Aesthetic,
antiaging and facial rejuvenation treatments are gaining popularity every year.
A growing demand has a positive effect on this medical field. This is
especially true for non-surgical treatments, such as dermal fillers and Botox,
because they are cheaper, less risky and require only a short recovery period.
Overview
Dermal fillers
and Botox are the two most popular non-surgical aesthetic treatments. However,
most people are not fully aware of the differences between the two. Both, Botox
and dermal fillers are injected but this is the only thing they are similar in.
Botox is a
toxin of a bacterial origin which is injected into the muscles in a very small
dosage. Botox relaxes and paralyzes the muscle. By doing so, it minimizes the
appearance of frown lines, crow’s feet, and other wrinkles caused by facial
expressions. The effects of Botox’ treatments are always temporary.
On the other
hand, dermal fillers are natural or synthetic substances which are injected
into the skin to add fullness. They are used to treat creases, deep wrinkles,
and the lack of volume. Lips, chin, and cheeks augmentation can also be
achieved with dermal fillers. Depending on the type of the filler used, the
results can be short-lasting, long-lasting, or permanent.
Both types of
treatments usually do not require the use of anesthetic or a hospital stay. The
treatments are short and the results are visible within a few days. Side
effects are rare. The most common ones include localized swelling, bruising,
and redness.
Because they
are different, Botox and dermal fillers treatments can be combined to achieve
better results. The treatments should always be performed in an appropriate
environment and by a trained medical professional. They are usually expensive
and require more follow-up treatments to maintain the desired effects.
Dermal Fillers
Dermal fillers
are a group of injectable substances commonly used in cosmetic procedures to
fill out creases and wrinkles in the skin. They can also be used to add
definition and volume to the cheeks and lips. Dermal fillers can be permanent
or temporary. This depends on the type of a filler and the material it is made
from.
The following
is a list of most commonly used dermal fillers:
Hyaluronic acid is the most popular dermal
filler. This substance is naturally found in neural, epithelial, and connective
tissues of the human body. Hyaluronic acid is an important component of
cartilage and skin, and it has a major role in tissue repair.
As a dermal filler hyaluronic acid is used
to treat wrinkles and add volume to different parts of the face (e.g. cheeks,
lips, etc.)
The results of the hyaluronic acid
cosmetic treatment usually last between several months and a year.
A protein called collagen is a major
component of connective tissue in humans. Collagen makes up a third of all protein
in our body. It can be found in bone, tendon, cartilage, skin, and muscle
tissue.
Collagen has many medical uses. Most of
these are in reconstructive surgery and cosmetic treatments. Medical collagen
can be human in origin but in most cases, it is derived from bovine (beef
cattle).
In cosmetic procedures, purified collagen
is used as a dermal filler for filling in wrinkles and facial creases. Although
its effects do not last very long (up to three months), compared to other types
of dermal fillers, collagen is often praised for the natural-looking aesthetic
results it provides.
The use of collagen requires allergy
testing prior to the treatment.
Calcium hydroxylapatite is a mineral-like
compound naturally found in human bones. However, the naturally occurring
calcium hydroxylapatite is not used for cosmetic purposes. This substance can
be biosynthetically produced. The use of calcium hydroxylapatite made in this
way eliminates the risk of allergic reaction.
As a dermal filler, calcium
hydroxylapatite is used to:
- Enhance facial
contours
- Fill out frown lines
and Nasolabial Folds
Calcium hydroxylapatite produces natural
looking results with little or no side effects.
- Poly-L-Lactic acid
(PLLA)
Poly-L-Lactic acid is a dermal filler used
to add volume and create facial contours. It also possesses bio-stimulatory
properties which means it stimulates the skin to produce more collagen.
The use of poly-L-lactic acid dermal
fillers is appropriate in the cosmetic treatment of:
PLLA is not appropriate for lips
augmentation and it is not recommended to people suffering from diabetes,
blood-clotting problems, lupus, and oral herpes. Pregnant and breastfeeding
women should not undergo a PLLA treatment.
The effects of the use of PLLA dermal
fillers usually last up to two years. Some side effects such as redness,
swelling, bruising, and the creation of lumps under the skin are also possible.
These usually resolve over time.
- Polymethylmethacrylate
beads (PMMA)
Polymethylmethacrylate is a type of
transparent thermoplastic. In cosmetic treatments, micro-beads made of this
material are mixed with biological fluid (usually collagen) and injected, as a
dermal filler, under the skin. This is done to restore the volume of the skin
or reduce scars and wrinkles.
Once the PMMA micro-beads are injected the
collagen is absorbed and a thin layer of connective tissue is formed around
them. The growth of connective tissue increases the volume of the skin and over
time (two to three months) causes the wrinkles and scars to become less
noticeable.
PMMA beads have a long-lasting and
sometimes permanent effect.
Dermal fillers
can be used for a variety of purposes. These include both, cosmetic and
reconstructive procedures. Regardless of the purpose of their use, dermal
fillers are usually expensive. They also have their limitations. The most
important limitation is the longevity of the results as the effects of most
dermal fillers are not permanent. Also, dermal fillers cannot stop the aging
process nor can they be used to fix all aging-related issues (e.g. sagging
skin).
