Dr. Elizabeth Roche explains why younger patients are using preventative Botox, also called baby Botox or neuromodulators, to soften dynamic expression lines before they become resting wrinkles. She discusses how small doses can preserve natural facial movement, when fillers may be needed for deeper etched lines, and why expertise matters for safe treatment.
Preventative Botox and Neuromodulators Explained
John Maher: Hi, I’m John Maher. I’m here today with Dr. Elizabeth Roche, founder of the Elizabeth Roche MD MedSpa in Bergen County, New Jersey, a medical aesthetics center committed to providing people with the most advanced procedures available to restore youth while preserving the beauty and functional health of your skin. Today, our topic is preventative Botox, how small doses can make a big difference. Welcome, Dr. Roche.
Dr. Elizabeth Roche: Thank you, John. Today I’ll be talking about how preventative Botox early on can really make a big difference in long-term appearance and holding onto that youthful appearance. I’ll be using the term Botox, but I interchange that with neuromodulators, which is the medical term, and neuromodulators also include Dysport, Jeuveau, Xeomin, Daxxify. So I’ll go back and forth with those terms.
Botox Trends and the Rise of Prejuvenation
John: Okay. So tell me a little bit about what trends you’ve seen over the past 23 years of injecting Botox.
Dr. Roche: Yeah. 23 years of injecting Botox, you see a lot of changes. So what I see now are patients who are much more educated and looking for ways to prevent the aging process instead of waiting for the aging process to occur and asking for ways to correct that. So my patients are also a little bit younger too. They tend to be in their 30s or even 20s and they come in specifically asking for preventative measures.
One of those treatments is doing small doses of Botox or neuromodulators early on. This is also called baby Botox, and the trend is prejuvenation, and I think it’s a trend that’s going to be here to stay for a while. In the past, I would have patients who would wait until these lines have become etched in the skin, lines that are now present at rest and it takes a little more than just Botox to correct those lines.
Dynamic Facial Lines vs. Static Wrinkles
John: So tell me a little bit more about those lines etched in the skin, like you said, and what are the different types of lines that you might have on your face and in your skin?
Dr. Roche: So lines that are present just with normal facial movements are called dynamic facial lines. They occur when we raise our eyebrows, when we’re surprised, or furrow our brows or squint. And these little lines happen because the muscle folds the skin over. Over time, over decades of doing that, if the skin gets folded and folded and folded, these lines now become present even at rest. So they’re resting wrinkles or lines that are etched in the skin. It’s similar to, let’s say, a leather shoe that’s been folded over and even when the foot’s not in the shoe, you still have that line across the top.
So in order to prevent these dynamic facial expression lines from becoming static wrinkles, we do small doses of neuromodulator such as the baby Botox and that will help weaken the muscle ever so slightly. You still preserve the ability to make facial expressions, but you’re doing a preventive measure so that you don’t have to do more treatments in the future to correct deeper lines.
Treatments for Resting Wrinkles
John: So if someone already does, though, have resting wrinkles, are there any treatments that can help with that and that can help kind of roll back time a little bit?
Dr. Roche: Yes. If patients have resting wrinkles, there are treatments that can help with that. So it’s a two-step process. The first step is to have Botox injected, the typical dose of Botox or another neuromodulator. I wait two weeks until that’s fully in effect and I have the patient come back for the second step. I assess the line that’s present at rest and depending on how superficial or how deep it is, that determines the amount or type of dermal filler that I will use to fill that line in.
Choosing the Right Dermal Filler Safely
John: How do you know what dermal filler to use?
Dr. Roche: So dermal fillers are…there’s a large variety of them. Some are thicker, some are thinner. And I look at the patient’s line. If it’s a little superficial hairline, I’ll use one of those thinner dermal fillers. If the line is more of a deeper wrinkle, then I’ll use something a little more robust.
What’s very important though is knowing the anatomy of especially the lines in between the eyebrows, these “11” lines. If you have deep resting lines there and you’re seeking to have dermal filler put in there, I caution you to go to somebody who has years of experience and anatomy knowledge of this area, because it’s a very technical area and, if not done properly, can lead to dangerous complications.
But this is something I’ve been doing for many, many years and I have many happy patients. The patients who said, “Botox doesn’t help. I’m not getting rid of my lines.” And it’s not that the lines were those facial expression lines, they were lines that were present at rest and that’s why the Botox didn’t work alone. They needed a second step and they needed something to lift up that wrinkle, that deep wrinkle and that’s where dermal fillers come in.
Small-Dose Botox for Long-Term Prevention
John: So can you summarize this for us and talk about how these smaller doses of Botox early on help later on?
Dr. Roche: If you’re seeking preventative measures of how to prevent lines from becoming deep lines later on in life, then small doses of baby Botox or preventative Botox or neuromodulators may be the answer for you. If you’re interested in learning more about this or if you have those deeper static lines that you’re interested in having dermal filler [injected for], I recommend that you call our office for a consultation at 201-505-1020 or go on our website at elizabethrochemedspa.com and you can book an online appointment right then and there.
John: All right. Well, that’s great information, Dr. Roche. Thank you again for speaking with me today.
Dr. Roche: Thank you, John.