Botox is a purified form of the botulinum toxin that is obtained from bacteria. Botox works by blocking nerve signals in the muscles where it is injected. When those nerve signals are interrupted, the affected muscle is temporarily paralyzed or frozen. Without movement of these selected muscles in the face, certain wrinkles may be softened, reduced, or even removed. Botox is not a permanent treatment. Repeated treatments are necessary for continued wrinkle-reducing effects. Most people find that the muscle-relaxing effect of Botox lasts for 3 to 4 months. Botox only works on wrinkles that are caused by muscle movement. These are known as dynamic wrinkles, and are often called "expression lines." The most common dynamic wrinkles that Botox can treat are lines on the upper face, such as the "11" between the brows, horizontal lines on the forehead, and crow's feet around the eyes. These lines are caused by smiling, frowning, squinting, and other facial expressions.
Dermal fillers, sometimes called soft tissue fillers, are substances designed to be injected beneath the surface of the skin to add volume and fullness. These use hyaluronic acid and similar substances to "fill in" or plump areas that have lost volume and smoothness. This includes wrinkles around the mouth, thin lips, and cheeks that have lost fullness. Different types of dermal fillers are designed to treat varying signs of aging. Depending on the filler selected, they may:
- Plump up thinning lips
- Enhance or fill in shallow areas on the face
- Decrease or remove the shadow or wrinkle under the eyes caused by the lower eyelid
- Fill in or soften static wrinkles, especially on the lower face
Static wrinkles include those smile lines and marionette lines. These wrinkles are usually a result of a loss of collagen and elasticity in the skin.