The
application of dermal fillers should only be trusted to a trained specialist.
This is the way to achieve the best results and decrease the risk of
complications to a minimum.
Dermal fillers
are injected causing minimal trauma to the skin. Low-intensity pain can
sometimes be present and the treatment usually lasts less than one hour. A
specialist can use a local anesthetic to reduce the discomfort. The treatment
is commonly followed by a massage to ensure the even spreading of the injected
filler. No hospitalization is necessary.
Following the treatment,
the treated area can become slightly swollen and sensitive for the next 24
hours. During this period it is best to avoid the exposure to sunlight as well
as drinking coffee or alcohol.
Potential Side Effects
Not all dermal
fillers are associated with the same side effects. In most cases, when the
procedure was performed correctly, in a proper environment and with the right
type of filler, the risk of complications is very low. Permanent fillers are
avoided by some specialists as they are the ones usually connected with more
severe complications.
However, there
are some general risks associated with the use of all dermal fillers:
- Infections – Dermal filler’s injection is a mildly invasive procedure which
involves the introduction of a needle into deeper layers of the skin.
- Swelling and Bruising
- Itchiness
- Dislocation of the
Filler – Over time the filler can move from the
treated area into an unwanted position. This can cause a lump to appear under
the skin.
- Tissue Death – This is extremely rare and it can happen in cases when a dermal
filler blocks a blood vessel stopping the oxygen supply to the depending
tissue.
Botox
Botox or
Botulinum toxin is a neurotoxic protein used in medicine to treat conditions
such as muscle spasticity, migraines, excessive sweating, neuropathic pain, and
certain allergy symptoms. Botox is naturally produced by a type of bacteria
called Clostridium Botulinum. Its
medical application is possible only in low doses as it is very toxic otherwise
(a single gram can kill 1 million people).
This substance
has found a wide application in cosmetics. Injections of botulinum toxin are
used to facilitate the relaxation of facial muscles. Such use of botulinum
toxin is beneficial for making the frown lines, wrinkles, and crow’s feet less
visible.
Cosmetic
treatment with botulinum toxin injections can temporarily improve the physical
appearance and, to a certain degree, replace plastic surgery.
However, these
treatments are normally expensive and they have their limitations:
- The effects are not permanent
- Botox’ injections do not stop the aging process
- The results can be less than expected
It is
important to understand that Botox is only helpful when muscle relaxation is
needed to achieve an aesthetic result. Other facial imperfections such as saggy
eyelids cannot be improved with Botox.
Today Botox is
the most popular non-surgical cosmetic treatment worldwide.
How Botox Works
Muscle
contraction occurs when the nerves, which are attached to muscle cells, release
a neurotransmitter (chemical messenger) called acetylcholine. This chemical
gets attached to the muscle cells receptors causing the muscle to contract.
This is a perfectly normal activity. However, the contraction of certain
muscles, such as facial muscles, can cause wrinkles to appear on the surface of
the skin.
When Botox is
injected into facial muscles it inhibits the release of acetylcholine. This
prevents the contraction and paralyzes the muscle in a relaxed position.
Botox is
mainly used in cosmetic procedures but its application is constantly expanding
beyond aesthetic medicine.
The following
is a list of medical conditions currently treated with botulinum toxin
injections:
- A chronic migraine
- Excessive sweating (Hyperhidrosis)
- Spasm of the eyelids (Blepharospasm)
- Strabismus (Crossed eyes)
- Severe neck spasms
- Urinary incontinence caused by detrusor overactivity
- Post-stroke upper limb spasticity
Commercially,
botulinum toxin is available under the names:
- Botox
- Dysport
- Vistabel
- Bocouture
- Xeomin
- Myobloc
It is normally
available in a powder form which is mixed with saline solution and injected
into the neuromuscular tissue. The effects start after one to three days and
they can be fully visible after one or two weeks. They usually last for three
to six months.
Side Effects
Usually, there
are no side effects following the treatment with botulinum toxin. When the
substance is properly injected by a trained professional it is, in most cases,
well tolerated. One in every hundred patients will develop antibodies which
will make future treatments ineffective.
In rare cases
when side effects are present they can include:
- Pain
- Swelling
- Redness
- A headache
- Nausea
- Numbness
- Unwanted paralysis of nearby muscles
- Dysphagia – problems with swallowing
- Temporary eyebrow and upper eyelid weakness
- Decreased eyesight
- Blurred vision
- Double vision
- Bleeding
- Gallbladder dysfunction
- Full legs symptoms
To avoid
potential complications botulinum toxin should be injected by a qualified
healthcare professional (Doctor, Dentist, or a Trained Nurse) and in a clean
and safe environment.
Botulinum
toxin treatments are not recommended for pregnant or breastfeeding women.
The Final Word
Dermal fillers
and Botox injections are a safe and minimally-invasive way to achieve limited
aesthetic results. For this reason, the approach to their use should be
realistic and their application in other, non-cosmetic, medical treatments
should also not be underestimated.