American Academy of Facial Plastic and Reconstructive Surgery
American Academy of Facial Plastic and Reconstructive Surgery

I am 35 years old and have a lot of facial wrinkles.

Question: Would Botox be a good alternative to a facelift?

Answer: Yes, absolutely.  Botox, or neurotoxin, is the preferred method to manage facial wrinkles of the upper face.  Facelifts really do not offer any benefit to wrinkles since a facelift is used to lift and suspend sagging of underlying facial muscles.  With repeated injections of Botox, the facial muscles of the upper face start to relax, and the skin begins to heal.  Long-term neurotoxins are so powerful in terms of their ability to help you with helping skin have better texture, tone, and fewer wrinkles.  Early-on consistency is the key so that over time you need less Botox.  The earlier you start the better.  If you wait until wrinkles get very deep, it takes longer to heal the skin.

I’ve been looking into wrinkle treatments.

Question: Which is the best injectable for facial wrinkles?

Answer: The problem with this question is to divide wrinkles into static (non-moving) and dynamic (moving) wrinkles.  Another way to categorize wrinkles is to focus on upper versus lower facial wrinkles.  The upper face tends to have more dynamic wrinkles and the lower face tends to have more static wrinkles like the smile lines between the nose and the sides of the mouth.  For dynamic wrinkles, neurotoxins (like Botox) are truly the preferred way to address them in many cases since the neurotoxin helps to target the cause (movement) rather than the effect. By blocking bad habits like frowning, over time the skin will heal and the wrinkles start to diminish.  When the wrinkle gets very deep and you are impatient for the neurotoxin to work, then additional fillers may help but with the thin skin of the upper face, fillers may not be the ideal way to go.  With the lower face, neurotoxins carry the risk of speech problems if done in the wrong areas so in general lower facial folds and larger wrinkles are better candidates for injectable fillers.  Which filler is best?  That all depends on a conversation with your treating surgeon.  Why he would prefer one filler over another based on ability to fill a certain wrinkle characteristic, longevity, permanence, ease of correction if there is a problem with the filler, etc.  He would be better to counsel you on your specific type of wrinkle and his experience level with treating that wrinkle with a certain type of filler.