Program Botulinum Toxin vs Program Dermal Fillers: Which to Choose? Which Wrinkle Reduction Method is Right for You? by Dr. Nono, Entrio Clinic, Ratchaprasong Aesthetic Clinic
- Admin MaskHunter
- 13 minutes ago
- 25 min read
Many people may have heard of both of these or may have even had them done, but still have lingering questions like, "Are Botox and Filler the same?" "How are they used differently?" "Which should I inject for this type of wrinkle?" And most importantly, "Which wrinkle reduction program is truly right for me?"
Today, Dr. Nono will delve deep into comparing the differences between Botulinum Toxin and Dermal Fillers to help everyone "know beforehand" so you can "choose" the wrinkle reduction and facial contouring procedure that is "on point" and most suitable for your problem at Entrio Clinic, Ratchaprasong Aesthetic Clinic!
In this article, I will explain in detail, in an easy-to-understand way, with examples to help everyone clearly see that when encountering this type of "wrinkle," which program you should aim for, and why evaluation by an experienced doctor is the most important factor in choosing the right program for you. Stay tuned
Understanding "Wrinkles"... Not Just Folds, But Different "Causes"!
Before we compare popular wrinkle reduction programs like Botulinum Toxin and Dermal Fillers, the most important thing is for us to "know" and "understand" our formidable enemy: "wrinkles".
Many people may think that wrinkles are all the same type of folds and creases on the face, but in reality, "wrinkles" do not have only one cause!
At Entrio Clinic, Ratchaprasong Aesthetic Clinic, we believe that understanding the "root cause" or "true cause" of each type of wrinkle is extremely important in choosing the "right" treatment program that addresses the problem "on point".
Facial wrinkles can be divided into 2 main types based on their mechanisms and causes, and each type requires completely different care methods:
1. Dynamic Wrinkles (Wrinkles from Facial Expressions) "Creases" that appear with movement
True Cause
These types of wrinkles originate from the "work of facial muscles". Our faces have many small muscles attached to the skin that help us make various facial expressions, whether it's smiling, laughing, frowning, raising eyebrows, or squinting. Every time we make a facial expression, these muscles contract, causing the overlying skin to "fold" or "crease". In youth, our skin is still rich in collagen and elastin (like the "structure" and "spring" of the skin), and the skin is highly elastic. When we stop making facial expressions, the skin quickly returns to its smooth and taut state, making the folds from muscle movement disappear. But as we age, our body's production of collagen and elastin decreases. The quality of existing collagen and elastin fibers also begins to deteriorate, causing the skin to lose its elasticity and ability to bounce back to its original shape. Now, when we repeatedly move the same facial muscles in the same area for a long time, the skin starts to "remember" those folds and leaves small lines, even when the face is relaxed. And if the same facial expressions are continued repeatedly for a long time, these small folds will gradually deepen and become wrinkles that are visible all the time.
Key Characteristics of Dynamic Wrinkles
They are most apparent when we make facial expressions. For example, crow's feet are visible when smiling, forehead wrinkles when raising eyebrows, and frown lines between the eyebrows when frowning.
Initially, they may appear as small lines that disappear when facial expressions stop.
As we age, they appear constantly, even when the face is relaxed, but become much more pronounced when making facial expressions.
Common Areas Found
Forehead Lines: Caused by raising the forehead, by the Frontalis muscle.
Glabellar Lines or Frown Lines: Caused by frowning, by the Corrugator and Procerus muscles.
Crow's Feet: Caused by smiling or squinting, by the Orbicularis Oculi muscle.
Bunny Lines: Small wrinkles on the side of the nose, caused by scrunching the nose.
Managing Dynamic Wrinkles at their root involves "relaxing the activity of the underlying muscles", which is the main role of Botulinum Toxin, which we will delve into further.
2. Static Wrinkles (Deep Grooves / Wrinkles from Deterioration) "Folds" that are always present
True Cause
These types of wrinkles are not caused directly by muscle movement. Instead, they result from the "deterioration of skin structure" and "volume loss" in the dermal layers and subcutaneous tissues. The main causes include:
Decrease and deterioration of collagen and elastin: When the supporting structure and skin's elasticity weaken, the skin loses its firmness and flexibility. This leads to "collapsing" or "sinking" of the skin.
Becoming grooves or wrinkles that are visible all the time.
Subcutaneous Fat Loss: Our faces have small layers of fat distributed in sheets that help support the skin structure and provide plumpness. As we age, fat in some areas (such as the mid-cheeks, temples, under eyes, around the mouth) diminishes, causing the skin in those areas to lose volume, resulting in noticeable grooves or sagging, such as deeper nasolabial folds or sunken cheeks.
Bone Resorption: As we age, some facial bones undergo slight resorption, such as in the eye sockets, cheekbones, and jaw. These changes affect the overall structure of the face and contribute to the overlying skin losing its support base, leading to sagging and deep grooves.
