Injectables (Fillers, Botox, More)

Darren M. Smith, MD -  - Board Certified Plastic Surgeon

Darren M. Smith, MD

Board Certified Plastic Surgeon located in Upper East Side, New York, NY

Dr. Darren Smith provides many different types of injectables, such as Botox, Dysport, Kybella, and more. Book your injectables consultation at his New York City-based practice today. Use our book online tool to schedule online or call the office to schedule over the phone.

Injectables (Fillers, Botox, and more)


Cosmetic injectables can be broken down into two major categories: neuromodulators (like Botox, Dysport and Xeomin) and fillers (like Restylane, Juvederm, and many others). These products have a common goal: achieve a refresh the face (and other areas of the body) to achieve a rejuvenated appearance. Fillers help towards this goal by treating lines and folds and adding volume in areas of inappropriate depth or hollowness. Neuromodulators contribute by addressing a different kind of wrinkle or line. As neuromodulators and fillers are best suited to address specific types of facial lines, there is great deal of art and science that goes into designing an individualized injectable treatment plan. Dr. Smith will work with you one-on-one to design your optimal approach to cosmetic injectables. You can read about the basic principles here for background to bring with you to your consultation. Also, note that we mentioned that there were two “major” categories of cosmetic injectables. There is one cosmetic injectable that falls into its own category: Kybella. More on that below.

To better understand the role of fillers and neuromodulators in facial rejuvenation, it is helpful to discuss the two different kinds of lines on the face and what causes each type.

“Dynamic” lines are lines that appear when the muscles of the face contract to create facial expressions (for example the horizontal lines on the brow that occur when the eyebrows are raised). These appear because when muscles contract, the skin over them folds in order to move (like when you open a book and the spine wrinkles). With repeated brow motion over time, these dynamic lines actually cause the other kind of lines on the face: “static” lines.

“Static lines” are the horizontal lines present on some foreheads, even at rest. Going back to the book analogy, a new book will have a smooth spine. When it is opened for the first few times, lines appear on the spine only while it is open (the dynamic lines). Over time, however, the dynamic lines on the spine of the book will cause permanent lines that are present on the spine of the book even when it is closed (the static lines).

Neuromodulators (products such as Botox, Dysport and Xeomin) are useful in treating dynamic lines. They work by weakening the muscles in the area in a carefully controlled manner to minimize overlying wrinkle formation. Neuromodulators can be used for the prevention of static lines before they start. Once static lines are present, however, it is very hard if not impossible to treat them with neuromodulators.

Fillers, alternatively, are used to treat static lines and to add volume to the face. The fillers used in our practice are for the most part gels that are different formulations of hyaluronic acid, a substance naturally present in the body that can be placed in creases to dramatically lessen their severity. They can also be added to provide volumes in regions of the face that have “sunken” or “deflated” over time.

Kybella is the injectable that does not fit into either one of the above categories. This product is used to dissolve well-defined pockets of excess fat. It is specifically designed to treat “double chins.”