Dermal fillers such as Juvéderm and neuromodulators such as Botox work in entirely different ways. As their name implies, when injected beneath a wrinkle, crease, or area of volume loss dermal fillers simply add instant volume. They “fill” in space and push the skin back upward. This only works when the wrinkle is known as a “static” wrinkle. These are wrinkles caused by sun damage, declining collagen production, personal habits, and other factors. Static wrinkles show themselves at all times.
Botox and the other neuromodulators work in a completely different fashion. They are made from the botulinum toxin type A, the same bacteria that cause botulism. When the botulinum toxin is injected into a muscle, it stops the muscle from contracting for a period of time. Certain wrinkles on the upper third of the face form above muscle contractions under the surface skin. These are known as “dynamic” wrinkles. These are crow’s feet at the outside of the eyes, glabellar/frown lines between the brows, and forehead lines. When Botox is injected into the muscles that create these wrinkles when they contract, the botulinum toxin stops the muscle contraction. The muscle stays at rest and the wrinkle that forms on the surface skin is erased for a period of around four months.
Bottom line — neuromodulators only work on dynamic wrinkles on the upper third of the face, and dermal fillers only work on static wrinkles and areas of volume loss on the mid to lower areas of the face.