First State Vein & Laser MediSpa…

Grand Opening!

By Medical Director, Nadiv Shapira, MD, FACS, FACPh

Botox® vs. Dermal Fillers: Which One is For You?

Botox® and dermal fillers (Belotero®, Radiesse®, Juvederm®, Restylane® etc.) are different products for treatment of skin wrinkles and folds.

Skin Wrinkles and Folds which occur naturally as we age, can develop through two mechanisms:  through repeated muscle over-activity, or, loss of skin fullness due to depletion of fat, connective tissue and elasticity. Muscle overactivity during facial expressions like frowning or smiling, will form wrinkles over time. It often occurs at the forehead, between the eyes, or at the outer eyes (crow’s-feet). On the other end, loss of skin fullness results in skin sagging and development of folds. It is common at the cheeks resulting in Naso-labial folds or Marionette lines.  Loss of skin fullness can also lead to skin depression like the dark circles under the eyes or thinning of the lips.


How These Drugs Work?

A simple way to visualize the difference between Botox® and fillers is to think of a skin crease as a valley between two mountains.  Botulinum toxins prevent the mountains from getting closer to each other; fillers fill-in the valley.

Botox® contains an agent that in large quantity paralyzes nerves and muscles. The minute quantity that is injected into a facial muscle will just weaken and relax it so that it won’t overwork and will slow formation of wrinkles. It can also be used to treat neck bands and lines and for armpit and hands sweating.  Furthermore, as facial muscles relax, the patient gets out of the habit of creasing and overusing those muscles. In this way, Botox® may actually prevent the progression and deepening of wrinkles.

Dermal Fillers on the other hand, are used to treat established and deeper wrinkles by replacing the lost fat and connective tissue support. Fillers usually contain hyaluronic acid, a naturally occurring substance. The difference between fillers has to do with thickness and longevity. Generally, thicker fillers – for deeper creases, thinner – for superficial wrinkles and thin skin.

Fillers are used not only to “lift” the skin beneath wrinkles, but also to reshape and enhance facial structures such as filling-in acne scars, enhancing cheekbones, restoring the fullness of lips or filling-in hollows dark circles under the eyes.


When to Use what?

If creases are

apparent only when we squint, only Botox® is needed.

visible at rest, and NOT made worse by squinting, only fillers are necessary.

present at rest and get worse with facial expressions, Botox® AND fillers will be necessary.


Is it painful? 

Discomfort is usually minimal and brief. The area is numbed by local anesthetic cream and ice packs, and we use a very tiny needle for injection.

How long does it last?

Both products are not permanent and will last for different lengths of time depending where they are injected, how much, and which product are used. On average, Botox® lasts 3-4 months and dermal fillers about a year.

Will I still be able to make facial expressions? 

Yes. Your facial appearance will not be radically changed. Muscle activity will be temporarily reduced but you will be able to frown or look surprised. We don’t want you to look “plastic” or fake.  We would rather initially inject “less” than “too much”; we can always add some a few days later.

Light-Heat Energy (LHE) 

State-of-the-art technology – delivers effective and safe skin treatment for many applications; Psoriasis, Acne, Skin Tightening and Rejuvenation, Wrinkles, Collagen Renewal, Vascular and Pigmented Lesions and Hair Removal.

The LHE Difference: Laser and I.P.L. (Intense Pulse Light) devices rely only on light energy while discard the associated heat. Since they remove the heat instead of using it, they require a very high concentration of light energy (fluence) to be effective which can be damaging and painful. LHE however, uses the heat! By utilizing light AND heat energy, it uses low fluence which minimizes the risk of harmful side effects, eliminates the need for skin cooling, simplifies the treatment and makes it more cost effective.  Patients are much more comfortable.

safe!  comfortable!  affordable!

L.H.E Hair Removal

Flashes of broad spectrum light and heat are applied to the target area. The energy is drawn by the pigment (melanin) within the hair shaft. The temperature of the shaft is raised and conducted down to the hair follicle, the part responsible for producing the hair, and destroys it without damaging the skin.

What Area Can be Treated?

Any, except the eyebrows. Areas most popular for women are bikini, underarms, and face; for men – face, neck, shoulders and back.

When Can I See Results? 

In as little as three treatments, but it is advised to do six to ten treatments, spaced about three weeks apart.

Does it Hurts? 

LHE treatment feels like a very short tingling, a quick pulse of heat, or light snap of a rubber band. Numbing cream or ice pack may help but rarely needed.

Is L.H.E. Hair Removal Suitable for Everyone? 

All light-based treatment modalities require hair darker than the surrounding skin. Light hair color contains very little pigment and may not respond. On the other hand, dark brown or black skin is very rich in pigment and may absorb too much energy causing unwanted damage to the skin.  Laser or I.P.L. hair removal cannot treat this type of skin. L.H.E. has a hand-piece specific for dark skin and is safe and comfortable.

How Many Treatments Will I Need?

Each hair follicle goes through growing and resting phases. It is most successfully treated during the growing phase, called the Anagen. At any given time, 15% to 20% of your hair will be in this stage. During a treatment, only the hair that is in Anagen will be destroyed. After a few weeks, previously resting hair follicles go into Anagen, which then needs to be treated. This is why at-least five treatments are required to treat a given body part.

Is it Permanent? 

To date, no method results in permanent hair removal. The correct term is PERMANENT HAIR REDUCTION. With the best technology you can expect 80-90% reduction. Since we cannot control factors such as hormones, genetics and medications, touch-up sessions may be necessary over time.

L.H.E Skin Rejuvination

Wrinkles, age spots, sunspots and spider veins are common manifestations of aging or sun damaged skin. These skin imperfections can now be safely and simply treated by LHE. By utilizing heat AND light and optimizing their balance, LHE achieves excellent clinical efficacy while utilizing a relatively low total energy.

Although the repair mechanism of each of the above listed imperfections is different, with optimal balance of light and heat, LHE enables to simultaneously accomplish this multi-factorial processes. This safe method will not scar or harm the skin.  It is painless and improvement is seen by the second treatment.  Most importantly, it jump-starts the rebuilding of new collagen under the skin, tightening, and smoothing fine lines and wrinkles.

Jan. 1, 2014