Gravity: The force of gravity continuously pulls the skin downwards, and this effect becomes more pronounced as the skin's structure weakens, leading to sagging and deep grooves in various areas.
Dynamic Wrinkles that become permanent: If Dynamic Wrinkles (wrinkles from facial expressions) are not treated for a long time and the skin loses enough elasticity, those folds will "deepen" and become Static Wrinkles that are visible all the time, even when the face is relaxed.
Other external factors: Such as sunlight, pollution, and smoking, also accelerate the formation of Static Wrinkles by damaging collagen and elastin structures.
Always visible, even when the face is relaxed.
Often deep grooves or folds that are more prominent than Dynamic Wrinkles.
Sometimes accompanied by sagging skin or loss of volume.
Common Areas Found
Nasolabial Folds
Marionette Lines
Tear Trough / Deep Eye Sockets
Neck Wrinkles
Small wrinkles all over the face that are not directly caused by muscle movement but by skin lacking moisture and collagen (Crepey Skin).
Wrinkles around the corners of the mouth.
Managing Static Wrinkles at their root involves "replacing lost volume" or "supporting the sagging skin structure", which is the main role of Dermal Fillers, which we will delve into next.
Understanding the "Cause" is the Key to "Choosing" the Right Wrinkle Reduction Program!
Understanding the "Cause" is the Key to "Choosing" the Right Wrinkle Reduction Program! From what I've explained, it's clear that Dynamic Wrinkles and Static Wrinkles arise from completely different causes.
Dynamic Wrinkles (lines from facial expressions): The problem lies in the "muscles" that move, causing the skin to fold.
Static Wrinkles (deep grooves, Volume Loss): The problem lies in the "skin structure" and "Volume" that are lost, causing the skin to sag.
Therefore, choosing the appropriate wrinkle reduction program must start with evaluating what type of wrinkles you are concerned about and what their primary cause is.
If the main problem is wrinkles caused by facial expressions that appear when you move, or you want to prevent these wrinkles from deepening in the future, then the Botulinum Toxin Program is the most precise solution.
If the main problem is deep static wrinkles that are always present, or Volume Loss that makes your face look hollow and tired, then the Dermal Fillers Program is the answer.
And in many cases, especially in individuals with complex signs of aging, skin problems may involve both Dynamic and Static Wrinkles. In such cases, using Combination Therapy with both Botulinum Toxin and Dermal Fillers together may yield the best and most natural-looking results.
At Entrio Clinic, Ratchaprasong Aesthetic Clinic, Dr. Nono and our team of doctors specialize in evaluating skin problems on a case-by-case basis. We will help you analyze the primary cause of your wrinkles and recommend the most suitable wrinkle reduction program for you, whether it's the Botulinum Toxin Program, Dermal Fillers, or Combination Therapy.
"Know Beforehand... To Choose Correctly!" Understanding the types and causes of wrinkles will help you communicate clearly with your doctor and choose the program that will precisely help you achieve a more youthful-looking face.
Delving into Botulinum Toxin (Botox) Program... The Expert in "Wrinkles from Facial Expressions" and Facial Contouring!
Now that we've understood the difference between Dynamic Wrinkles (wrinkles from facial expressions) and Static Wrinkles (deep wrinkles), let's get to know the first program, which is considered the "expert" in managing wrinkles from facial expressions specifically: the Botulinum Toxin Program, or what most people commonly know and call "Botox".
At Entrio Clinic, Ratchaprasong Aesthetic Clinic, we see Botulinum Toxin as a highly effective, safe, and very versatile program, not just for wrinkle reduction as many people understand
What is Botulinum Toxin? "Pure protein... that helps relax muscles"
Botulinum toxin is a pure protein extracted from a type of bacteria. However, when used in medicine, it undergoes complex and high-standard manufacturing processes to obtain a highly pure, safe protein that is used in very small quantities for treatment.
How does Botulinum Toxin work? "Stops" muscle signals... relaxes... reduces folds!
The mechanism of action of Botulinum Toxin is fascinating and quite specific. It targets the neuromuscular junction in the area where it is injected.
Normally, when the brain instructs a muscle to move, signals are sent along the nerve, and at the nerve ending, a neurotransmitter called acetylcholine is released. This substance binds to receptors on the muscle surface, causing the muscle to contract.
However, when we inject Botulinum Toxin into the target muscle, the Botulinum Toxin substance inhibits the release of acetylcholine at the nerve ending. This is like "switching off" the signal transmission, causing the signals from the brain that instruct the muscle to contract to not reach or reach less.
The result is that the muscle in that area will temporarily relax. It's very important to note that it does not cause permanent muscle paralysis, but rather temporarily reduces the muscle's ability to contract, thereby reducing or lessening the severity of muscle movement in that area.
When the muscles used for facial expressions (e.g., the muscles that make us frown, raise our forehead, or smile causing crow's feet) relax, the muscle contractions that cause repeated folding of the overlying skin are reduced. This reduces the formation of "folds" on the skin caused by muscle movement, which is the main mechanism for reducing Dynamic Wrinkles.
