Dr. Cat Burkat Talks Botox and Fillers

Dr. Cat Burkat, MD, FACSBotox® remains one of the most popular non-surgical options for facial rejuvenation. It is a facial injectable purified from botulinum A toxin and FDA-approved to help eliminate or improve facial wrinkles.


It is important to distinguish between the facial wrinkles that are brought out with facial movement, in contrast to those creases that are present even when the facial muscles are at rest.


The latter creases can often be softened with the use of dermal fillers.


Common Uses for Botox®


The most common areas treated with Botox® are:
  • The frown lines between the eyebrows
  • The "crow's feet" around the eyes
  • Lip lines
  • Angles of the mouth
  • The horizontal creases on the forehead

When carefully injected near the target muscle, Botox® works by blocking the release of acetylcholine from the nerve terminal, which stops the muscle from contraction, thereby relaxing the wrinkle.


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The procedure requires only several minutes, with little to no downtime, allowing one to return to work immediately. Botox® generally takes effect within 3-10 days, and lasts for 3-6 months.


The literature suggests that patients who maintain regular treatments over time may permanently reduce the severity and onset of deep facial wrinkles.


Side effects are rare and generally limited to mild bruising at the injection sites. Rarely, headache, flu-like symptoms, droopy eyelids, and nausea may also occur, depending on the location of the areas treated.


Botox® injections are also effective for hyperhidrosis (excess sweating) of the underarms.


Common Uses for Fillers


Over the years, our face also loses its youthful fullness due to decreasing collagen, elastin, and hyaluronic acid, which are the foundations of vibrant, healthy skin. The injection of dermal fillers, also known as soft tissue augmentation, offers a great option to replenish the lost volume of our face, and restore youthful facial contours.


Signs of aging that can be treated with fillers include:

  • The "laugh lines" around the eyes and mouth
  • Hollow cheeks
  • Thin lips
  • Downturned mouths

Additional expertise may be required to consider placement to help lift a droopy brow, or to fill out the dark hollows around the eyes. Fillers are also an excellent minimally invasive technique of subtly reshaping facial contours, such as smoothing the shape of the nose or tip, elevating the bridge of the nose in Asian faces, softening sharp cheekbones or jaws, or smoothing jowls.


There are a multitude of fillers available to address the wide range of cosmetic concerns. Many popular fillers, such as Restylane, Juvederm, or Radiesse, offer immediate results and minimal downtime. The options for fillers are continuously growing and changing, and proper selection and placement of the filler are essential for optimal results. Often, fillers can also be combined with botulinum toxin for an even smoother effect.


While fillers are generally considered safe, minor bruising, swelling, small lumps, under-filled areas, and asymmetry may occur. It may be helpful to avoid blood-thinners, aspirin, ibuprofen, and vitamin E prior to the procedure to help minimize bruising. Taking homeopathic Arnica montana tablets prior to an injection may also help diminish bruising and swelling.


Most fillers are temporary and require repeat treatments to maintain results. Depending on the type of filler used, results may last from several months to 2 years, and can be repeated when needed. Your physician can help guide you to the most appropriate filler depending on the depth of the lines, and the specific area of the face to be contoured.   


Interested in Learning More About Botox® and Fillers?


Request a free consultation with our UW Health Transformations physicians