Botox and fillers

Botox and fillers are common topics of interest nowadays; I get many questions regarding these procedures. But not everyone seems to know their function and where they are applicable.
First, let us discuss botox, which is used in aesthetics to reduce wrinkles. Throughout the body, muscles are present under our skin. The ends of these muscles are inserted into our skin, so as they contract the skin to which they are attached also contract.
Muscles are also present under the skin of the face, known as muscles of facial expression. When these muscles contract creases appear on our face, thereby creating facial expressions. For example, when we frown, the muscles on our forehead contract and produce a wrinkling effect.
Over the years these creases become more and more prominent due to laxity of skin and loss of facial fat. So, we can see the wrinkles outright.
The same happens to muscles around the eyes and lower face. This happens at different times in different people. So whenever a person feels uncomfortable with the appearance of wrinkles on their face they can opt for rejuvenation by Botox injections.
What is Botox?
It is an acetylcholine blocking neurotoxin which is produced by a bacteria known as clostridium botolinum. There are several types of toxin that are produced by this bacteria, but the one that we use commercially for facial rejuvenation is known as BTX-A. Different pharmaceutical companies all over the world make BTX-A commercially.
The Food and Drug Administration (FDA) of the USA has approved the use of BOTOX for facial rejuvenation since 2002 and so far is considered the best drug available for elimination of crease lines on the face and neck. It is available in vials and administered as an injection with very fine needles.
Getting results hinges on the technique as well as dosage, and so the expertise of the doctor administering the injection is very important. No anaesthesia or hospitalisation is needed, and is usually done as an office procedure.
Botox in different doses is used for treatment of diseases by neurologists, ophthalmologists and even orthopaedic surgeons. How does Botox work?
It works on the nerve endings present in muscles in our body. Usually in aesthetics we use Botox on the face or facial muscles to be precise. The procedure is more or less painless as very small gauge needles are used. The patient is assessed in an upright sitting position, then asked to produce wrinkles on the face to asses the depth as well as the prominence of the lines. Then the areas to be treated are marked, after injecting into the muscles their activity decreases, thereby reducing the pull on the skin and so there is reduction in the wrinkles.
As the amount injected is very low it is a very safe procedure with almost no side effects. What the patient needs to remember is that this is not a permanent procedure and top up injections need to be given at six- to nine-month intervals for continuation of the results.
Fillers and lipoinjections
As time passes a lot of changes take place in our skin due to the result of aging, photo damage, trauma, scarification and diseases. Also with age there is redistribution of fat in our body and face. The search for an ideal dermal filler for the correction of wrinkles, facial lines and depressions has been an ongoing process for years. The goal is to get something, which is non-toxic, safe, and lasting.
The FDA has approved many products for dermal and sub-dermal filling. These are produced from animal dermal collagen, and also some are artificially produced. Most of these products are safe and their durability varies.
In aesthetics we use these to fill up defects in small scars, deep wrinkles or lines, and to augment lips or eyelids. Basically as the name suggests it is used to fill up gaps. The products used vary from surgeon to surgeon. It is to be remembered that these are not permanent and top ups are needed from time to time.
Injection of fillers can be done under local anaesthesia or if small areas are treated no anaesthesia is needed. It is done as an office procedure and the patient does not need hospitalisation.
Lipoinjection has now become very popular as a filling agent. It is a procedure by which fat is taken from the body, usually the abdomen, then processed and injected into the areas that need to be treated. As it can be taken from the patient's own body there is less chance of side effects and it is said that its absorption rate is slower.
It is a good filler for large areas like depressions under the eyes, augmentation of lips and even sometimes used for slight enlargement of breasts, filling up of wrinkles on hands and feet.
The procedure is done as a day case under general anaesthesia. It is very safe and results are longer lasting than fillers, but do need top up from time to time according to patient's need. It should be remembered that whatever product your cosmetic surgeon is using you should know the details so you can make an informed decision.