most people want to know is it really worth it will it make a difference
hi i'm dr ronaldo mix harris and i'm a cosmetic physician here at reflection
center in martinsville new jersey and today i'm going to talk about filler and botox
for people over 60. most people want to know is it really worth it will it make a difference okay so
let's start with botox first i would like to clear up what the difference is between botox and filler
botox uses a substance to temporarily make the muscles less able to contract very strongly if you
have a tendency to use certain muscles a lot like constantly raise your eyebrows or constantly
you know skull when you're talking to people then over time this will cause etched in lines
into your skin botox kind of makes the muscles that do that less able to do that and that's
how you can smooth the lines and wrinkles if you have nice plump young healthy skin
when you use botox even if you have some etched in lines over time even the etched in lines will get
better as long as you kind of stay on top of your botox once those etched in lines are very deep
from years of repetitive motion then it's much harder to erase them with botox you can spook them
you know however and over time if you stay on top of your botox they will get better and better
you may not be able to get rid of them completely so there are four situations where botox doesn't
seem to work as well meaning that it doesn't get rid of your wrinkles completely and the first
case is kind of what i explained earlier it's when you have those deep etched in lines that
have caused like little creases and scars into the skin for those people botox will not smooth that
out completely if you start early before you have those deep creases or if they're still very mild
then botox will completely smooth out the lines over time so the second situation is when people
are not consistent with staying on top of their botox in most people botox lasts about three to
four months it kind of depends on your metabolism you know how fast you break it down and also how
much you use if you use more it takes your body longer to get rid of botox ideally you would like
to retreat when it's just starting to wear off so your skin doesn't get a chance to be completely
creased back by those overactive muscles however i sometimes have people who come in maybe just once
a year or twice a year you know before big events like the holidays or summer and then if they let
their botox wear off completely in that time in between you kind of have to start back from
scratch those people it's going to be much harder to get rid of edge deadlines the third situation
is for people who actually have developed antibodies to botox people for who botox will
not work at all sometimes this is spontaneously sometimes this happens after they've done botox
a few times it's very rare we're not sure why it happens if that happens sometimes we can switch
to a different type of botox which is either the brand name xeomin or this sport they use a
slightly different molecule that the body doesn't recognize again it's very rare and i personally
do not have any patients who have had that we have a video that specifically talks about this and
there will be a link below this video in case you would like to know a little bit more about that
the fourth situation where botox really doesn't seem to work for wrinkles is when the wrinkles are
actually caused by laxity or volume loss and not overactive muscles this happens a lot in the lower
face or the radial cheek lines you know you that's not a muscle that's just the skin that's kind of
sagging down that's causing these lines to appear and in that case you can't use botox
to improve that once you have etched in lines that do not improve much with botox there's
different options to treat that you can do things to improve the skin quality like laser resurfacing
or rf micro needling or softwave slash ulthera usually we use energy based devices to improve the
skin quality you can also use fillers that work as a biostimulator to help the body create more
collagen like for example radiesse or sculptra in addition to that you can also use fillers
to replace volume loss and kind of prop up kind of expand the skin and you know you can imagine
that if you stretch the skin out a little bit you can help smooth some of those wrinkles that way
it's something that works for example really good the forehead when people have those deep etched in
lines that do not go away with botox and they have a very flat or sometimes even concave forehead if
you put filler underneath there you can really help to improve the skin appearance by kind of
stretching out the skin there making those lines look a lot better so next i want to talk about
fillers and there's two types of fillers there's hyaluronic acid fillers which are made out of
a sugar molecule that everybody has in their skin and subcutaneous tissue it's a gel that you can
use to replace volume or create volume and then there's biostimulators like sculptra and radiesse
that are more used to make your body make new collagen in the area that you place it
usually when we're talking about fillers we're talking about ha or hyaluronic acid fillers so
most people in their 60s will have significant volume loss in their face and usually that's a
combination of fat loss and bone loss especially along the jawline people don't realize but their
jaw bone literally shrinks to half the size that it is you know when they're 18 years old and that
slowly happens over time it starts in your 40s but you can really notice it in your late 50s and 60s
so a lot of times you're going to need a lot of filler to try to compensate for that volume loss
and it may not always be cost effective to do that however for people who absolutely do not want to
do surgery it would be a good way to improve their appearance most of the times you treat different
areas of the face you can treat the upper face which is the forehead and the temples you can
treat the mid face which includes the cheek and the under eye area and then you can treat
the lower face which is the chin and the whole jawline you don't have to do everything all at
once you can do it in stages and most of the time for my patients in their 60s i recommend to do
filler in combination with biostimulator fillers and energy-based treatments so they can get an
overall improvement because just filler alone will probably not do it so there are a lot of
different options for people 60 and over and it's important to go to somebody that has experience
with all these different options and can have a conversation with you about what would be
the best plan for you if you would like to know what would be your best option i invite you
to come to our office for a free consultation with either me or any of our other physicians
so we can examine you and lay out the different options of what would be the best plan for you
you