Botox is a weakened form of the botulinum toxin, and it is FDA approved for wrinkles between the eyebrows.  It’s delivered via injection, and the procedure requires no anesthesia.

How does Botox work?  All of our facial expressions cause our skin to become wrinkled, bit by bit.  Botox injections block the signals being relayed between the nerves and the muscles, causing weakness in the muscle that’s been injected.  When the muscle doesn’t contract, the wrinkles aren’t as visible.  Improvement is generally seen within the month after treatment, with some patients noticing a difference in less than a week.

For cosmetic use,  Botox is approved for forehead wrinkles only.  This will reduce crow’s feet and frown lines.  Botox is also used “off label” to treat other conditions, such as excessive underarm sweating, strabismus, and involuntary blinking.  It may also help with enlarged prostate and migraines, but more research is needed to back up those claims.

Treatment methods are different from one clinic to another.  Some physicians recommend that patients avoid drinking alcohol for a week before treatment, and they also suggest that aspirin and other anti-inflammatory drugs be avoided as well.  This helps to reduce bruising after treatment.

You’ll still be able to laugh, smile, frown and make all your normal facial expressions, just without those annoying wrinkles between the brows.  Problems with facial expressions usually appear when the wrong muscle has been injected (usually when the treatment is done by someone who doesn’t know what they are doing).  For that reason, it’s not recommended to attend a “Botox party”.

Botox results can last for up to six months, with wrinkles gradually returning as the paralyzed muscle regains its normal function.  Over time, wrinkles will diminish even without the injections, as Botox conditions the muscles to be more relaxed.  Side effects are something that should be considered.  They include bruising, headache, drooping eyelids, flu-like symptoms, and possible allergic reaction.  Botox can cost $200-$500 per treatment, and if it’s for cosmetic reasons, it isn’t usually covered by insurance.  The procedure, being fairly simple, is approved for anyone between 18 and 65.  But, there are some people who shouldn’t use Botox, and they include:  those who are nursing, pregnant, or who have a muscular disorder.  If you have any questions, you should talk to your doctor before you get the treatment.

The FDA has approved Artefill, a permanent cosmetic filler.  It works well on smile lines, and it has minimal side effects.  Artefill is a more pure version of Artecoll, which has been in use in Canada for years.  Studies on Artefill show improvement up to five years after treatment, and results are generally considered permanent.  Injected areas will continue to lose volume with age, so periodic “touch ups” will be necessary.

Results are seen immediately, although two treatments may be required.  Artefill may also be used on lines between the mouth and chin, and may minimize the appearance of scars.  Artefill contains spheres of PMMA (polymethylmethacrylate) in a collagen gel, with an added anesthetic to reduce pain during injection.  The collagen is a carrier for the PMMA, and will dissolve over a few months.  The PMMA spheres remain in the skin, providing a structure for the skin to deposit its natural collagen around.

Juvederm and Restylane are still the most popular fillers, and Radiesse is the top choice for plumping the cheeks.  Artefill is most effective on smile lines, when a permanent result is wanted.  It may also work to smooth crooked contours on the nose.  It can be used in conjunction with Restylane, Botox, and Juvederm, or with laser treatments like Fraxel.  These treatments have virtually no downtime!

Each treatment will last from 10-20 minutes, and is usually pain-free.  Depending on the injected area, a patient may need more than one syringe.  A “touch up” may be needed up to three months later, requiring a smaller amount of Artefill.  Before treatment, you’ll need to take a skin test to see if you have an allergy to collagen.  To reduce bruising, avoid large amounts of vitamin E, or taking aspirin.  Taking arnica, a homeopathic remedy, will reduce bruising and swelling.  Some people may have tenderness, pain or swelling.  This will usually go away within a day or so.  Don’t massage the injection site as it may move the gel.

Artefill’s results are permanent, so keep that in consideration.  If you are unsure, try a temporary filler like Juvederm or Restylane first.  And always, always make sure that your chosen doctor is experienced in Artefill use.  Your dermatologist may be able to refer you to an expert.  Artefill is a safe, relatively easy way to achieve permanent plumping results for facial skin.  Talk to your physician today!