Botox and dermal fillers are the two most common non-surgical procedures performed. It’s mostly because they give instant results, they’re temporary, and they’re way cheaper than surgical procedures. Even though they’re both injectables that improve the look of wrinkles, they work differently.
What they have in common is their efficiency in giving you a subtle makeover by smoothing out wrinkles, plumping up the skin, and just helping you achieve a more youthful appearance.
However, the way they do all those things are completely different. And if you’re thinking about going in for some injections, you need to know the difference between Botox and fillers.
Because it’s not really a matter of which one is better, but a matter of which one is the right one for your specific areas of concern.
Personally, I consider injectables an important part of my routine to maintain wrinkle-free skin. But I’ve realized that people around me sometimes even use these two words interchangeably.
So this is not a comprehensive guide but more about painting a picture where you can see what Botox does and where fillers come in handy.
And note that I’m not qualified to give you any advice on these treatments and my perspective is based on my experience with injectables and with my injector.
Botox is a type of botulinum toxin or neurotoxin. It’s just a brand name; a successful one! So when we say Botox, we also mean other neurotoxins like Dysport or Xeomin. All of them do the same thing; they relax the muscles in the injected area and limit their movement (1).
When the muscles are relaxed or numbed, they can’t contract. That’s how Botox smooths out wrinkles. The most popular areas for Botox injections are forehead wrinkles, frown lines between the brows, and crow’s feet.
On a side note, Botox has other uses as well. It’s used to slim the jawline, smooth out bunny lines -the lines around the nose, fix a gummy smile, treat necklines, and even wrinkles on the chin.
Botox is mostly pain-free; about 1/10. The procedure usually doesn’t require a numbing cream and takes about 10 minutes to perform. And it can last for 4-6 months depending on how your body metabolizes it.
The most common side effect associated with Botox is bruising on the injected area, which is normal and usually goes away in a few days. The safest Botox injection is the one performed by a board-certified plastic surgeon!
Fillers, on the other hand, literally fill in wrinkles. The most common material used in dermal fillers today is hyaluronic acid (2). About 90%! Dermal fillers serve two purposes; they can replace volume loss or they can enhance volume.
The most common use of dermal fillers is for volume loss on the cheeks and under the eyes. Fillers are also used for filling in wrinkles around the mouth called marionette lines and nasolabial folds.
With dermal fillers, those areas look plumper and lines disappear as they’re literally filled in. And for volume enhancement, fillers can be used for plumping up lips, and enhancing the jawline and the chin.
Unlike Botox, fillers usually require the application of some sort of numbing cream. So it can be a bit more painful than Botox injections.
Fillers can last anywhere between 6-24 months. A possible side effect of dermal fillers is the unevenness of the fillers where one side looks plumper than the other.
As fillers give real-time results, you and your doctor can see if there’s any unevenness right after the procedure. If that happens, your doctor can either inject more filler into one side or dissolve the filler on the other side.
Another side effect is the Tyndall effect where the skin looks bluish after the procedure (3). Again, your doctor can dissolve the filler by injecting hyaluronidase.
Should You Get Botox or Fillers
In the simplest terms, Botox relaxes expression lines and smoothes them out whereas fillers plump them up. Each has its own set of complications and benefits. And each of them works for different types of wrinkles.
As you can gather, deciding between Botox and fillers is not really about personal preference but more about what your face needs. Some wrinkles need to be “paralyzed” and others simply need to be “filled in”.
If you’re worried about forehead wrinkles and crow’s feet, Botox will be the right way to go. If you’re more worried about nasolabial folds or an overall volume loss, dermal fillers will work great.
Combining Botox and Fillers
Any type of facial injection requires a good understanding of facial anatomy. Even though these procedures sound standard, they’re really not. For example, my doctor mixes Botox with some sort of anesthetic.
That way, he gets instant feedback and sees how my injections are going to look like as opposed to waiting for a week to see the results.
Every doctor has their own method with their preferred products. It’s really an art. A board-certified plastic surgeon will listen to your concerns and examine your unique facial anatomy.
They can offer the use of both Botox and fillers which can give you better results. As long as you’re seeing an expert with a good amount of experience, you can try both treatments for more enhanced results.
So this is roughly how things are. As you can infer, the most important difference between Botox and fillers is that they work on different types of wrinkles and satisfy different concerns!
Again, this is not a comprehensive guide, and nor should you decide based solely on what you read here or anywhere else online. But having a general idea on the subject is always better before you go in for a consultation.
- Satriyasa B. K. (2019). Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clinical, cosmetic and investigational dermatology, 12, 223–228. https://doi.org/10.2147/CCID.S202919
- Brandt, F. S., & Cazzaniga, A. (2008). Hyaluronic acid gel fillers in the management of facial aging. Clinical interventions in aging, 3(1), 153–159. https://doi.org/10.2147/cia.s2135
- King M. (2016). Management of Tyndall Effect. The Journal of clinical and aesthetic dermatology, 9(11), E6–E8.