Categories: blogThe South Bay Aesthetics Blog

A Plastic Surgeon’s Cheat Sheet (Part 1)

Blog Exclusive: A Plastic Surgeon’s Cheat Sheet for Fillers and Blockers!!!

Will Botox fill in your wrinkles? Where can you put Voluma? What the heck is Xeomin???

(Note: the information provided in this blog is Dr. Verbin’s preferred off label uses. This blog is not to represent FDA approved indications of any product mentioned. Please consult with your doctor to determine if you a candidate for treatment.)

With more and more injectable products on the market, how is a patient to know what could and should be put where? Here is Dr. Christopher Verbin’s patient cheat sheet to help sort out all the confusion!

Blockers: A toxin botulin injected to block certain muscle movements. Used to treat muscle conditions, migraine headaches, and cosmetically used to prevent and smooth wrinkles in the face. Also, strategic placement in certain muscles allows one to lift the eyebrows (the chart below is for cosmetic uses only). Note: all blockers come in unique units of measurement creating a range of cost per unit; however the costs per area average out to about the same.

Blocker	Made Of	Good For	Not So Good For
Botox	onabotulinumtoxinA	Fine lines and wrinkles around the eyes, between the eyebrows, forehead, chin and lips; preventing deep lines; lasts 3-6 months; results in 5-7 days.	Filling in deep wrinkles
Dysport	abobotulinumtoxinA	Same as Botox; many Dysport faithfuls believe results come quicker and last a bit longer.	Filling in deep wrinkles
Xeomin	incobotulinumtoxinA	Same as Botox; does not contain additives like Botox/Dysport, so is good for patients that are no longer getting a good block since they may have built antibodies to the others; lasts 3-6 months; results in 5-7 days.	Filling in deep wrinkles

Dermal Fillers: While the main ingredient may vary, the purpose of fillers is to volumize the area. This can mean plumping up the deep lines and folds in the face, or giving volume to the cheeks, temples, chin and other areas to create a more youthful and balanced appearance.

1. HA Fillers

Fillers we commonly use in our clinic are generally 3 types of HA clear gel fillers. There are many different brands and they can be reversed or dissolved away quickly and easily if correction is needed.

Filler	Made Of	Good For	Not So Good For
Belotero	Hyaluronic Acid Sulfur Gel	Fine lines and fine wrinkles, delicate areas; lasts 3-6 months.	Deep lines/folds, major volumizing, those who want the longest lasting filler.
Restylane	Hyaluronic Acid	Localized small volume correction, a more temporary fill; lips and areas to test; lasts 6-9 months.	Those who want the longest lasting filler.
Perlane	Hyaluronic Acid	Volume restoration in cheeks, temples; medium lines and folds; nasolabial folds, marionette lines; lasts 6-12 months.	Those who want the longest lasting filler.
Juvederm Ultra	Hyaluronic Acid	Volume restoration in cheeks, temples; medium lines and folds; nasolabial folds, marionette lines, under eyes; lasts 12+ months.
Juvederm Ultra +	Hyaluronic Acid	Volume restoration in cheeks, temples; deep lines and folds; especially great for lips; lasts 12+ months.	Very fine lines and wrinkles.
Voluma	Hyaluronic Acid	Volume restoration for hallows of the face such as the temples, cheeks, above the eyebrow, along the jaw line, and under the eyes; lasts 2+ years and is the longest lasting HA filler.	Very fine lines and wrinkles, those who want a very temporary look (less than 1 year).

2. Non-HA fillers, temporary but non-reversible

Filler	Made Of	Good For	Not So Good For
Radiesse	Hydroxylapatite	A thick, putty-like filler for volume in the deep folds, cheeks, bridge of the nose, chin; lasts up to 12 months.	Very fine lines and wrinkles, under eyes.
Sculptra	Poly-L-Lactic Acid	Volume restoration for the hallows of the face such as the temples, cheeks, above the eyebrow, along the jaw line; stimulates own college, results in 2 weeks, peak at 6 weeks; lasts 2+ years.	Very fine lines and wrinkles, under eyes, those who want a very temporary look (less than 1 year).

3. Permanent Fillers (not a service we provide…ask us why!)

Filler	Made Of	Good For	Not So Good For
Artefill	Polymethylmethacrylate Beads, Bovine Collagen	Non-resorbable filler; FDA approved for nasolabial folds; considered semi-permanent lasting 10+ years and requiring surgery to remove.	Anyone who is not comfortable with permanent filler that can migrate and possibly harden over time. A skin test for allergies must be done 4 weeks prior to injection.
Silicone	Silicone/Other	Not safe as a loose injection	This is very dangerous as an injectable. Avoid any clinic or individual offering to inject this material into the face, buttocks or elsewhere.