Anti-Aging Skin Care Questions Answered

Dermatologist Dr. Guanche answers questions about injectables like botox and other anti-aging skin care to get rid of fine lines and wrinkles.

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Anna Guanche, Board-Certified Dermatologist and Dermatologic Surgeon:

I'm Dr. Anna Gaunche. I'm a board certified dermatologist specializing in anti-aging skin care, namely cosmetic procedures.

The difference between Botox and fillers is that Botox is a protein and that inactivates muscles and prevents you from over-expressing in your face so that you don't get wrinkles. Over time what happens is you lose elasticity in the skin. So when you're a little kid you can make any face you want to and your skin bounces back with no lines. But over time what happens is you start to have a memory in your skin. You make an expression, you frown, and then all of a sudden there's a little line left there after you're done frowning. People suddenly think that you're angry or frustrated or tired or that kind of thing so that's what we try to get rid of with that protein.

The fillers on the other hand are used more on the lower face. They're actually plumpers, because what happens over time is you lose volume in the lower face. And so a lot of these lines around the nose start to show. They're called the parenthesis, and we can plump these and kind of reduce the lines with fillers. We wouldn't want to use any of anti-aging skin care treatments like protein in the lower face. It would inactivate muscles because we want to we want to have a nice big smile and be able to express ourselves with our lower face.

I think it's possible to have an allergic reaction to the fillers, however, I've done thousands of filler procedures and I've never seen an allergic reaction to Juvederm. Common side effects with anti-aging skin care procedures like injections include a little bit of redness, bruising, there's a little bit of discomfort with the injections. Even though we put a little topical anesthetic on, you still feel a little bit of discomfort. And the redness usually goes away within two days but can persist a little bit longer in certain individual. Bruising is variable. Some don't bruise at all, and some get a little bit of a bruise and if you do it usually lasts seven to ten days and then goes away.

Actually there is some evidence that using fillers over time promotes your own collagen. You end up with better results even after the filler has resolved, so it actually makes your skin better. And many people use Botox as a preventative. Because if they're not making frowns on their skin over time, their skin is taking a break from those types of expression and is informing that groove in the skin that you continue to make when you're making that frown. So it's more of a preventative than anything else. So no it is not true that it causes more lines when you do the treatment.

The fillers can be anywhere from 450 dollars to 1600 dollars depending on what type of filler you use and how much filler the person needs. For example, if someone is very young and they don't have a lot of lines or a lot of volume loss they may get away with one syringe of filler. If they have a lot of deep lines and never have had a treatment before they may require anywhere from two to three syringes of fillers. Botox can cost anywhere from 250 dollars to 800 dollars depending on how many areas are treated.

There are three main areas that we treat. The glabella, the forehead and the paraorbital lines. So for the squinting and crow's feet, for the horizontal lines you get across the forehead and for the frown lines you get in between the brows. So those three areas are the main ones that we treat, and if somebody is only concerned with one area they can get away with 250 dollars or 300 dollars worth of Botox. If they want a perfectly smooth upper face and they have a problems in all three areas then they may be spending up to 700 dollars for a treatment.

Botox treatments generally last about four months. And in four months you're fully back to your muscle function that you had prior to your treatment, so you're completely back to base line. A lot of people will do their next treatment about three to three and a half months after their initial treatment. As far of fillers, fillers vary a little bit. Juvederm is a hyaluronic acid type filler that lasts nine months to a year. Collagen for example only lasts four months. Fillers like Radiesse can be longer acting -- one to two years. But each type of filler has its own characteristic. So one filler is not good for everybody. There are certain areas of the face that do better with different fillers, certain types of lines that do better with different fillers.

I kind of evaluate each person's face and what their goals are, and then determine what kind of filler to use.

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Nice presentation. I'm wondering about the length of maintenance on this. Should this be monthly?

by Dessa0226 Saturday, January 11, 2014 at 11:00AM Report as inappropriate

thanks

by jessicaviolett Friday, May 31, 2013 at 06:48PM Report as inappropriate

good to know :)

by y.isle Tuesday, July 24, 2012 at 08:13PM Report as inappropriate

Thanks. Very informative video. I'm afraid of needles period! I may change my mind as I grow older.

by toddfan Saturday, June 30, 2012 at 03:18PM Report as inappropriate

I wish the results were permanent, as I am considering Botox and/or injections.

by robyne00 Saturday, May 26, 2012 at 03:07PM Report as inappropriate

good

by vitaskin Tuesday, April 3, 2012 at 05:19PM Report as inappropriate

I went to an event by Allergan and learned about these in depth and might try some in a few years.

by beautybody Sunday, April 1, 2012 at 11:03AM Report as inappropriate

Thank you for taking the time to explain the difference between fillers and Botox. I never did understand the difference. I have 1 wrinkle that drives me crazy above my lip and under my nose that gives me a double lip when I smile but, I still can't justify putting needles and poison into my face...Not yet, anyway! ;)

by powerwoman033 Tuesday, March 20, 2012 at 10:20AM Report as inappropriate

Wow, we spend way too much money on trying to stop a natural process.

by mpardee Saturday, February 18, 2012 at 09:02PM Report as inappropriate

Very informative. I would not mind botox on my 11s but not ready for anything else yet.

by TrillianAlice Wednesday, October 19, 2011 at 12:48AM Report as inappropriate

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