There are five types of wrinkles that we developed over time. It’s important that you understand them in order to know which treatment is right for you.

Type I or Expression Wrinkles:
These are wrinkles of expression. This is how we communicate our emotions and feelings when we interact with one another. This constitutes your character, so it’s important to leave you with the ability to “emote” how you feel in order that you don’t look “frozen”. This is the art of using Botox and the person who is performing the treatment should be as much of an artist as a doctor.

Type II or Collagen Wrinkles: These are fine lines that come with aging, most commonly seen around the eyes or cheeks. The basis of these wrinkles is poor collagen production and damage of the collagen producing cells. As the collagen becomes damaged, the skin sags creating fine lines.

Type III or Dynamic Wrinkles: These are deep wrinkles that look worse when you raise your eyebrows, squint or pucker your lips. Most often, they are found between the eyebrows, along the forehead, around the lips and eyes and down the nose. This is Botox country. These wrinkles are really valleys between the muscles of your face. Like all muscles, the more these get exercised by facial expressions, the bigger the muscel becomes and the deeper the valley in between them appears. By injecting Botox into the muscles, it inhibits their ability to contract. It’s like putting the muscle in a cast. If a muscle can’t move, it atrophies and becomes smaller. So, the ‘mountains’ collapse and the valley becomes flat. Hence, the wrinkle is softened.

Type IV or Static Wrinkles: When you look in the mirror and you see deep lines that are present when you have a neutral facial expression, you are looking at Static Wrinkles. They are formed from the skin being torn from strong muscles, collagen damage and sun damage. Methods of softening these include fillers like Radiesse or Juvaderm or resurfacing.

Type V or Facial Collapse Wrinkles: As we age, our facial bones collapse and the fat that was on top of the bones slides down the face. An example of this type of wrinkle is found running from the side of the nose to the corner of your mouth. You can also see that your cheeks that once were under your eyes appear hollow and caved in. The treatment for this is fillers, fat transfer or the stem cell face lift.


Botox is one of the safest procedures around today, and the risks are extremely low as any side effects experienced are often temporary. When shopping for the best value, remember to ask for the price per unit of Botox. It makes no sense to me to charge by the area injected because the amount of Botox injected can vary. Also, be sure that your doctor is experienced because Botox is an art form. I have been injecting Botox for decades and its part of my “beauty toolbox”.

Join Dr Keller’s Botox Club! For every 10 Units of Botox purchased you get an additional unit free!

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Xeomin and Dysport

Botox is not the only filler available, Dr Keller offers an array of fillers tailored to get clients the best possible results. Scheduling a consultation is a great way to help Dr Keller determine which is the best filler or treatment for wrinkle reduction and for a clients budget. Much like Botox, these products offer a rewards program for units purchased.

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If you are facing static wrinkles and looking for a filler that also promotes natural collagen, then Radiesse is a perfect choice. Radiesse is a calcium based filler that is injected and provides instant lift to dimension wrinkles and folds. Radiesse also acts as structure for natural collagen production over time. The results can last for over a year making the treatment results both immediate and long lasting.

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Juvederm is filler used to smooth lines and increase volume in areas of the face. As you age, your skin loses elasticity and moisture, Juvederm adds volume to smooth lines and folds and gives you natural, long lasting results by adding volume beneath the skin’s surface. Results can last 9 months to two years depending on the type of Juvederm injection.

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Ask Dr. Keller about the Brilliant Distinctions Rewards Program which can help you earn points to be used towards future treatments.