Various Brands of Botulinum Toxin... Choose the Right Program!
When it comes to Botulinum Toxin in the market, there are many brands to choose from. Although the main active ingredient is the same Botulinum toxin Type A, differences in manufacturing processes, purification, or other components may result in each brand having slightly different properties, such as drug diffusion, onset time, or duration of results.
Well-known and widely used Botulinum Toxin brands worldwide:
Botox® (USA)
The first brand and the name most people commonly use. Produced by Allergan, it has high purity and a long history of studied results.
Dysport® (UK)
Has a relatively wider diffusion property, suitable for areas requiring good diffusion or larger muscles.
Xeomin® (Germany)
A Botulinum toxin with a less complex molecular structure, which may help reduce the risk of Botulinum Toxin resistance.
Nabota® (Korea)
Another popular quality brand from Korea that has been widely imported and used in Thailand.
Aestox® (Korea)
A popular Botulinum toxin brand from Korea as well, and one of the rising choices for Thais.
Botulinum Toxin Program: Expert in Managing "Wrinkles from Facial Expressions"
Based on its muscle-relaxing mechanism, Botulinum Toxin is the most effective program for managing Dynamic Wrinkles, or wrinkles from facial expressions. Popular areas for treatment with clear results include:
Forehead Lines: Caused by frequent forehead raising by the Frontalis muscle. When Botulinum Toxin is injected, it helps relax the forehead muscles, making horizontal wrinkles appear less pronounced or disappear when facial expressions stop.
Glabellar Lines or Frown Lines: Also known as "11 lines". Caused by frowning by the Corrugator and Procerus muscles. Injecting Botulinum Toxin helps relax these muscles, making vertical frown lines appear smoother and the face look more relaxed and less stern.
Crow's Feet: Caused by smiling or squinting by the Orbicularis Oculi muscle. Injecting Botulinum Toxin helps relax the muscles around the eyes, making crow's feet appear less pronounced and the eyes look brighter.
Bunny Lines: Small wrinkles on the sides of the nose caused by scrunching the nose. Injecting Botulinum Toxin helps these lines appear smoother.
Chin Wrinkles (Mental Crease or Peau d'orange chin): Some people, when tensing their chin, may see dimples or the chin skin appear bumpy like an orange peel. Injecting Botulinum Toxin helps relax the chin muscles, making the chin area appear smoother.
In addition to reducing wrinkles caused by muscle movement, Botulinum Toxin also plays an important role in "preventing" existing Dynamic Wrinkles (especially in those who are starting to see small wrinkles) from becoming Static Wrinkles (permanent deep grooves) in the future. This is the origin of the "Preventative Botox" concept, which is gaining popularity.
More than just wrinkle reduction... Other benefits of Botulinum Toxin in aesthetics!
The versatility of Botulinum Toxin is not limited to just wrinkle reduction. It can also be used to address other problems and enhance facial and body aesthetics in many ways, which are also popular programs at Entrio Clinic.
Masseter Reduction: For individuals with large masseter muscles, injecting Botulinum Toxin helps relax the activity of this muscle, gradually reducing its size and making the lower face appear slimmer and the jawline more defined (Botox for Jaw Reduction Program).
Nefertiti Lift: This technique involves injecting Botulinum Toxin along the jawline and the platysma muscle in the neck. It helps relax the muscles that pull the skin down, slightly lifting and tightening the jawline and neck (Botox for Jawline Lifting Program).
Brow Lift: Precise injection of Botulinum Toxin around the eye muscles and forehead can help relax the muscles that pull the eyebrows down, making the eyebrows appear lifted and the eyes brighter.
Gummy Smile Correction: For individuals who show a lot of upper gums when smiling, injecting Botulinum Toxin into the muscles that pull the upper lip up will reduce the elevation of the lip, making less gum visible when smiling.
Lip Flip: Injecting small amounts of Botulinum Toxin around the mouth muscle (Orbicularis Oris) can help relax this muscle, causing the upper lip to subtly roll outwards, making it appear fuller, without needing Dermal Filler (but it does not add significant volume like lip fillers).
Hyperhidrosis Reduction: Botulinum Toxin can be injected into the armpits, palms, or soles of the feet to inhibit the release of neurotransmitters that control sweat gland activity, effectively reducing excessive sweating.
The Botulinum Toxin Procedure at Entrio Clinic Ratchaprasong: Fast, Precise, Safe!
Botulinum Toxin injections are a highly popular procedure at Entrio Clinic Ratchaprasong Aesthetic Clinic. The procedure is quick and straightforward, but requires significant expertise from the doctor.
Consultation and Evaluation by the Doctor: This is the most crucial step! The doctor (Dr. Nono or the Entrio Clinic medical team) will assess your wrinkle concerns or the areas you wish to address, discuss your expectations, and analyze your facial muscle activity during various expressions to plan the treatment, determine the injection sites, and the appropriate unit dosage of Botulinum Toxin for you.
