Vancouver, British Columbia - Alastair and Jean Carruthers, M.D., pioneers in the use of Botox in cosmetic procedures, are once again championing a technique involving Botox used adjunctively with other therapies to rejuvenate aging faces.
"Using Botox in conjunction with other treatment modalities is currently the gold standard," according to Dr. Alastair Carruthers, who, with his wife, Dr. Jean Carruthers, heads a private practice here. He is also clinical professor of dermatology, University of British Columbia.
Dr. Carruthers notes that in the glabella area, the addition of a filler such as Restylane to the previously administered Botox will dramatically improve patient satisfaction as well as prolong the duration of the effect.
"Conversely but similarly, the use of Botox around the mouth can significantly improve the appearance of the result of fillers, and will also increase duration of the effect," he says.
Evidence of effectiveness As evidence of the effectiveness of Botox/Restylane combination therapies, Dr. Carruthers cited a test study he and his wife performed involving 38 of their respective patients. The objective of the test study was to determine whether a Botox/Restylane combination approach produced better results than when Restylane was used alone. The study protocol comprised 38 patients, randomized to treatment with Restylane alone or to the Botox/Restylane combination. Patients in the combined group were injected with 30U of Botox, than a week later injected with Restylane. The Restylane group was injected only with Restylane. Patients in both groups displayed moderate to severe facial problems pre-treatment.
According to Dr. Carruthers, among the more significant findings of the 32-week study were the following:
Enhanced, prolonged effects Dr. Carruthers adds that while fillers are the mainstay of treatment in the perioral area, including lips, marionette lines and the chin, Botox can enhance and prolong effects of fillers when used adjunctively.
"The bottom line is that Botox and fillers work well together and the combination approach can be done almost as quickly and easily as using one or the other modality," Dr. Carruthers says. "In most cases, both Botox and the filler can be injected during the same treatment session, though there may be situations where it is preferable to get the Botox effect prior to filler injection."