Wrinkle Smoothers and Fillers: A Quick Rundown from Dr. Amy Wechsler

Wondering what injectable muscle relaxers, like Botox, and the various kinds of wrinkle fillers can do for you? If you're considering a facelift, these products may make it postponable, if not completely unnecessary. And fillers can vastly improve the appearance of scars left by acne or injury, too. There's a menu of safe choices -- natural and synthetic, semipermanent and permanent -- and new injectable materials are coming on the market every year. Want to know more? Check Dr. Amy's book, The Mind-Beauty Connection.

Muscle Relaxers/Wrinkle Smoothers

Botox completely dominates the market on these treatments.

How They Work: Paralyze tiny muscles to stop the expressive movements that etch-in frown lines and brow furrows to begin with.

What Gets Injected: Botulinum toxin.

Brand Names: Botox, Reloxin.

Cost: About $400 per area, but prices may vary considerably in different parts of the country.

Lasting Power: 3 to 6 months; less and less needed over time to maintain smoothing effect.

Extra Tips: Headache may follow injection; take aspirin or another NSAID for relief. To maintain smooth appearance, have follow-up injection before benefit disappears.

Wrinkle Fillers

Several are available, and new ones are appearing every year.

How They Work: They plump up and smooth out deep folds and creases, and they can also dramatically improve scars left by acne or injuries.

Which wrinkle filler is used, and how often it has to be renewed, depends on the location of the fold, groove, or crinkle that bothers you; the effect you want; and the depth of your pockets, since fillers don't come cheap. Doctors almost always make this decision -- you're paying for their expertise, artistry, and skill, after all -- but it's smart to know in advance what you're getting into. Three varieties of wrinkle-filling injections are listed below.

1. Hyaluronic Acid

Brand Names: Restylane, Perlane, Hylaform, Hylaform Plus, Juvederm Ultra, Juvederm Ultra Plus, Elevess.

Cost: $500–$850 per syringe, depending on city.

Lasting Power: Typically lasts up to 6 months.

Extra Tips: Try to avoid aspirin, NSAIDs, ginkgo, vitamin E, or any other blood thinner for 2 weeks prior to injection. Swelling and bruising is unpredictable, so avoid injections within the week of a major event.

2. Collagen

Brand Names: Captique, Zyderm, Zyplast, CosmoDerm, CosmoPlast, Fascian, Cymetra.

Cost: $400+ per syringe.

Lasting Power: From 2 weeks to 6 months.

Extra Tips: To minimize swelling and bruising, apply ice to area immediately after injection; repeat every 5–10 minutes, as needed, for 24 hours. To prevent bumps, massage filled areas for a few minutes several times a day for 24 hours.

3. Synthetic Fillers

Brand Names: Radiesse, Sculptra, ArteFill.

Cost: $850+ per syringe.

Lasting Power: Radiesse, a year or more; Sculptra may last up to 2 years; ArteFill is permanent.

Extra Tips: Sculptra lasts longer than other fillers, but filling results may not be apparent for 10–12 weeks. Permanent fillers are extremely difficult to remove.