Skin Cleansing: The skin in the injection area will be thoroughly cleaned.
Injection: The doctor will use a very fine needle to inject Botulinum Toxin into the target muscle. Cold compresses or topical anesthetic may be used before injection to minimize discomfort. During the injection, you might feel a slight sensation similar to an ant bite. The injection takes only a few minutes per area.
Post-Treatment Care: After the injection, there may be small bumps at the injection sites (similar to mosquito bites), which will subside within a few hours. Slight redness or bruising may occur, which will disappear on its own within a few days. You can resume normal activities immediately, but you should avoid pressing, massaging, or applying hot compresses to the injected area for the first 2-3 days, and avoid lying flat for the first 4 hours after injection.
Expected Results and Duration: Onset of Results: The results from Botulinum Toxin injections are not immediate. The muscles will gradually relax in approximately 3-7 days after the injection, and the full effect will be visible in approximately 2 weeks. Dynamic wrinkles will gradually appear less pronounced or disappear.
Duration: The results generally last for approximately 3-6 months. This varies depending on individual factors such as the brand and quality of Botulinum Toxin, the amount used, the injected area, muscle strength, and facial expression habits. When the results begin to fade, the muscles will gradually return to normal function, and wrinkles will reappear. If you wish to maintain the results, you should return for re-injection as advised by your doctor (often recommended to re-inject before 100% of the effect wears off).
Expected Results and Duration
Onset of Results
The results from Botulinum Toxin injections are not immediate. The muscles will gradually relax in approximately 3-7 days after the injection, and the full effect will be visible in approximately 2 weeks. Dynamic wrinkles will gradually appear less pronounced or disappear.
Duration
The results generally last for approximately 3-6 months. This varies depending on individual factors such as the brand and quality of Botulinum Toxin, the amount used, the injected area, muscle strength, and facial expression habits. When the results begin to fade, the muscles will gradually return to normal function, and wrinkles will reappear. If you wish to maintain the results, you should return for re-injection as advised by your doctor (often recommended to re-inject before 100% of the effect wears off)
The Importance of Choosing Quality Botulinum Toxin and an Experienced Doctor at Entrio Clinic
As a doctor, I always emphasize that Botulinum Toxin injections must prioritize these two things:
Product Quality: You should choose genuine, standardized Botulinum Toxin approved by the FDA and verifiable, for maximum safety and confidence in the effectiveness and duration of the results. At Entrio Clinic Ratchaprasong Aesthetic Clinic, we use carefully selected quality Botulinum Toxin and are ready for patients to verify it.
Doctor's Experience and Expertise: Botulinum Toxin injection requires a detailed understanding of facial muscle anatomy, assessment of muscle function during facial expressions, and precise injection techniques to achieve the desired results (wrinkle reduction, facial contouring) without making the face look stiff, unnatural, or causing undesirable side effects. An experienced doctor can plan injections considering facial balance and the most natural-looking results. At Entrio Clinic, you can be confident in the doctor's experience and meticulousness.
Who is suitable for Botulinum Toxin Program at Entrio Clinic?
The Botulinum Toxin Program is ideal for:
Individuals with wrinkles that appear when making facial expressions (Dynamic Wrinkles) such as on the forehead, between the eyebrows, or around the eyes.
Those who want to prevent deep wrinkles or slow down the formation of Static Wrinkles in the future (Preventative Botox Program).
Those who want to reduce the size of their jaw muscles for a slimmer face.
Those who want minor facial adjustments, such as eyebrow lifts or corner of the mouth lifts.
Those who want to correct a gummy smile or chin wrinkles caused by muscle tension.
Those who want a wrinkle reduction program that is fast, has almost no downtime, and provides natural-looking results (when performed by an experienced doctor).
Important Note: Although Botulinum Toxin is highly effective for reducing wrinkles from facial expressions, it cannot directly address deep wrinkles caused by Volume Loss or sagging skin. This is where another program, Dermal Fillers, comes in, which we will delve into next.
Delving into: Dermal Fillers (Fillers)... The Expert in "Deep Wrinkles," Volume Restoration, and Facial Contouring!
Now that we've learned about Botulinum Toxin, the expert in wrinkles from facial expressions, let's explore another program that plays a crucial role in wrinkle reduction and restoring youthfulness: Dermal Fillers, or simply "Filler".
Dermal Fillers are like "sculptors" that help "mold" and "fill" missing areas on the face quickly and precisely.
What are Dermal Fillers? "Dermal fillers... restore volume to the skin"
Dermal Fillers are a group of safe "filling substances" that are well-compatible with body tissues. When injected into various depths of the skin, these substances "add volume" or "fill gaps" in the desired areas.
