Anti-Aging Skin Care Questions Answered

Anna Guanche, Board-Certified Dermatologist and Dermatologic Surgeon:

I'm Dr. Anna Gaunche. I'm a board certified dermatologist specializing in anti-aging skin care, namely cosmetic procedures.

The difference between Botox and fillers is that Botox is a protein and that inactivates muscles and prevents you from over-expressing in your face so that you don't get wrinkles. Over time what happens is you lose elasticity in the skin. So when you're a little kid you can make any face you want to and your skin bounces back with no lines. But over time what happens is you start to have a memory in your skin. You make an expression, you frown, and then all of a sudden there's a little line left there after you're done frowning. People suddenly think that you're angry or frustrated or tired or that kind of thing so that's what we try to get rid of with that protein.

The fillers on the other hand are used more on the lower face. They're actually plumpers, because what happens over time is you lose volume in the lower face. And so a lot of these lines around the nose start to show. They're called the parenthesis, and we can plump these and kind of reduce the lines with fillers. We wouldn't want to use any of anti-aging skin care treatments like protein in the lower face. It would inactivate muscles because we want to we want to have a nice big smile and be able to express ourselves with our lower face.

I think it's possible to have an allergic reaction to the fillers, however, I've done thousands of filler procedures and I've never seen an allergic reaction to Juvederm. Common side effects with anti-aging skin care procedures like injections include a little bit of redness, bruising, there's a little bit of discomfort with the injections. Even though we put a little topical anesthetic on, you still feel a little bit of discomfort. And the redness usually goes away within two days but can persist a little bit longer in certain individual. Bruising is variable. Some don't bruise at all, and some get a little bit of a bruise and if you do it usually lasts seven to ten days and then goes away.

Actually there is some evidence that using fillers over time promotes your own collagen. You end up with better results even after the filler has resolved, so it actually makes your skin better. And many people use Botox as a preventative. Because if they're not making frowns on their skin over time, their skin is taking a break from those types of expression and is informing that groove in the skin that you continue to make when you're making that frown. So it's more of a preventative than anything else. So no it is not true that it causes more lines when you do the treatment.

The fillers can be anywhere from 450 dollars to 1600 dollars depending on what type of filler you use and how much filler the person needs. For example, if someone is very young and they don't have a lot of lines or a lot of volume loss they may get away with one syringe of filler. If they have a lot of deep lines and never have had a treatment before they may require anywhere from two to three syringes of fillers. Botox can cost anywhere from 250 dollars to 800 dollars depending on how many areas are treated.

There are three main areas that we treat. The glabella, the forehead and the paraorbital lines. So for the squinting and crow's feet, for the horizontal lines you get across the forehead and for the frown lines you get in between the brows. So those three areas are the main ones that we treat, and if somebody is only concerned with one area they can get away with 250 dollars or 300 dollars worth of Botox. If they want a perfectly smooth upper face and they have a problems in all three areas then they may be spending up to 700 dollars for a treatment.

Botox treatments generally last about four months. And in four months you're fully back to your muscle function that you had prior to your treatment, so you're completely back to base line. A lot of people will do their next treatment about three to three and a half months after their initial treatment. As far of fillers, fillers vary a little bit. Juvederm is a hyaluronic acid type filler that lasts nine months to a year. Collagen for example only lasts four months. Fillers like Radiesse can be longer acting -- one to two years. But each type of filler has its own characteristic. So one filler is not good for everybody. There are certain areas of the face that do better with different fillers, certain types of lines that do better with different fillers.

I kind of evaluate each person's face and what their goals are, and then determine what kind of filler to use.