Why should neurotoxin and filler be used in combination?

Peanut butter and jelly, salt and pepper, neurotoxins and fillers. Fillers and neurotoxins go together perfectly. When a professional uses them in tandem, the result is a nonsurgical liquid lift. These injectables are a great combo, because most candidates for dynamic wrinkles also have early volume loss in their cheeks, jawline, and marionette lines. In short, dermal fillers address the volume loss in the face, while neurotoxins address the lines.

What Dermal Fillers Do

Fillers rejuvenate the face by restoring soft-tissue volume to the cheeks. They also smooth out deep creases and plump thin lips or vertical lines around the mouth. In addition, fillers can treat the under-eye area to reduce hollowness and dark circles.

Usually, hyaluronic acid fillers like Versa, Restylane, Juvederm, or Voluma get the job done. They are a popular choice for several reasons. They generally last as long as 6-18 months, they have very few adverse effects, and they can be reversed immediately with an injection of the enzyme hylenex if the results are not to your liking or there is an emergency.

How Neurotoxins Work

Neurotoxin injections are different from fillers. They smooth out dynamic or expression lines by blocking the signals from the nerves to the muscles, which softens wrinkles. For example, neurotoxins like Botox, Dysport, or Jeuveau are used on the frown lines, forehead lines, and crow’s feet. They can also create definition in the face, not just reduce wrinkles.

Who Needs Which?

Certain people may only need one or the other, not both. For instance, the ideal patient for a neurotoxin injection alone has great skin quality but has dynamic or static wrinkles on the forehead, frown lines, or crow’s feet. In contrast, the ideal candidate for filler alone has great skin quality but a small fold or early volume loss in the cheeks or jawline.

However, the majority of patients can benefit from both. This is important to address during a consultation. A highly skilled injector should naturally address both when understanding the aging face. After all, preventative aging starts early, before the skin is allowed to sag, age, and wrinkle.

How Long Results Last

Botox lasts around 3-4 months, and hyaluronic acid fillers last 6-18 months. Therefore, the injections will need to be repeated to maintain your appearance. The goal should be full-face rejuvenation first, followed by maintenance sessions after that.

Combining filler with neurotoxin does not necessarily make the filler last longer. That said, hyaluronic acid filler longevity is increased by a decrease in motion. This may explain why the combination seems to give the filler a slightly longer life in certain patients.

Finally, if you have tried neurotoxin or filler but have not yet tried the treatments together, you may want to consider it. Most injectors would agree that both in combination are necessary for optimal results.