Currently, Dermal Fillers come in various types, depending on the main substance used, such as Hyaluronic Acid (HA), Calcium Hydroxylapatite (CaHA), Poly-L-Lactic Acid (PLLA), or Polymethylmethacrylate (PMMA). However, the most popular and widely used type today is Filler with Hyaluronic Acid (HA) as the main ingredient. This is because it is highly safe, well-compatible with the body, and most importantly, it can naturally degrade on its own, and there are enzymes that can be injected to dissolve it if the results are unsatisfactory (in this article, I will focus primarily on HA Filler).
How do Dermal Fillers work?
The mechanism of action of Dermal Fillers, especially HA Filler, is quite straightforward. The Filler, which is a gel or liquid, will replace tissue in the area where it is injected, or add volume to the desired area.
Filling and Supporting: When injected into the desired skin layer (which can be the dermis or subcutaneous layer, depending on the problem and area), the Filler will fill the gaps caused by the breakdown of collagen, elastin, or subcutaneous fat. This makes the overlying skin, which had previously collapsed, appear shallower. The Filler also acts like a temporary "support base" or "scaffold," helping to support the skin structure from below.
Water-holding property of HA: Specifically for HA Filler, HA has a special property of absorbing and holding a large amount of water. When injected into the skin, HA draws water from surrounding areas, making the injected area appear plump, moisturized, and radiant (in addition to the direct volume-filling effect).
Variety of HA Fillers: Choose to suit the problem!
HA Filler is not just one type. Manufacturers have developed HA Fillers with different properties to suit different problems and depths of correction. This difference comes from the level of cross-linking or the bonding of HA molecules.
HA Filler with low cross-linking (small molecules, low viscosity): Often used for shallow wrinkle reduction all over the face (e.g., small wrinkles not caused by facial expressions), skin hydration (Skinbooster).
HA Filler with medium cross-linking (medium molecules, medium viscosity): Often used for filling moderate deep grooves, such as nasolabial folds and marionette lines.
HA Filler with high cross-linking (large molecules, high viscosity): Often used for filling large volumes in areas that require a lot of volume or for facial contouring, such as filling sunken cheeks, temples, chin augmentation, or jawline adjustment.
The choice of HA Filler type and viscosity requires assessment of the problem and facial structure by an experienced doctor only.
Various Brands of Dermal Fillers... Choose to suit the problem and area!
When it comes to Dermal Fillers with Hyaluronic Acid as the main ingredient, there are various brands and models available in the current market. Although they all share HA as the main active ingredient, differences in manufacturing technology, molecular cross-linking, particle size, or HA concentration result in each filler model and brand having different properties, including viscosity and elasticity. This means some fillers are suitable for filling areas that require high stability (such as the chin, cheeks), some are suitable for filling deep grooves (such as nasolabial folds), and some are suitable for filling areas that require high flexibility and smooth integration with the skin (such as under the eyes, lips). The water-holding capacity of some models may focus more on providing hydration and glowing skin than on adding volume. The duration of results depends on the level of cross-linking and other properties of the filler.
Well-known and widely used HA Dermal Filler brands worldwide, including in Thailand:
Juvéderm® (USA)
A highly popular brand with various models that use different manufacturing technologies to achieve diverse filler properties, suitable for use in many areas.
Restylane® (Sweden)
Another long-established and reputable brand with various models that use unique manufacturing technologies to create fillers suitable for addressing different problems.
Belotero® (Switzerland)
Stands out for its smooth, fine gel texture that blends well with the skin. It is suitable for correcting shallow wrinkles or areas requiring high smoothness, such as under the eyes and lips.
Revolax® (Korea/UK)
A brand that is steadily gaining popularity, with various models to choose from.
Neuramis® (Korea)
Another popular Korean filler brand used in Thailand, with various models suitable for addressing different problems.
Definisse™ (Italy)
A popular HA Filler brand in many countries. Its strengths include specific manufacturing technologies (such as XTR™ Technology) that emphasize high filler elasticity, ease of molding, and smooth integration with the skin, providing natural-looking and stable results for wrinkle correction, deep groove filling, and facial contouring.
Neauvia® (Switzerland/Italy)
A filler brand with interesting innovations. Neauvia has various models with different properties, with a key highlight being the use of Smart Crosslinking Technology, which helps the filler have high flexibility and integration with skin cells, giving very natural results and reducing the risk of lumpiness. It is also suitable for a wide range of uses, from enhancing skin quality to filling deep grooves and contouring the face.
The selection of the specific HA Filler brand and model requires the doctor's expertise to consider the problem, the injection area, the desired results, and the individual's skin condition. At Entrio Clinic, Ratchaprasong Aesthetic Clinic, Dr. Nono and the medical team will carefully evaluate and select the most suitable filler for each patient.
Dermal Fillers Program: The Expert in Managing "Deep Wrinkles," Volume Restoration, and Facial Contouring
Based on its mechanism of adding volume and supporting the skin structure, Dermal Fillers are highly effective for managing Static Wrinkles, deep grooves, and addressing volume loss on the face. Popular areas for treatment with clear results include:
Nasolabial Folds (Laugh Lines): These are lines that extend from the sides of the nose down to the corners of the mouth. They are often caused by the loss of fat and collagen in the mid-face. Injecting Filler helps to fill these grooves, making the face look smoother and younger.
