bit of a trick question. These are both simply just tools for facial rejuvenation. They accomplish different things and they have different indications for using them.

Fillers are for filling static wrinkles. One of the most common examples is the fold that goes from the side of your nose towards the corner of your mouth, the nasolabial fold. Fillers can also be used for volumizing the face. One of the signs of aging is a deflated appearance to the face. As people age their face changes from a more round shape to more triangular. Volumizing the face can help rejuvenate the face. A common filler that is used at the time of facelift is fat grafting. It can also be done independently from a facelift. The other use for fillers is for shaping the face. Fillers such as Radiesse have been, aside from its usual indication for the nasolabial folds and other uses around the face, has also been used to conceal nasal defects.

So while fillers are used to fill wrinkles that are there at rest neurotoxins such as Dysport or Botox are used to weaken the muscles that cause winkles. Wrinkles or facial lines are caused by animation of facial muscles. The wrinkles are usually perpendicular to the axis of the muscle. The muscles on your forehead run up and down thus the wrinkles run across the forehead. The wrinkles between your eyebrows are vertical. The muscles called the corrugator supercilii is perpendicular to this inline with the eyebrow.

Dysport is commonly used by me for the forehead, the glabellar (the 11 between the eyebrows), and around the crow’s feet. Another common use of it is around the mouth for softening lipstick lines.

To answer the question of which is better; fillers or neurotoxin, it just depends on whether you are trying to fill in a wrinkle that is there at rest or weaken a wrinkle that is caused by animation.

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