Cosmetic Injectables

Lines, wrinkles, areas of volume loss — if you’re over 40 you’re sure to have them. Blame declining collagen production as we age. Blame thinning skin. Blame hundreds of thousands of muscle contractions. Blame the endless El Paso sun. 

But you don’t have to take those signs of aging and not fight back. At Cosmetic Surgery & Laser Centers of El Paso we offer a variety of injectables — neuromodulators like Botox®, dermal fillers like Juvéderm® and Belotero®, even specialized injectables like Kybella®. They’ll erase your wrinkles and return volume to areas such as the cheeks. Kybella® can even get rid of your double chin!

What are injectables?

Injectables are comprised of both what are called neuromodulators (Botox® and other brands) and dermal fillers (Juvéderm®, Belotero® Balance, and others). These products are injected either beneath an existing wrinkle or crease and they “fill” in the depression, or they are injected to stop a muscle from contracting and forming a wrinkle on the surface above. Kybella® is also an injectable but is intended solely for reducing fat in what is colloquially known as the double chin. 

Injecting substances under wrinkles to push them back up has been tried for a long time, most notably the reinjection of a person’s own fat. But results were unreliable. Everything changed in 2002. That was the year the FDA approved Botox® for the treatment of facial wrinkles on the upper third of the face. Botox® was the first neuromodulator and remains the world’s most popular cosmetic procedure year in and year out. The first dermal filler, Restylane®, was approved by the FDA in 2005. Juvéderm followed in 2006. Since then, many different injectables have come to the market.

What are the different types of cosmetic injectables in El Paso, TX?

Some of El Paso patients clump injectables together, but there are two completely different groups: neuromodulators and dermal fillers, plus Kybella. Here’s how they differ from each other:


The most well-known injectable the world over is a neuromodulator, Botox®. Neuromodulators consist of the botulinum toxin type A, along with some additional proteins. The botulinum toxin is the same bacteria that can cause botulism, but they are also found throughout the natural world. The fact that these bacteria cause botulism seems scary, but it’s not. Way back in the 1950s, scientists discovered that when minuscule amounts of the toxin were injected into a muscle the muscle stopped contracting for a period of time. Botox was a direct result of this research.

Once injected, neuromodulators work by blocking the nerve messenger, acetylcholine, from transmitting messages from the muscles to the brain. The brain never receives the message to contract the muscle, so the muscle remains relaxed. This obviously had immediate implications for health issues involving involuntary muscle spasms. In fact, that was the first FDA approval for the use of Botox® in 1996 — to treat involuntary eyelid spasms, a condition known as blepharospasm.

But it was 2002 when Botox® became a rock star of the aesthetic world. That was the year the FDA approved Botox® for cosmetic use to erase frown lines and forehead lines on the upper third of the face. (Approval to treat crow’s feet was added in 2011, although Botox® had long been used off label for that.) Every year since 2002, Botox® injections have been the world’s most popular cosmetic procedure, surgical and non-surgical, across the globe.

Botox® works its magic on what are known as “dynamic” wrinkles. These are wrinkles that form when we make expressions such as frowning, showing surprise, or squinting. Go head, form a frown. You can feel the muscles engage around the eyes, between the brows, and on the forehead. Over time and hundreds of thousands of muscle contractions, wrinkles begin to form on the skin above those contracting muscles. These are crow’s feet at the outside of our eyes, glabellar/frown lines between the brows, and forehead lines. When Botox® is injected into these muscles, the muscles remain at rest so the wrinkles that form on the surface don’t form.

Dermal fillers

Dermal fillers are the other category of injectables. True to their name, dermal fillers are injected beneath a wrinkle or crease and they add instant volume, pushing the skin back up and erasing the wrinkle. They can also instantly return volume to areas that have flattened, such as the cheeks, the lips, and the backs of the hands.

Dermal fillers are categorized as “natural” or “synthetic.” Natural fillers, such as the entire Juvéderm® line, are made from hyaluronic acid, a naturally occurring substance in the human body responsible for hydrating, plumping, and firming the skin. Hyaluronic acid does this by binding with nearby water molecules. Belotero® Balance is another hyaluronic acid filler we offer at Cosmetic Surgery & Laser Centers of El Paso.

Synthetic fillers use manmade ingredients, such as calcium microspheres, to add volume and encourage new collagen production. Bellafill® is a synthetic filler.

Dermal fillers only work on what are known as “static” wrinkles. These are wrinkles caused by sun damage, declining collagen production, personal habits such as smoking, and other factors. Static wrinkles show themselves at all times; they have nothing to do with muscle contractions.

Neuromodulators only work on dynamic wrinkles on the upper third of the face. Dermal fillers only work on static wrinkles on the mid to lower face.

