Botox vs Filler – Not All Lines Are Created Equal

Posted on Friday, December 28th, 2012 by Dr. Babak Dadvand

As a plastic surgeon who performs many injectable procedures, one of the most common sources of confusion is when Botox should be used for a line and when a filler is better. Some doctors only use botox on their patients, while my practice uses both. Regardless, the answer to this question requires knowledge of what caused the line in the first place. The line or wrinkle is the end result of a process and even though the goal of both treatments is to decrease lines, the way in which they do it is completely different.

Some lines are formed from muscle movement. Certain facial muscles have attachments to the skin and so when the muscle contracts, it pulls on the skin causing a line or a crease. Examples of this are:

Frontalis Muscle: Causes horizontal forehead lines

Corrugator Muscle: Causes the scowl lines between the eyes

Orbicularis Oculi Muscle: Causes the crows feet lateral to the eyes

Orbicularis Oris Muscle: Causes the vertical lines above the upper lip

In the photo below A is the frontalis muscle, B is the corrugator muscle, C is the orbicularis oculi muscle, and G is the orbicularis oris muscle.

Botox is the best treatment for these lines because Botox targets muscle contraction. Using a filler for these lines may lead to lumpiness especially in the crows feet.

Some lines are formed, not by muscle movement, but by natural breaks in the face that can be exacerbated by aging among other things. A great example of this are the nasolabial folds, otherwise known as smile lines. Botox would be the wrong thing to use to treat these lines because they are not directly caused by muscle contraction. In these cases, using a filler like Juvederm is the treatment of choice.

To learn more about non-surgical procedures and to view before and after pictures visit my website at drdadvandplasticsurgery.com.

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