At Cosmetic and Reconstructive Specialists of Florida, in our CRS MedSpa, we offer the neuromodulators Botox and Dysport, and we offer the entire Restylane line of dermal fillers along with Sculptra. Patients often are a little confused as to where a filler is right and where a neuromodulator is right. They often lump Botox/Dysport along with those dermal fillers. But really the only thing the two classes of injectables have in common is that they are…well, injectable.
At CRS we like our patients to be knowledgeable about what we offer and how it can benefit them. So, in June’s blog, let’s get into how the injectables we offer vary.
What’s the difference between Botox and dermal fillers?
Botox and Dysport (we carry both of these) are classified as neuromodulators. They are both made basically from the botulinum toxin type A, the same bacteria that cause botulism. Back in the early 1950s scientists discovered that when a miniscule amount of the toxin was injected into a muscle it stopped that muscle from contracting for a period of time. Botox arose directly from that research.
Neuromodulators work by blocking the nerve messages that are sent from a muscle to the brain. Since the brain never receives the message to contract the muscle, the muscle stays at rest. So, how does this have anything to do with wrinkles? On the upper third of the face, the expressive area, wrinkles form when we make certain expressions thousands and thousands of times over the years. These are expressions such as frowning, showing surprise, squinting, and the like. As the skin thins with age, wrinkles form on the surface skin above the wrinkle. These are known as dynamic wrinkles.
When Botox or Dysport is injected into a wrinkle forming, say, crow’s feet, the botulinum toxin keeps the muscle from contracting, so the wrinkle doesn’t form. Neuromodulators work on crow’s feet, the 11s between the brows, and on forehead lines.
Dermal fillers are true to their name — when injected beneath a wrinkle or area of volume loss (such as the cheeks) they simply “fill” in the space, pushing the skin back upward. They work on the other type of wrinkle, static wrinkles. Static wrinkles are the result of sun damage, personal habits, declining collagen production, and other things. Unlike like dynamic wrinkles, static wrinkles have nothing to do with muscle contractions.
There are natural fillers and synthetic fillers. Natural fillers are made predominantly from hyaluronic acid, a naturally occurring substance in the human skin that is responsible for plumping and firming the skin. Hyaluronic acid does this by binding with nearby water molecules. At CRS we offer the entire line of Restylane natural fillers.
Synthetic fillers are made from other materials. The synthetic filler we carry at CRS is Sculptra. Sculptra is made of microparticles of a synthetic material called poly-L-lactic acid. This is the same material that has been used to make dissolvable sutures for decades. Once Sculptra is injected, the body begins to absorb the PLLA particles and this triggers the production of new collagen. This firms and thickens the skin over the course the next 18-24 months.