Cosmetic Plastic Surgery Articles

You probably know about Botox. You may even be aware of the fact that there are other botulinum toxins—even though just about everyone, aside from board-certified plastic surgeons, refers to them as Botox, the same way you may refer to all tissues as Kleenex. But have you ever stopped to wonder what the difference is between Botox and the others? Lindsay Kirkman has, and she wrote about it recently for RealSelf.

In fact, she went further than that. She had Botox injected into one half of her forehead and Jeuveau, the newest of the four botulinum toxins approved by the FDA, injected into the other. Interestingly, of the three not named Botox, Jeuveau is the first to be formulated with the same 900 kDa molecular weight as Botox. The similar chemical composition should mean that Jeuveau’s results would most closely resemble those of Botox.

Kirkman cites one study that showed that Jeuveau could even begin working sooner and last longer than Botox. That said, how long a botulinum toxin treatment lasts depends more on the person than the toxin because how we metabolize it varies from person to person.

As for Kirkman, she had 18 units of Jeuveau injected into the left side of her forehead and the crow’s feet (the wrinkles etched into the corner of the eye) on the left side of her face and the same amount of Botox injected into the right side of her forehead and the crow’s feet on the right side of her face. 

“Ultimately, the pain level on both the Jeuveau side and the Botox side was exactly the same—as in very minimal,” she writes. “I felt a slight pinch every time the needle went in, but the tingly feeling went away within seconds.”

A couple of days later, the Jeuveau had “clearly” taken effect, Kirkman writes, while she hadn’t yet noticed a response from the Botox. That changed on Day Six. “The Jeuveau side feels even more locked in place, but for the first time, the Botox side has also started to produce that feeling of muscle immobilization,” she writes. “I can also tell that my brow lift has started to kick in—again, even more so on the Jeuveau side, where I’m seeing more of an arch start to form.”

Two months out, she writes, “Now when my face is at rest or when I am smiling, the lines on my forehead and between my brows still look equally smoothed out on both sides.

“However, in order to go beyond my own general observations in the mirror, I also asked my husband and a few friends to weigh in. All parties pointed out that as I naturally engaged in conversation—particularly when I looked surprised or curious—there were more obvious lines starting to reappear near the temples on the side of my face injected with Botox,” Kirkman says. “The difference is subtle enough, though, that I don’t think it’s anything anyone else would notice without specifically paying attention.”

If nothing else, it’s always good to know you have options. Comparable options.

If hyaluronic acid isn’t already a household name, it’s right on the cusp. It features prominently in a growing inventory of popular serums, sheet masks, and moisturizers.

It’s a sugar molecule that occurs naturally in the skin and binds to water to plump up your skin and make it somehow look dewy and like it’s glowing all at once. Natural hyaluronic acid is bound to collagen on one side and linked to water molecules on the other, which is what gives skin its plumpness.

Trouble is, as we age, we lose both collagen and hyaluronic acid naturally, which means our skin becomes dehydrated more easily. Our faces can also start to look a bit deflated, as a result.

Picking up where nature leaves off

The aforementioned products have been shown to increase moisture and even firm skin around the eye area and soften fine lines on the rest of the face. Hydrating skin-care ingredients—think glycerin, urea, propylene glycol, and sorbitol, among others—act as humectants, attracting water to the skin in an effort to hydrate it.

As an ingredient, hyaluronic acid does that and more. It can lock in moisture from the environment and deeper dermis, enhancing the hydrating effect. And that effect is more pronounced in those who are middle-aged and older, since our bodies are producing less of it.

Going even deeper

You may also recognize the injectable version. In dermal fillers, hyaluronic acid is a gel-like product that attracts water to the injection site to regenerate volume and recreate lost structure, reducing the face’s deflated appearance and softening the overall look of lines and wrinkles.

These fillers can address a range of concerns, including the nasolabial folds, marionette lines (the folds that run vertically from the corners of the mouth down to the chin), cheek augmentation, under-eyes, lips, and the tops of the hands. But one filler does not fit all. Yes, they’re all made up of the same ingredient, but depending on the size of the formulas’ molecules and how they’re structured, they vary in density, lift-ability, and longevity. So, finding a board-certified plastic surgeon with extensive experience with dermal fillers is critical.

Aside from their versatility, hyaluronic acid fillers are a good way to dip a toe into cosmetic plastic surgery for the uninitiated because they’re minimally-invasive, require very little, if any, recovery time, and they’re reversible.

If you’re not happy with the results, your plastic surgeon can insert an enzyme called hyaluronidase to dissolve the filler within a matter of minutes. Minimal risk and a potentially big reward.