Clients often come to Refresh Medispa to get rid of an annoying wrinkle that is making them look unhappy or angry, and they ask me if they should get Botox or filler. The answer is, it depends on the type of wrinkle. Some wrinkles are ‘dynamic’ and some are ‘static’. The best way to decide whether we should use Botox or filler is to determine whether the wrinkle is dynamic or static.

Dynamic wrinkles are caused by the contraction of facial muscles and are only present when the muscle is used. Examples include Crow’s Feet caused by contraction of the eye muscle when smiling, vertical lines between the eyes from contracting muscles when frowning, and horizontal forehead lines due to the expressive raising of the eyebrows. Botox is the treatment of choice for dynamic wrinkles as it prevents muscle contraction by interfering with the muscle’s response to the message to contract.

Static wrinkles can develop over time and are present at rest when the muscle is not contracted. They are the result of a loss of elasticity and volume in the face which occurs with aging and with sun exposure. Over time, tethering of the skin to the underlying tissues can take place making wrinkles appear even deeper. Fillers are used for static wrinkles to “fill-in” areas where the body’s natural collagen, elastin, and hyaluronic acids are lacking and where dynamic wrinkles have caused a structural change in the skin.

When we meet to discuss your goals and treatment options, I will be able to categorize your wrinkle as either Dynamic or Static by observing your face at rest and then with contraction of the various muscle groups. Occasionally, both Botox and filler are used together to treat the wrinkle or group of wrinkles in order to get the pretty effect we are looking for!

Havve a great day, and I hope you continue to “Look Fresh and Feel Confident”.

-Dr. Tara Wegryn

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