Botox and Juvederm, what is the difference?

With the extreme popularity of both products in our office, Botox and Juvederm, we continually have to sort out confusion between the two, and what each can accomplish. Just today on the Twitter stream the issue was raised. Do you need one, or the other, or will you need both?

In order to set the record straight let’s go back to the basics. Starting with Botox, the medication is a neurotoxin, which sounds a bit scary, though this is indeed how it works. There are now three formulations out there; Botox, Dysport, and now a new one from Merz called Xeomin. They are all formulations of botulinum toxin type A, and studies to date show a very similar result and duration for all three with skilled application. The toxin binds to the end of the motor nerves and stops the connection so the muscle cannot react. Over time, the nerve ends replenish themselves and the muscles again respond to commands to flex and frown. The key here is ‘flex and frown’. Botox, and the like, treat dynamic lines and folds from facial over expression. Wear your worries on your forehead, or smile and squint expressively from the corner of your eyes, Botox is your cure.

Juvederm is quite a different matter, and is one of a group of “fillers” based on hyluronic acid gel. The gel is a chemical which is a normal component of cell membranes, part of the regular stuff in the body and is importantly not a protein. The fact that it is not, prevents any reaction or inflammation which was a dread from collagen injection of days gone by. The hyluronic acid gel is a great plumper because it is hydrophilic, which means it attracts and holds water, and is slowly absorbed and recycled by the surrounding cells. A filler does just that, it plumps and softens lines and folds that are always there or have crept in during the aging process. Smile lines and folds are the first to come to mind.

So, Botox or Juvederm, what is the difference? Wrinkles at rest, Juvederm to fill and contour. Dynamic line or wrinkles with motion, Botox is the cure. Will you need both? Maybe.