Square pegs into round holes

One of the most common questions I get online and in the office is how someone can know if they "need" Botox vs filler vs a laser or surgical procedure. Let's break it down:

1) Botox and Dysport
These products are ideal for paralyzing muscles that cause wrinkles associated with facial expression. The three most common areas are the glabella, the forehead and the crow's feet. The mechanism of action is simple: because your skin has lost elasticity (from sun, smoking or time), the strategy is to weaken the muscles since your skin can't effectively move with your skin. When those muscles can't move, the wrinkles recede.

2) Facial fillers
There are numerous fillers on the market - Juvederm, Restylane/Perlane, Radiesse and others. The general principle is the same: restore the volume that your face has lost with time. Generally speaking, the normal fat of the midface descends, causing a hollowing around the eyes and the frown lines around the mouth. Facial fillers do add physical bulk but also attract water and aid in collagen deposition. The most common site of injection is around the mouth but it can also be used for a cheek lift or fuller lips. They generally last 9-12 months and are very comfortable with the addition of a local anesthetic to the mixture.

3) Laser resurfacing
Simply put, this helps everything. For minimal downtime, CO2 resurfacing results in tighter skin, fewer wrinkles, smaller pore size and more even skin pigmentation. It is the reset button that really does turn back the clock. Effects generally last for years. This will not get rid of deep static lines that typically need fillers, which is why it's important to get evaluated by a trained professional.