Wrinkles come in two main types: dynamic wrinkles, caused by repeated muscle contraction (think forehead lines or crow's feet from years of expressions), and static wrinkles, which are visible even at rest due to collagen loss and sun damage. Understanding which type you have is the first step to treating it effectively, since the two respond to very different approaches.
What Causes Wrinkles?
Per the American Academy of Dermatology, the primary drivers are cumulative sun exposure, natural collagen and elastin decline, repetitive facial movement, and lifestyle factors like smoking. Dynamic wrinkles in the upper face — forehead lines, frown lines (the '11s'), and crow's feet — are almost entirely movement-driven, which is why neuromodulators are so effective there. Over years, a dynamic wrinkle that only appears when you make an expression can become etched into the skin even at rest, as the repeated folding eventually breaks down the underlying collagen.
Dynamic vs. Static Wrinkles: Why the Difference Matters
Dynamic wrinkles respond well to neuromodulators like Botox and Dysport, which relax the muscle responsible for the movement that creates the crease. Static wrinkles, which are visible even when your face is completely relaxed, are less about muscle movement and more about lost collagen and thinned skin — these typically respond better to treatments that rebuild structure, such as dermal fillers, laser resurfacing, or radiofrequency skin tightening. Many patients have a combination of both types by their 40s and 50s, which is why a treatment plan often combines neuromodulators with other modalities rather than relying on one alone.
Botox vs. Dysport: What's the Difference?
Both Botox and Dysport are FDA-approved neuromodulators (botulinum toxin type A) that temporarily relax the targeted muscle so it can no longer create the crease. The main practical differences: Dysport tends to diffuse slightly more, making it well suited to larger areas like the forehead, while Botox offers more precise, pinpoint control, useful around the eyes. Onset can be a touch faster with Dysport (2–3 days vs. 3–7 for Botox), though both last roughly 3–4 months. Dosing units also aren't directly interchangeable between the two products, which is why a treatment plan built around one can't simply be converted to the other without reassessment.
Can Wrinkles Be Prevented?
Daily broad-spectrum sunscreen is the single most evidence-backed way to slow the formation of new wrinkles, since cumulative UV exposure is one of the biggest accelerants of collagen breakdown. Some patients also use neuromodulators preventively in their late 20s and 30s, known as "baby Botox," on the theory that relaxing a muscle before a line becomes etched can slow its progression — though the evidence for this preventive approach is less robust than for treating existing lines.
What to Expect
Treatment takes about 10–15 minutes with no downtime. Results appear gradually over the following days and are most natural-looking when dosed conservatively and tailored to your individual muscle strength and expression patterns. Most patients don't experience a "frozen" look when treatment is dosed appropriately — the goal is softened movement, not eliminated expression.
Frequently Asked Questions
How long do Botox and Dysport results last?
Both typically last three to four months, though individual metabolism and muscle strength can affect duration.
Will my face look frozen?
Not when dosed conservatively. Modern injection technique aims to soften movement while preserving natural expression.
Can Botox be combined with fillers?
Yes, and many patients benefit from combining the two, since neuromodulators address dynamic wrinkles while fillers address volume loss and static lines.
Is one better than the other for beginners?
Neither is inherently better — the right choice depends on the treatment area and your individual anatomy, which your provider can assess during consultation.
At what age should I start treating wrinkles?
There's no universal age; it depends on when dynamic lines begin to bother you or become visible at rest.
Choosing the Right Treatment for You
Dr. Karp and the team at Journelle Skin evaluate your specific wrinkle pattern to recommend Botox, Dysport, or a combination for the most natural result. Learn more about Botox and Dysport in NYC.