Non-surgical anti-aging procedures are often combined during a single visit to Dr. Ron Shelton’s cosmetic dermatology practice. One of the most commonly performed cosmetic procedures is injecting Botox™ and other botulinum toxins along with fillers, says Dr. Shelton. The goal is to restore both the lost facial volume and the facial structure to create a NATURAL appearance — a more youthful semblance of how the patient’s face used to appear, but not made to look artificial or to no longer resemble the patient.  Due to their correction of volume and wrinkles, Botox™ and Fillers are a winning combination. The good news is, this combination can be done in the Summer without disrupting outdoor activities, provided you are using a sunscreen.

Botox in NYC

What is the benefit of combination treatments?

Numerous research studies have shown improved outcomes of combination treatments. Botox™ works best for the upper part of the face in reducing wrinkles and lines. Hyaluronic acid dermal fillers are best for the mid face. Although Botox™ and fillers give results separately, there are certain dynamic areas that are safe to inject Botox™ to relax the muscle contraction, which may prolong the duration of filler’s effectiveness. In this manner, a combined anti-aging treatment can produce more natural and refreshing results.

What is the difference between Botox™ and Fillers?

Botox™ injections relax the underlying muscle. On a daily basis our facial muscles perform numerous tasks such as laughing, frowning, smiling, chewing etc. When you are young, you will not encounter any problem by doing these movements because the skin is young and elastic. However, as you grow old, when the skin gets exposed to sunlight, the active expandable elastic fibers get cooked and are permanently damaged sitting in the dermis (the layer of support underneath the epidermis). These fibers are clumped up and are no longer able to move back and forth like a spring. Collagen and elastin production are slowed down. As a result, the skin gets thinner, yellower, lumpier and starts sagging. Injecting Botox™ to the upper face produces outstanding results as it softens the lines between the brows, forehead and around the eyes.

Injecting Botox™ to the lower part of the face is limited as it could distort the facial expressions. It should only be performed by an experienced board-certified dermatologist or plastic surgeon, says Dr. Shelton.

When the deep fat pads get absorbed as we age, fillers are the best treatment to correct the skeletonized appearance of the temples and the cheekbones. Fillers are used to replace the lost volume in the cheeks, which contributes to sagging, producing deep smile folds and jowls that hang over the jaw line. Dermal fillers increase lip fullness, reduce the appearance of nasolabial folds (smile folds), marionette lines, creases around the mouth, and improve projection of the chin to create a better profile and neck angle.

The most widely used filler consists of hyaluronic acid, a natural substance in the skin, which can be replaced cosmetically through fillers. Fillers give fullness to the sagging face by filling deep set facial lines and wrinkles. As Dr. Shelton says, it is turning the raisin back into the grape.

How is combination treatment done at Dr Shelton’s practice?

Dr Shelton often injects Botox™ and fillers in separate areas on the same visit. When the same region of the face can benefit from both, Dr. Shelton first injects the Botox to relax the muscles and then has his patients return between a week and two to inject the fillers in the same site. This way Botox™ helps to lengthen the duration of the effect of dermal fillers. It helps the fillers to settle properly for a longer lasting result. There are some areas that Botox™ is not injected to prevent important muscles from being relaxed. There are also some sites that increase the risk of filler complications, however, it is possible to treat these filler-avoided sites with Botox and vice-versa.

fillers with cannula

Ready to find out more?

To speak with Dr Shelton about your Botox® and filler treatment options, please call (212) 593-1818  or email to book an appointment.