At Cosmetic Surgery & Laser Centers of El Paso, we offer the neuromodulator Botox®, and the complete line of Juvederm® fillers (Juvederm, Ultra, Volbella, Vollure, and Voluma). We also offer Belotero® Balance and Bellafill®.


Kybella® is a wild card in the injectable world. It is used only to address the double chin, clinically known as submental fullness. It is an injectable, technically, but it is completely different than a neuromodulator or a filler. Kybella® is essentially made from deoxycholic acid, which occurs naturally in the body. The job of deoxycholic acid in the body is to aid in the breakdown and absorption of dietary fat.

Deoxycholic acid doesn’t discriminate between dietary fat you eat and the existing fat that accumulates under our chin in the jowls. So, when Kybella® is injected into the jowls, it immediately attacks and breaks down the fat it encounters. Over the next few weeks, the body removes the destroyed fat cells, and this reduces the jowls. Kybella® dramatically slims the profile.

Kybella® is only approved for use in treating double chins.

Would I be right for Botox or a dermal filler?

As mentioned above, Botox® and other neuromodulators only work on wrinkles formed by muscle contractions under the skin when we make various facial expressions. These occur on the upper third of the face. That’s where Botox® works its magic: on crow’s feet at the outside of the eyes, on frown lines between the eyebrows, and on forehead wrinkles. If these are the areas you seek to treat, Botox® is your answer.

However, if your wrinkles are due to declining collagen production, to sun damage, to personal habits such as smoking, and other environmental issues, these are “static” wrinkles. They show themselves at all times, and Botox® has no effect on them because they aren’t caused by muscle contractions. These wrinkles are common around the lower face and mouth areas: smile lines from the nose down to the corners of the mouth, marionette lines from the corners of the mouth downward, parentheses lines framing each side of the mouth, and barcode lines above the lips. All of these areas need dermal fillers to fill in the depressed areas forming the creases. Dermal fillers are also used on the lips, to add volume to the cheeks, and to hide the tendons and blood vessels on the backs of aging hands.

How soon will I see my results from cosmetic injectables in El Paso, TX?

Dermal fillers provide instant results. As soon as they are injected the hyaluronic acid binds with nearby water molecules and plumps the skin, erasing the wrinkle or returning volume. Long-lasting Bellafill® doesn’t provide immediate results in the same way. It contains calcium microspheres that slowly are broken down by the body. This creates a reaction where the body produces new collagen, and this process takes a couple of weeks to fully start, and it can last up to five years.

Botox® doesn’t provide instant results. Once injected, it takes about four days for the botulinum toxin in Botox® to stop the injected muscles from contracting. Without the contractions, the surface wrinkles are erased.

How long do Botox results last?

Botox erases crow’s feet, the 11s, and forehead lines for from 4 to 6 months. At that point, the body will absorb the now-inert botulinum toxin and the muscles will begin contracting again. Another Botox® session with Dr. Jabar or Dr. Reynolds will maintain your results.

How long do dermal fillers last?

Juvéderm® fillers last typically from 9-12 months, although Ultra Plus lasts about 15 months and Voluma lasts up to two years returning volume to sunken cheeks. Bellafill® is the longest lasting filler, correcting nasolabial folds and facial acne scarring for up to 5 years.

Are there side effects with these injectables?

The most commonly observed side effects with fillers are swelling, redness, pain, bruising, headaches, tenderness, lump formation, and itching at the injection sites. These are typically mild in severity and usually resolve themselves in seven days with smile and marionette lines, and within 14 days on the lips.

Because hyaluronic acid is a naturally occurring substance in the body, there are very few reactions to Juvéderm® products. Occasionally, lumps or granulomas can form near the injection sites. This side effect can be reversed with an injection of hyaluronidase, an enzyme that speeds up the natural degradation of the hyaluronic acid in the filler.

Bellafill® has the same minor side effects listed above, but it can also create some initial discoloration in the injected sites. Some patients feel as if they can “feel the filler under the skin.”

Botox® has the same possibilities of redness, minor swelling, etc. at the injection sites. But once you have your Botox® injections, the patient needs to be sure not to rub the injection site, as this can make the Botox® migrate to an unwanted muscle. This can create problems such as a droopy eyelid. Overall, however, Botox® is very safe and has been proven in millions of injections around the world.

Kybella® causes swelling when injected as the deoxycholic acid attacks the fat cells. This can be somewhat prominent for 1-2 weeks, and then it resolves. This is most typical during the first injection session (Kybella® is FDA approved for up to six injection sessions).

Schedule a consultation for Cosmetic Injectables in El Paso, TX

If you are interested in fighting back against the signs of aging through treatments with cosmetic injectables in El Paso, TX, contact Cosmetic Surgery & Laser Centers of El Paso to schedule a consultation today!

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