Botox vs. Juvéderm

The choice between Botox and Juvéderm is easy for patients who are familiar with the distinct abilities of each of these products and have a clear idea of the results they would like to achieve. These minimally invasive cosmetic injectables can be used separately or in combination to satisfy patients’ unique preferences. These two products contain naturally occurring chemicals. When injected into your facial tissue, they react in different ways to produce equally spectacular results. Choosing between the two can be confusing. Luckily, Dr. Silvia Rotemberg is a board-certified plastic surgeon with extensive knowledge and experience in non-surgical facial procedures. If you would like to schedule a consultation, Dr. Rotemberg can walk you through the differences between the two injectables and determine which one will perfectly achieve your desired aesthetic result. To reach our office directly, please call (305) 539-7083.

An Aging Visage

As we age, our tissue weakens. Skin starts to loosen and sag from gravity’s persistent pull. One of the reasons this occurs is because of the gradual decrease of collagen in our dermis. Collagen, a fibrous, flexible protein that makes up 70-80% of our skin,^[1] is vital to our skin’s inner structure as well as its youthful elasticity and moisture.^[2] But, as we age, the fibroblast cells in our dermis, the cells responsible for collagen production, weaken and secrete less collagen. By 50 years old, we have lost up to 30% of our natural collagen supply.^[3] Skincare products aim to restore your collagen production with creams, serums, and supplements. While this may work for some, many of the patients who see Dr. Rotemberg report having tried these solutions and saw little to no improvement in their skin. That’s where products like Botox and Juvéderm take the stage. 

About Botox

First reported in 1994 for its effectiveness in reducing the appearance of facial wrinkles, ^[4] Botox has become a pillar in the cosmetic industry because it consistently supplies superb results. Botox contains Botulinum toxin type A, a naturally occurring chemical that, when injected directly into the muscle tissue, causes the muscle to relax, limiting its ability to contract and form dynamic wrinkles.^[5] Once paralyzed, the muscles cannot aid in expression, resulting in the loss of overlying wrinkles, fine lines, and folds in the skin. Before, constant contractions in muscle tissue – smiling, frowning, or furrowing – caused the skin to crease and wrinkles to form. But now, with the tissue relaxed, the local muscles can’t crease the skin, leaving the skin free of hanging, drooping, or folding. The skin remains in place with the muscles. Botox is effective at treating:^[4]

About Juvéderm

Juvéderm is a family of hyaluronic acid fillers. While each formulation targets a specific area, all the Juvéderm products work similarly to restore volume and vibrancy to your visage. Hyaluronic acid, the active ingredient in all Juvéderm products, sets these products apart from other cosmetic injectables, like Botox. Naturally occurring in humans (50% of our hyaluronic acid is found in our dermis),^[6] hyaluronic acid is an extremely hygroscopic molecule, meaning it can hold one-thousand times its weight in water. To create the family of Juvéderm products, specially engineered hyaluronic acid is formulated into a gel. Then, it is injected directly into the dermis layer. Here, the gel expands under the epidermis, causing the overlying wrinkles to smooth out. The hyaluronic acid filler binds with the water molecules in your skin to support the skin’s hydration and volume, as well as provide structural support.^[7] 

Dr. Rotemberg can help you decide which Juvéderm product is just right for your desired results. If you want to see what each one can do for your facial appearance, please schedule a personal consultation with her at our South Miami office. 

The Similarities 

When deciding between either Botox or Juvéderm, it is important to understand that it is not a competition to find the “best”. Both are incredible cosmetic products that offer consistent results. One might be right for you now, and the other might be perfect for you later down the road. They both offer:

The Differences

Where there are similarities, there must also be differences. While they both create a refreshed complexion, they do so in different ways. 

Injection Location

Two main differences lie in their chemical makeup as well as their injection sites. The botulinum toxin type A in Botox is injected into the muscle whereas the Juvéderm’s hyaluronic acid gel is injected just under the skin in the dermis. 

Duration of Results

Another difference is in how long each lasts. Botox is great for the person in need of subtle, noticeable change that lasts three to six months^[4] whereas Juvéderm is ideal for the person who needs their results to last up to 12 months.^[6] 

Function

Juvéderm erases wrinkles by adding volume to the face’s appearance whereas Botox erases wrinkles by limiting movement in the underlying facial muscles. Patients who wish to see a subtle change in their facial features, diminished dynamic wrinkles, and aren’t concerned with adding volume are good candidates for Botox. On the other hand, patients who want to enhance volume in their cheeks, lips, and under eyes, and address static wrinkles are a perfect match for Juvéderm. It truly comes down to your desired results. 

Personal Consultation

At your consultation, we will perform a brief physical exam and a new patient intake interview. Then, we will ask about the results you wish to see. We want all of our patients to feel and look their best, so we are eager to learn about your aesthetic concerns. Dr. Rotemberg will gently inspect the areas of concern. This inspection will help inform her decision on recommending either Botox or Juvéderm. Once we have finalized on a treatment plan, we will schedule a time and date for your treatment. 

Procedure

Juvéderm and Botox procedures are fairly similar. First, we will have you sit upright in one of our comfortable treatment chairs. Next, we will then administer a topical anesthetic to the target areas. This will help dull your pain receptors during the procedure. Then, after the anesthetic has taken effect, we will inject either Botox or one of the five Juvéderm products into the target tissue. Patients report feeling a little pain as the needle goes in, but don’t worry, it won’t be there for long. After administering Juvéderm, we will massage the area and equally distribute the chemicals under the skin. Next, we will address any other areas you’d like to address Once all your areas of concern have been treated, you will be able to return to your daily routine. 

Corresponding & Complementary Procedures 

While they offer incredible results, neither Juvéderm nor Botox provide results that last longer than a facelift. With a facelift, Dr. Rotemberg can reverse the signs of aging on your face. She does so by making a hidden, hairline incision around your ears. Next, she gently smooths the skin upwards and towards the forehead. She will also adjust the underlying muscles and carefully trim away the excess skin. Once healed, your face looks remarkably younger, tighter, and smoother. 

References

1. Oikarinen A. (1994). Aging of the skin connective tissue: how to measure the biochemical and mechanical properties of aging dermis. Photodermatology, photoimmunology & photomedicine, 10(2), 47–52. https://pubmed.ncbi.nlm.nih.gov/8043384/
2. Markey A. C. (2000). Botulinum A exotoxin in cosmetic dermatology. Clinical and experimental dermatology, 25(3), 173–175. https://doi.org/10.1046/j.1365-2230.2000.00606.x
3. Shuster S, Black MM, McVitie E. The influence of age and sex on skin thickness, skin collagen and density. Br J Dermatol. 1975;93:639-643.
4. Vleggaar D, Fitzgerald R. Dermatological implications of skeletal aging: a focus on supraperiosteal voluminization for perioral rejuvenation. J Drugs Dermatol. 2008;7(3):209-220.
5. Satriyasa B. K. (2019). Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clinical, cosmetic and investigational dermatology, 12, 223–228. https://doi.org/10.2147/CCID.S202919
6. Kablik, J., Monheit, G. D., Yu, L., Chang, G., & Gershkovich, J. (2009). Comparative physical properties of hyaluronic acid dermal fillers. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 35 Suppl 1, 302–312. https://doi.org/10.1111/j.1524-4725.2008.01046.x
7. Ballin, A. C., Cazzaniga, A., & Brandt, F. S. (2013). Long-term efficacy, safety and durability of Juvéderm® XC. Clinical, cosmetic and investigational dermatology, 6, 183–189. https://doi.org/10.2147/CCID.S33568