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 and when used in tandem by a professional, a nonsurgical liquid lift results. These injectables are a great combo since most candidates for dynamic wrinkles also have early volume loss in their cheeks, jawline and marionettes. Dermal fillers can address the volume loss in the face while neurotoxins can address the lines.

Fillers are used to rejuvenate the face by restoring soft-tissue volume loss to the cheeks, smoothing out deep creases, plumping up thin lips or vertical lines around the mouth. Fillers can also be used in the under-eye area to decrease hollowness and dark circles.

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

Neurotoxin injections are different from fillers. They're used in cosmetic procedures to smooth out dynamic or expression lines by blocking the signals from the nerves to the muscles, softening wrinkles. Neurotoxins like Botox, Dysport, or Jeuveau are used on the frown lines, forehead lines, crow's feet and other areas as well to create definition in the face, not necessarily for wrinkle reduction. 

Certain people may only need one or the other, not both. The ideal patient for a neurotoxin injection alone is someone who has great skin quality but they have dynamic or static wrinkles on their forehead, frown lines, or crows feet. The ideal candidate for filler only is someone who has great skin quality but has a small fold or volume loss starting in the cheeks or jawline.

The majority of patients can benefit from both, which is important to address during a consultation. A highly skilled injector should naturally address both when understanding the aging face. Preventative aging starts early, not allowing the skin to sag, age and wrinkle.

With Botox lasting around 3-4 months and hyaluronic acid fillers lasting 6-18 months, the injections will need to be repeated to maintain your appearance. The goal should be full face rejuvenation, then maintenance sessions there after. 

Filler combined with neurotoxin doesn't necessarily make the filler last longer, but hyaluronic acid filler longevity is increased by a decrease in motion. This may explain why the combo effect of the two seems to give the filler a slightly longer life in certain patients.

If you've tried neurotoxin or filler but have yet to try the treatments together, you may want to consider it. Most injectors would agree that both in combo are necessary for optimal results.