Marionette Lines: These are lines that extend downwards from the corners of the mouth, giving a sad or downturned appearance. Filler can fill these lines, improving the expression and making the face look more uplifted.
Tear Troughs / Under-eye Hollowness: The area under the eyes can become hollow and dark due to bone loss and fat loss, making one look tired. Injecting a suitable Filler can fill this hollowness, making the under-eye area look fuller and brighter.
Sunken Temples: As we age, the temples can lose volume, making the face appear narrower at the top and the cheekbones more prominent, giving a "peanut-shaped" face. Filler can be injected to fill the temples, restoring facial harmony.
Cheek Augmentation (Sunken Cheeks / Midface Volume Loss): Loss of fat and bone in the mid-cheek area can lead to sagging skin and a tired appearance. Filler can be used to restore volume to the cheeks, lifting the face and making it look plumper and more youthful.
Chin Augmentation: For individuals with a recessed or small chin, Filler can be injected to enhance the chin projection, making the face look more balanced and defined (Chin Filler Program).
Lip Augmentation: Filler can be used to add volume to the lips, redefine the lip borders, or create a more balanced lip shape, making them look fuller, more attractive, and moisturized (Lip Filler Program).
Jawline Definition: Filler can be injected along the jawline to enhance its definition and create a sharper, more contoured look.
Small Wrinkles all over the face (Crepey Skin): For small wrinkles that are not caused by muscle movement but by skin lacking moisture and collagen, a softer Filler (often called Skinbooster) can be injected superficially to hydrate the skin and improve its texture, making it smoother and more radiant.
The Dermal Fillers Procedure at Entrio Clinic Ratchaprasong: Precise, Artistic, Natural!
Dermal Filler injection is an art that requires both medical knowledge and artistic skill. At Entrio Clinic, Ratchaprasong Aesthetic Clinic, Dr. Nono and the medical team emphasize precision in every step to achieve natural-looking and beautiful results.
Consultation and Evaluation by the Doctor: This is the most crucial step! The doctor (Dr. Nono or the Entrio Clinic medical team) will assess your facial structure, analyze the cause of your wrinkles or volume loss, discuss your expectations, and plan the treatment, determining the appropriate type and amount of Filler, as well as the injection sites, to achieve the most natural and balanced results for your face.
Skin Cleansing and Anesthesia: The skin in the injection area will be thoroughly cleaned. A topical anesthetic cream will be applied to the area for about 30-45 minutes to minimize discomfort during the injection.
Injection: The doctor will use a fine needle or a blunt-tipped cannula to inject the Filler into the target skin layer. The choice of needle or cannula depends on the area and the type of Filler to reduce the risk of bruising and swelling. During the injection, the doctor will constantly observe the facial balance and make adjustments to achieve the desired results.
Post-Treatment Care: After the injection, there may be slight swelling, redness, or bruising at the injection sites, which will subside within a few days. You should avoid pressing or massaging the injected area and avoid intense exercise or exposure to extreme heat for the first few days.
Expected Results and Duration
Onset of Results: The results from Dermal Filler injections are visible immediately after the injection. The injected area will appear fuller and smoother.
Duration: The duration of results varies depending on the type of Filler, the injected area, the amount used, and individual metabolism.
HA Fillers generally last for approximately 6-18 months.
Other types of Fillers (e.g., CaHA, PLLA) may last longer. When the Filler gradually degrades, the volume will decrease, and wrinkles will reappear. If you wish to maintain the results, you should return for re-injection as advised by your doctor.
The Importance of Choosing Quality Dermal Fillers and an Experienced Doctor at Entrio Clinic
For Dermal Filler injections, the quality of the product and the doctor's expertise are paramount.
Product Quality: You should choose genuine, standardized Dermal Fillers approved by the FDA and verifiable, for maximum safety and confidence in the effectiveness and duration of the results. At Entrio Clinic Ratchaprasong Aesthetic Clinic, we use carefully selected quality Fillers and are ready for patients to verify them.
Doctor's Experience and Expertise: Dermal Filler injection is an art that requires an in-depth understanding of facial anatomy, facial analysis, artistic vision, and precise injection techniques. An experienced doctor can identify the root cause of the problem, choose the right type and amount of Filler, and inject it at the correct depth and position to achieve natural-looking, balanced, and harmonious results with the overall facial structure, without looking unnatural or overfilled. At Entrio Clinic, you can be confident in the doctor's experience and meticulousness.
Who is suitable for Dermal Fillers Program at Entrio Clinic?
The Dermal Fillers Program is ideal for:
Individuals with deep static wrinkles that are always present, such as nasolabial folds, marionette lines, or tear troughs.
Those who experience volume loss on their face due to aging, leading to hollowness in areas like the cheeks, temples, or under the eyes.
Those who want to contour their face and enhance specific features, such as chin augmentation, lip augmentation, or jawline definition.
