All about skincare > Wrinkles > Anti-Wrinkle treatment by injection
What is the difference between Botox and Filler agents, specifically non-animal hyaluronic acid
By dr Renaud St-Laurent

For this edition, we decided to sit down with an experienced professional, the Medical Director at Epiderma clinics (with more than 32 years in medical experience oncluding 13 years in aesthetic medicine), to get some clear and concise answers to the questions we all have about injectables.

What are the main types of injectables available on the market?
The two most popular anti-aging injectables are:

• Botox (botulinum toxin), a protein substance that causes muscles to relax.
• Filler agents, specifically non-animal hyaluronic acid, which is an injectable gel.

How do they work and what are they for?
These two anti-aging treatments have different effects and are used together to compliment each other.
Cosmetic Botox neutralizes and relaxes the skin’s muscles.

• Is used to treat expression lines (secondary to muscle contraction).
• This treatment is particularly recommended for the top portions of the face (forehead, glabella and crow’s feet).

Hyaluronic acid (HA) restores dermal volume and fills wrinkles.

• Is used to compensate for the loss of HA, which is naturally present in the body, due to aging.
• This treatment is recommended for the lower portion of the face (cheeks, mouth, chin, jaw).

How long does a treatment take?

• One Botox session takes 5 to 10 minutes.
• An HA session takes an average of 20 to 30 minutes depending on the area being treated and the quantity that is injected.

How long do the effects last?

• Botox: From 3 to 6 months. The first treatment lasts 3 to 4 months, with the subsequent ones lasting longer (5 to 6 months). This also depends on the quantity that is injected and the sensitivity of the individual that is being treated.
• HA: From 6 months to 2 years depending on the area being treated and quantity being injected. For example: the effects of injections into the lips are not as lasting because it is the part of the face that moves the most.

How can we make sure that we achieve the best possible results?

• By staying out of the sun (especially prolonged exposure) and avoiding UV rays, tanning salons, cigarette smoke, and air that is too dry.
• By properly hydrating your skin and protecting it after treatments.
• By carefully selecting your clinic and doctor.
• By having realistic expectations.

Why do some people look frozen following their injections?
This is a problem caused by dosage or treatment abuse.

Clients sometimes insist on being given a little too much and there are doctors who make the decision to allow it. The results can therefore be disproportionate or unappealing.

It is important to remember that the doctor should know when to say no and is allowed to say no. It is not up to the doctor to decide for the client, however he or she must display good judgment. A client may always request a second opinion if he or she disagrees with the practitioner.

Are there any contraindications?

• Pregnancy and nursing (as a precaution).
• Botox: allergy to the product (very rare), neurological disorders that relate to muscle contraction (as a precaution).
• HA: product allergy (even more rare).

What are the risks? Are there any side effects?

• Botox: sagging of the upper eyelid (less than 1% of cases, temporary reaction that must be treated), side effects from the injections (bruises, sensitivity, redness), minor occasional headaches.
• AH: redness, swelling, bruises. Rarely: injection in an artery that causes sores or ulcers.

What is the right age to begin treatments like these?
There is no right age, however clients must have reached the age of majority; in practice, the average age of clients seeking these treatments is between 35 and 65.

What advice do you have for someone who is considering undergoing a wrinkle reduction treatment by injection?

• Ask for information about the doctor who is administering the injections (does he or she have any
• relevant experience or training?).
• Ask your friends who have seen satisfactory results for recommendations.
• Make sure you have excellent communication with the physician and get the answers you need to your questions.
• Clearly express your expectations to the treating physician.
• Do not hesitate to ask questions so that you understand what to expect.
• Have realistic expectations (listen to the doctor’s recommendations).
• Carefully consider the reason why you are seeking such a treatment (you must be doing it for yourself and not for others).
• Take the time to talk about it and discuss it (a beautiful face to the doctor may not be a beautiful face to you).

In conclusion, when the time comes to entrust a doctor with our most valuable asset, our face, it is important to make the right selection in terms of the professional who administers the treatment. The experience and reputation of a clinic and doctor are imperative. Beyond the technical aspect, the psychological aspect is just as important. You must be comfortable talking with your doctor, and it is essential that you feel as though you are on the same wavelength. A trusting relationship must be formed, your personality must be respected, and this involves a frank discussion. It is important to remember that the perception of aesthetic beauty differs significantly from one person to the next and that to avoid negative consequences, it is absolutely necessary to communicate to be understood.