Eyelid & Facial Injectables: Frequently Asked Questions

 

Eyelid and facial injectables are a wonderful adjunct to our treatment armamentarium because they are minimally-invasive to perform, comfortable, and have less downtime compared with surgery. The two main categories of injectables are neurotoxins (i.e. Botox, Xeomin, Dysport) and dermal fillers (i.e. Restylane, Juvederm, Sculptra, etc.). There are many important considerations when deciding upon which injectables are suitable and safe for you to use. A one-size-fits-all approach will not work.

What is the difference between botox and filler?

Neurotoxins (Botox, Xeomin, and Dysport) are used to treat dynamic facial lines and wrinkles by temporarily suspending the communication between the nerve and muscle into which the injection is performed. These work best for lines that have developed around muscles that are constantly moving (e.g. forehead, frown lines, laugh lines, etc.). In contrast, dermal fillers (e.g. Restylane, Juvederm, Sculptra) are used to treat deflated areas of the face that are causing shadowing and deep lines. Popular sites of injection are the nasolabial folds, marionette lines, lips, and cheeks.


How long do injectables last?

Neurotoxins (Botox, Xeomin, Dysport) last on average for 3-4 months after which reinjection is necessary to maintain the effect. Dermal fillers (e.g. Restylane, Juvederm, Sculptra) can last for 6-18 months depending upon the specific product used, how much is injected, and where it is injected.

What are the risks involved in receiving injectables?

The risks of neurotoxin (Botox, Xeomin, Dysport) injection include over-treatment, under-treatment, bruising, pain, dry eyes, eyelid droop (ptosis), facial asymmetry, difficulty with speech, allergic reaction, and infection. The risks of dermal filler injection include the above, but the most serious risk is blindness or facial necrosis secondary to injection into a blood vessel. Overall, the risks mentioned are extremely rare in the hands of an experienced injector.

How much do injectables cost?

Of the neurotoxins, the most expensive is Botox followed by Xeomin and then Dysport. While some injectors charge by the number of units injected (e.g. $12/unit) others will charge per treatment area (e.g. $400 for the frown lines, etc.). Dermal fillers typically cost $400-$800 per syringe depending upon the specific product used and injector expertise. The price for additional syringes is typically reduced by most injectors.

Am I a good candidate for injectables?

Injectables are a great option for most patients who have noticed superficial wrinkles or deep lines around the eyes, forehead, or mouth as well as deflated facial tissues including the cheeks or lips. The EFI philosophy is to be relatively conservative and absolutely avoid attention to treated areas. In fact, we regularly see patients who were “over-filled” and visit us to have some of it dissolved. You will want to avoid undergoing injectables if there is a known allergy, hypersensitivity, or a skin infection near the injection site. Certain medications (including muscle relaxants and aminoglycosides) can interact with Botox and it is best avoided during pregnancy and breast-feeding. If you suffer from dry eyes, injections around the eyes might make this worse.