Those who want to improve the skin texture and hydration (with Skinbooster type fillers).
Those who want a program that provides immediate results and can restore youthfulness and facial fullness.
Botulinum Toxin vs Dermal Fillers: A Clear Comparison Table! Know Before You Go... Choose the Right Wrinkle Reduction Program!
Here's a detailed comparison to help you understand the key differences between Botulinum Toxin and Dermal Fillers:
Feature | Botulinum Toxin (Botox) | Dermal Fillers (Filler) |
Main Action | Relaxes specific muscles to reduce muscle contraction. | Adds volume to fill hollow areas and support skin structure. |
Primary Target | Dynamic Wrinkles (Wrinkles from facial expressions) | Static Wrinkles (Deep grooves, folds), Volume Loss |
How it Works | Blocks nerve signals to muscles, causing temporary relaxation. | Physically fills space under the skin; some types also hydrate. |
Main Use Cases | - Forehead lines | - Nasolabial folds (laugh lines) |
- Frown lines (between eyebrows) | - Marionette lines | |
- Crow's feet | - Tear troughs / under-eye hollowness | |
- Bunny lines | - Sunken temples | |
- Chin wrinkles (peau d'orange chin) | - Cheek augmentation (midface volume loss) | |
- Jawline slimming (masseter reduction) | - Chin augmentation | |
- Neck bands (Platysmal bands) | - Lip augmentation | |
- Gummy smile correction | - Jawline definition | |
- Excessive sweating (hyperhidrosis) | - Fine lines from volume loss / skin dryness (e.g., Skinbooster) | |
Onset of Results | Gradual (3-7 days, full effect in ~2 weeks) | Immediate |
Duration of Results | Approximately 3-6 months | Approximately 6-18 months (varies by type and area) |
Composition | Purified protein (Botulinum toxin Type A) | Various substances, most commonly Hyaluronic Acid (HA) |
Reversibility (for HA) | Not directly reversible (wears off naturally) | Can be dissolved with an enzyme (Hyaluronidase) if HA Filler is used |
Texture/Feel | No change to skin texture, just muscle relaxation. | Adds volume and can feel like a soft gel under the skin. |
Primary Goal | Reduce muscle-induced wrinkles, prevent deepening, facial contouring. | Restore lost volume, fill deep grooves, enhance facial features. |
Side Effects | Temporary bruising, swelling, mild headache, temporary asymmetry. | Temporary bruising, swelling, redness, tenderness, lumpiness (rare). |
Best for | Dynamic expressions, preventative treatment, muscle-related concerns. | Static wrinkles, volume loss, facial shaping, skin hydration. |
Can be used with | Dermal Fillers for comprehensive anti-aging results (Combination Therapy). | Botulinum Toxin for comprehensive anti-aging results (Combination Therapy). |
It's not about "choosing one"... but about "using them together" for perfect results! (Combination Therapy)
Now that we've delved into the distinct properties of both programs, the final crucial question, and the core of modern aesthetic medicine, is... should we "choose" to do only the Botulinum Toxin Program or the Dermal Fillers Program? Dr. Nono of Entrio Clinic, Ratchaprasong Aesthetic Clinic, says the answer is "Not always!"
In reality, for most patients who clearly show signs of aging and are concerned about complex skin problems, the treatment that yields the best, most natural-looking, and comprehensive results often comes from "using these programs together," which we call Combination Therapy!
Why is Combination Therapy the "Key to Perfect Results"?
As we understood in the previous section, wrinkles and signs of aging on the face are not caused by a single factor. Dynamic Wrinkles arise from muscle movement, while Static Wrinkles and Volume Loss stem from the deterioration of skin structure and tissue breakdown.
Botulinum Toxin excels at managing Dynamic Wrinkles and muscle-related concerns.
Dermal Fillers excel at managing Static Wrinkles and Volume Loss.
When your skin problems involve both types (which is common as we age), choosing only one program is like solving only half the problem. For example:
If you have both forehead lines when raising your eyebrows (Dynamic) and prominent nasolabial folds that are always visible (Static), injecting Botulinum Toxin alone will improve your forehead lines, but your nasolabial folds will remain. Injecting Dermal Fillers alone will fill your nasolabial folds, but your forehead lines will still appear when you make expressions.
This is where Combination Therapy plays a crucial role! Using both Botulinum Toxin and Dermal Fillers together allows us to address both the "root cause" and the "symptoms" of wrinkles comprehensively.
How do Biostimulators enhance the role in Combination Therapy?
In addition to Botulinum Toxin and Dermal Fillers, in the previous article, we also learned about the Biostimulator group, which are collagen-stimulating substances that play a role in skin rejuvenation and new collagen creation from within. At Entrio Clinic, we often integrate Biostimulators into our Combination Therapy plans to achieve more natural, long-lasting, and complete wrinkle reduction and skin rejuvenation results.
