The 13 most frequently asked questions about botox and fillers

What are the differences and similarities between a Botox treatment and fillers?

'Both treatments are for anti-aging, intended to make people look a bit fresher and younger. Only the mechanism of action is different. Botox is a substance that temporarily relaxes muscles so that wrinkles no longer form. It improves skin texture and fades lines. With a filler, as the name suggests, you inject wrinkles and lines with a filling agent. It is a hyaluronic acid filler, a naturally biodegradable product that resembles the hyaluronic acid in the body but is synthetically manufactured. With a filler, you can restore volume or fill in certain wrinkles, thus softening them. Botox removes the cause of the wrinkle. If someone no longer frowns, the skin, where the line originated, will also no longer crease. With a filler, the symptom is treated; only the wrinkle is filled, but the skin creasing remains. Botox is good for frown lines, crow's feet, and dynamic wrinkles. But not for volume loss in the cheeks, because you want to be able to keep smiling and you simply cannot turn off certain muscles.'

Which wrinkles are suitable for these treatments?

'Botox is ideally suited for a frown line, a forehead wrinkle, crow's feet, or lines around the nose, which are also called bunny lines. It also helps with headaches, teeth grinding or clenching, and if you have a downturned mouth, a gummy smile (gingival smile), or dimpled chin. All indications for Botox. And furthermore, you can, of course, fill every line or wrinkle with a filler. However, this is not always the first-choice treatment. Fillers can also be used for volume loss, for example, in the tear trough, a nasolabial fold or a marionette line, fine cheek lines and lip lines. Additionally, a filler can add more volume to the jawline, or to cheekbones or lips. These are treatments that can only be done with a filler, not with Botox.'

When is the effect of a treatment visible?

'You see a filler immediately because you inject the volume right away. Before you see the true result, I would allow about a week; there might be a small bruise near the lip or some swelling. With Botox, it can take a few days before you notice it starting to work. After 2 weeks, the effect is maximal. We always ask patients to return after 2 weeks to check if everything is as desired.'

How long does the effect remain visible?

'Botox typically lasts about 3 to 4 months; often, you see that the interval lengthens if people have had treatments more frequently. If your muscles become less strong, you can enjoy the effects longer. A filler lasts approximately 9 to 12 months. They break down slower than Botox.'

What are the possible side effects of the treatments?

'Sometimes a small blood vessel is hit, then a small bruise might be visible. And with a filler, there's a chance of some swelling. Very occasionally, people might experience some headache after Botox. These are actually the most common side effects.'

Are the treatments painful?

'Botox is not; I always inject myself too. It's a small prick but it's not bad. A filler can be a bit more sensitive, depending on where you inject. You can imagine that injecting into lips is somewhat sensitive. That's why we always ask our patients to come half an hour earlier to allow the numbing cream to work effectively. It doesn't mean it's pain-free afterward, but the sharp edges are taken off.'

What are the recommendations after the treatments?

'We find aftercare very important, and we also always mention what you should not do: no sports or sunbeds or saunas for a while, no makeup on the first day, and no facial treatments for 2 weeks. And with fillers, we always advise cooling, which can also be done here in the clinic. When patients come for the first time, I routinely make a follow-up appointment, unless they don't want one. After a 5th Botox treatment, someone usually knows how it goes, then it's usually not necessary to come back again. A follow-up is very important because someone who walks out your door doesn't fully know what to expect. Then I think it's good if we briefly check together if everything went well. Everyone has different muscles, and not everyone needs the same dosage. And with Botox, you only really see what it has done after 2 weeks. With fillers, you see it a bit better, and it's only a question of whether we need to add a bit more.'

What can someone considering a Botox or filler treatment expect?

'I think it's especially good to know that you can still look very natural. Many women come who have been through a stressful period, their faces have started to show signs of it, and they no longer recognize themselves in the mirror. You then try to bring people back a bit to themselves. Patients should be able to see that they've had a treatment, but not so much that people start saying to them, 'hey, did you get Botox?'. I'd prefer them to be told, 'oh, you look so well-rested, have you been on holiday?'.'

Is there a success story to tell?

'I once had a bus driver in the clinic with a very deep frown. Every day on the bus, she was told, 'my, you look angry'. At some point, she was fed up. Because she wasn't angry at all, but simply had a very strong frown muscle and consequently a wrinkle. After the Botox treatment, she was very happy; she no longer received comments, and she felt that people finally saw who she really was.'

Do people also come who want extra full lips?

'Yes, but we don't get many patients here who want that 'inflated' look. Of course, they exist. But we find the natural result more important. You can also see that on our website and in the brochure with examples. Those people still look like themselves.'

Would you advise against it if someone came for that?

'Absolutely, if it's something I don't support, where I think 'this will be too much', then I will honestly say so. I don't support it either. There are certain clinics known for it, 'if you want lips like that, you can get them here'. I won't mention names.'

Do you have any other advice?

'Being a cosmetic physician is a precise profession and requires a lot of experience and expertise. Therefore, I recommend checking before a treatment whether the physician is BIG-registered and a member of the NVCG. You can also read reviews about the clinic and the physician. Yes, because it's your face you're having something done to, after all.'

How quickly can someone get an appointment for Botox or fillers?

'That depends a bit on how full the schedules are. In Amsterdam, you often have to plan 2 or 3 weeks in advance. We haven't been open very long here in Utrecht, so I still have a fair amount of availability. There are no months-long waiting times.'

Source: Zorgkrant.nl