Neuromodulators (“Wrinkle Relaxers”)

These are injections that reduce muscle activity, thereby softening dynamic wrinkles.

Botox® (onabotulinumtoxinA)

How it works: Blocks the release of acetylcholine at the neuromuscular junction → muscle contraction is reduced, so wrinkles caused by muscle movement (like frown lines, crow’s feet, forehead creases) soften.  

What it treats: Dynamic expression lines (forehead lines, glabellar “11” lines, crow’s-feet around eyes)  

Onset & duration: Results generally begin within 3-7 days; duration ~3-4 months for many patients.  

Benefits: Minimally invasive; relatively quick treatment; noticeable effect.

Risks/considerations: Requires repeat treatments; cannot address volume loss or sagging skin; over-treatment can lead to flattening of expressions; must be administered by a trained professional.

Good candidate if you: Have upper‐face dynamic wrinkles and want a non-surgical refresh.

Might consider alternatives if you: Have static deep wrinkles, volume loss, or sagging that needs filler or surgery.

Xeomin® (incobotulinumtoxinA)

How it works: Same basic mechanism as Botox (botulinum toxin type A), but formulated without accessory proteins; may reduce risk of antibody formation in some patients.  

What it treats: Similar dynamic wrinkles, especially glabellar lines (between eyebrows) and other expression lines.  

Onset & duration: Comparable to Botox—results in a few days, lasts ~3-4 months.  

Benefits & considerations: Alternative option for neuromodulator; may be chosen if patient has responded less to other toxins or prefers “cleaner” formulation.

Good candidate if you: Want neuromodulator treatment and your provider suggests Xeomin for your case.

Newtox® (also known as Jeuveau® – prabotulinumtoxinA)

How it works & what it treats: Same category as above; a newer neuromodulator option approved for glabellar lines and expression wrinkles.  

Onset & duration: Similar timeline; individual variation.

Considerations: As with all neuromodulators—appropriate muscle targeting and dosing are key.

Dermal Fillers & Biostimulatory Injectables

These add volume, restore lost facial structure, stimulate collagen, or sculpt contours.

Juvederm® family (Hyaluronic Acid fillers: Ultra, Ultra Plus, Voluma, Volbella)

How they work: Hyaluronic acid (HA) gels are injected to restore volume, smooth folds, enhance lips or cheeks. The HA holds water, plumps the area, and gives immediate effect.  

  • Ultra / Ultra Plus: More versatile for lips or moderate folds.
  • Voluma: Thicker formulation for cheek/midface lift and stronger contouring.  
  • Volbella: More delicate; used in lips and perioral lines.  
  • What they treat: Lip enhancement, nasolabial folds, marionette lines, cheek hollowing, midface volume loss.  
  • Longevity: Varies by product and area; HA fillers generally last ~6-18 months depending on specificity.  
  • Benefits: Immediate visible result; reversible in many cases (via HA dissolving enzyme); customizable by product/formulation.
  • Risks/considerations: Placement matters; risk of bruising, swelling; higher risk if placed near vessels; maintenance needed.
  • Good candidate if you: Have volume loss, want moderate rejuvenation without surgery.
  • Might consider alternatives if you: Have extensive skin laxity, major sagging, or need surgical lift.

Belotero® Balance

How it works: A hyaluronic acid filler formulated to integrate smoothly with the skin—excellent for fine lines and delicate areas.  

What it treats: Shallow wrinkles (e.g., around lips, “barcode” lines), mild folds.

Benefits: Soft finish, less bulk; good for subtle enhancement.

Risks/considerations: Less “lifting” effect compared to thicker fillers; may need more frequent touch-ups.

Good candidate if you: Have fine lines and want discreet, natural results.

Radiesse® (Calcium Hydroxylapatite – CaHA)

How it works: Microspheres of calcium hydroxylapatite suspended in gel; provides immediate volume + stimulates collagen production (biostimulatory effect) over time.  

What it treats: Deeper wrinkles/folds, cheek/jawline contouring, hand rejuvenation.  

Longevity: Longer lasting than many HA fillers; may last 12-18+ months depending on area.  

Benefits: Good for structural support, contouring and collagen stimulation.

Risks/considerations: Not reversible in the same way as HA fillers; placement technique critically important; may leave nodules if not done properly.

Good candidate if you: Have deeper volume loss and want longer-lasting results.

Might consider alternatives if you: Want reversible filler or have very superficial wrinkles.

Sculptra® (Poly-L-lactic Acid – PLLA)

How it works: Stimulates your body’s own collagen production over time. PLLA particles are injected; as they break down, they promote new collagen formation.  

What it treats: Global facial volume loss, deep structural loss, sometimes jawline or temples. Results are gradual.  

Longevity: Up to ~2 years or longer in some cases.  

Benefits: Natural‐looking, builds support rather than just filling; good for aging faces.

Risks/considerations: Multiple sessions typically required; results take time (weeks to months); harder to reverse.

Good candidate if you: Want subtle, long-term volume rebuild rather than instant fill.

Might consider alternatives if you: Want instant dramatic change or have limited tolerance for gradual results.

Revanesse® Versa™+

How it works: A hyaluronic acid (HA) filler with specially formulated spherical HA particles manufactured for smoother injection, less swelling, and natural results.  

What it treats: Moderate to severe facial wrinkles and folds (nasolabial, marionette lines), volume in cheeks/lips.  

Benefits: Reduced swelling, smoother outcomes, good versatility.

Risks/considerations: As with all fillers—placement expertise matters, maintenance required.

Good candidate if you: Want HA filler with minimal downtime and natural feel.

Might consider alternatives if you: Need more structural support (Radiesse/Sculptra) rather than just volumizing.

RHA® Collection (Resilient Hyaluronic Acid: Redensity®, 2, 3, 4)

How they work: These HA fillers are designed for dynamic areas of the face (where there’s movement: talking, smiling). The “resilient” HA is formulated to adapt to motion and provide natural look at rest and in motion.  

  • Redensity®: For delicate lines around the mouth (perioral).  
  • RHA 2 & 3: For moderate to severe dynamic wrinkles/folds (cheeks, nasolabial, lips).  
  • RHA 4: For structural support—jawline, deeper folds, hollows.  
  • What they treat: Fine to deep wrinkles in dynamic facial zones; areas that require movement compatibility.
  • Benefits: Natural look with movement, longevity (up to ~15 months reported) in certain areas.  
  • Risks/considerations: As with all fillers; proper selection of product for area is key.
  • Good candidate if you: Want high-quality filler in movement‐rich areas (around mouth, lips, etc).
  • Might consider alternatives if you: Need major volume/contour in non-dynamic zones.

Kybella® (deoxycholic acid)

How it works: Injectable deoxycholic acid destroys fat cells in the treated area (approved for submental “double chin” fullness). The body then removes those fat cells.  

What it treats: Moderate to severe submental fat (under-chin fullness) and improving chin/neck contour.  

Longevity: Permanent fat cell destruction in treated area (though weight gain can affect the overall result).

Benefits: Non-surgical fat reduction in an area that is otherwise difficult.

Risks/considerations: Multiple treatments often needed (2-4+ sessions); swelling, bruising, discomfort common; not suitable for large fat removal or major skin laxity.

Good candidate if you: Have localized submental fat, good skin elasticity, and want non-surgical option.

Might consider alternatives if you: Have heavy fat deposits or loose neck skin—may require surgery.

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