Examples of Combination Therapy at Entrio Clinic
Planning Combination Therapy requires a detailed assessment by an experienced doctor. The doctor will consider which programs to use, in what quantities, injected in which areas, and at what depths, to achieve the desired results and the most natural look.
Comprehensive Facial Wrinkle Correction
Botulinum Toxin Program
Manages expression lines (forehead, frown lines, crow's feet) to reduce their appearance and prevent them from deepening.
Dermal Fillers Program
Fills deep grooves (nasolabial folds, marionette lines, under-eyes), restores lost volume (hollow cheeks, sunken temples), and contours the face.
Biostimulator Program (e.g., Sculptra, Radiesse)
Stimulates collagen production throughout the face to restore skin structure, increase firmness, and provide natural-looking volume in the long term.
Sculptra
Facial Lifting and Jawline Contouring
Ulthera Prime Lifting Device Program (Ulthera Prime, Oligio, Morpheus8)
Uses energy to lift and tighten skin at deeper layers (including the SMAS layer for Ulthera Prime) and stimulate collagen production.
Botulinum Toxin Program
Uses Nefertiti Lift technique to help lift and tighten the jawline and neck, or reduce jaw muscle size (if problematic).
Dermal Fillers Program
Uses suitable Filler types to sharpen the jawline or fill in missing volume to enhance structure.
Biostimulator Program (e.g., Radiesse)
Uses Vector Lifting technique to help lift the face and stimulate collagen to strengthen the skin.
Skin Quality Restoration and Problem Reduction
Morpheus8 Morpheus8
Morpheus8 Program (Fractional RF Microneedling)
Resurfaces skin, reduces pores, acne scars, and fine lines while tightening the skin.
Profhilo or Definisse Hydrobooster (Skinbooster/Hybrid Filler)
Increases hydration, brightens skin, and provides minor collagen stimulation.
Juvelook Program
Addresses concerns like pores, acne scars, fine lines under the eyes, and stimulates collagen.
May be used in conjunction with Botulinum Toxin Program for expression lines or Filler for prominent deep grooves/volume loss.
Combination Therapy at Entrio Clinic: "Not just doing many things... but smart planning!"
From the perspective of Dr. Nono and the medical team at Entrio Clinic, Ratchaprasong Aesthetic Clinic, Combination Therapy is not just about combining various programs arbitrarily. It is an art and a science that requires:
Holistic Problem Assessment We will evaluate your entire face, including various types of wrinkles, volume loss, sagging, skin quality, and overall facial structure, to truly identify the causes and factors affecting your concerns
Deep Understanding of Each Program's Mechanism and Properties The doctor must deeply understand how each program (whether it's Botulinum Toxin, different brands/models of Dermal Fillers, various types of Biostimulators, or different devices) works, its advantages, limitations, what problems it's suitable for, and how they will work together to achieve the best results.
Personalized Treatment Plan Design We will combine all the information to design a Combination Therapy treatment plan that is "specifically tailored for you." This includes the sequence of programs (what should be done first/last), appropriate quantities, injection areas, injection techniques, and treatment duration (can be done in one session or gradually over multiple sessions).
Focus on "Perfect" and "Natural" Results Our goal is to comprehensively address your concerns, making your face look naturally younger, without appearing stiff or overfilled. The results should harmonize with your overall facial features and genuinely boost your confidence.
Care by Experienced Doctors Combination Therapy particularly requires a high level of experience and expertise from the doctor. This ensures that the entire planning and procedure are safe and yield predictable results. At Entrio Clinic, you can be confident in the doctor's experience and meticulousness.
"Use Them Together" for Perfect Results... at Entrio Clinic Ratchaprasong
If you have complex skin problems and desire complete wrinkle reduction and youthful rejuvenation, considering Combination Therapy is an excellent option. You don't have to be confused about "choosing one or the other" because you can "use them together" for the best results!
Come consult with an experienced doctor at Entrio Clinic, Ratchaprasong Aesthetic Clinic. The doctor will assess your problems on a case-by-case basis and design a Combination Therapy treatment plan specifically for you, so you can have a more youthful-looking face, solve problems precisely, and achieve beautiful, natural, and perfect results as you desire!
Know before you go... make the right decision! Start by consulting with an experienced doctor at Entrio Clinic Ratchaprasong to find the right wrinkle reduction program and facial contouring program for you!
Entrio Clinic - Refined Aesthetic Experience "We believe that true beauty comes from good skin health and an understanding of science."
"We believe that true beauty comes from good skin health and an understanding of science."
📍 Location: https://maps.app.goo.gl/X9WpN51pnK5otKip8
4th Floor, Erawan Bangkok Building (next to Grand Hyatt Erawan Bangkok), Ratchaprasong Intersection (behind the Erawan Shrine), Bangkok.
💬 Line: @entrioclinic or click bit.ly/EntrioLine
📞 Tel: 097-154-2222
🌐 Website: entrioclinic.com
💻 Facebook: facebook.com/EntrioClinic
📷 Instagram: entrioclinic or click instagram.com/entrioclinic
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