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Fillers vs Neurotoxins
Let’s first talk about wrinkles. There are two types: dynamic and static.
Dynamic wrinkles appear when you express emotion, like surprise, sadness, anger, etc. They fade as quickly as they appear. These include forehead wrinkles, frown lines (between your eyebrows) and crow’s feet.
Static wrinkles, however, remain on the face, and don’t go away with muscle relaxation…and will deepen with age. These include lines across the cheeks, at the corners of the mouth, etc.
With the loss of hyaluronic acid and collagen production with age, and with overuse of facial muscles, dynamic wrinkles progress into static wrinkles.
Neurotoxins (Botox, Jeaveau, Xeomin, Dysport) help prevent the movement of muscles by blocking signals from nerves that cause muscles to contract. Thus, they prevent movement, and aid in elimination of dynamic wrinkles.
Fillers (Juvederm, Restylane, etc) help fill voids and deficits in collagen/hyaluronic acids. They help replace the lacking volume and rejuvenate the face!
OR
Filler Categories
According to the FDA, there are 4 main categories:
1- Hyaluronic Acid Fillers- based off of sugar molecules that bind water
2- Calcium Hydroxyapatite Fillers- based off of minerals, similar to our bones
3-Poly-L-Lactic Acid Fillers- based off of dissolvable synthetic molecules, similar to dissolvable sutures
4- Polymethyl Methacrylate Beads- permanent, and can be used solely around the mouth
My personal preference is Hyaluronic Acid based fillers! They’re a soft, non-animal based, gel-like injectable material that closely resembles the hyaluronic acid in our bodies.
Kinds of Fillers
My go to category of dermal fillers is Hyaluronic Acid based. And of those, my favorite brand is the Juvéderm line!
The Juvéderm line is comprised of several different kinds of fillers: Ultra, Ultra Plus, Volbella, Vollure, and Voluma.
Each filler has a different level of cohesiveness, molecular size, and consistency. This allows for each filler to be used in different areas of the face. For example, Voluma has a higher density, and mostly resembles bone- thus, it’s best used for chin, jawline and cheek augmentation. Ultra, on the other hand, has a lower density, and is much softer- and is best used for the lips!
Each kind of filler also has a different duration. Some fillers will last approximately 9 months, while others may last up to 18 months! Something to also note is- the XC designation on the fillers! XC implies that the filler has lidocaine mixed in. What this means is, as the filler is injected, you become more and more numb- and the process becomes easier and easier!
Filler Demonstration
Did you ever wonder how much 1 syringe of filler is when compared to a teaspoon?
This video demonstrates exactly that!
One syringe of filler is only 1cc or 1mL of quantity!
With that being said, 1 syringe can go a long way! It all depends on where you’re placing the filler. For example, 1 syringe can be plenty in the lips whereas it may not even touch the surface when enhancing your jawline.
Each filler has a different malleability profile. When you’re watching this video, check out the consistency and texture of the gel like substance!
Can Fillers Migrate?
A commonly asked questions is whether fillers can migrate from their injection site.
The answer is YES.
This can happen if the area is either overfilled, or if the injections are in the wrong anatomical plane. This is why it’s really important to undergo placement of fillers and Botox by an experienced injector!
There can also be the illusion of filler migration through swelling of the adjacent tissues! That’s a foreign body reaction to the placement of the filler. While this is often times short lived and may last a few days to weeks, it may last longer in more sensitive patients. For this reason, I always recommend starting slow!
Non-Surgical Cheek, Chin and Jawline Rejuvenation
Surgery isn’t for everyone. For that reason, we have non-surgical options for cheek, chin and jawline enhancement!
As we age, we not only lose collagen and fat in our face, but we also lose bone volume as well.
Fortunately, both are replaceable!
There are certain fillers that mimic boney structures and others that mimic soft tissues. This allows for the enhancement of the cheek, chin and jawline through ensuring proper proportionality of the face.
Adding volume to the face will also help alleviate skin redundancy to a certain point!
These enhancements will then allow for a well rested and balanced appearance to the face.
Hand Rejuvenation
In different videos, we covered non-surgical anti-aging techniques of the head and neck which include neurotoxins (Botox), fillers, and thread lifts. We also covered surgical techniques, such as face and neck lifts.
Today, let’s discuss hand rejuvenation- a common telltale sign of aging!
Hand rejuvenation is performed through the strategic placement of fillers within the dorsal (non-palm) aspect of the hand. This allows for subtle contouring of the hand, elimination of crepe-like appearance the skin, and blunting of skin wrinkles. It also allows for minimizing the appearance of tendons and veins of the hand! 

The procedure itself will hydrate the skin, and is quick, painless, and may last up to 18 months!
Hand Rejuvenation
