Many patients have come to appreciate the benefits of combining Botox ® with a filler such as Restylane, Collagen or Juvaderm. Not only are facial lines filled but, the muscles responsible for these lines are paralyzed limiting the progression of lines.

One problem with this “combination therapy” has been keeping patients “in synch” – fillers frequently last for 6-9 months while Botox ® is typically repeated every 4 months. A new filler called Prevelle Silk from Mentor may be the solution for such patients. The filler is hyluronic acid – the same material found in Restylane and Juvaderm – but it’s formulated to last only 4 months. The shorter duration comes with a lower cost which will be welcome too.

An additional benefit of Prevelle is its formulation with local anesthetic – a fact that will be welcomed by anyone who’s had fillers and knows the discomfort added by dental nerve blocks and infiltration of local anesthetics. At one recent plastic surgery meeting, Prevelle was given without any additional pain medications and was well tolerated. Anecdotally, patients also report less swelling with Prevelle compared with similar products.

Obviously, a better solution for all concerned would be a longer acting Botox ® equivalent. That may be on the horizon. Several companies, including Mentor, have products similar to Botox ® in the product pipeline. Whether they last longer than Botox ® at this point isn’t known but, doctors and patients alike are eager for a little competition – if for no other reason than to lower the cost.