What’s the difference between Botox and dermal fillers?

• Botox stops your muscles contracting, meaning wrinkles can’t form as easily when you move your face.
• Dermal fillers treat wrinkles that are visible when your face isn’t moving. Fillers also add volume to areas of the face which can become hollow with age—such as the cheeks and under the eyes—to create fuller, more youthful-looking face.

On this page you will find out more about:

• The difference between Botox and dermal fillers
• Common areas that can be treated
• Whether you can have both treatments done together
• Whether the effects of Botox or dermal fillers last longer
• How much the treatments cost
• Side effects and safety of Botox and fillers
• FAQs

Botox and fillers are not the same thing.

Botox:

• Blocks chemical messages from the nerves to the muscles, reducing muscle movement and making wrinkles less pronounced. The limited movement makes it harder for the wrinkles to form when you move your face, giving your skin a smoother look.
• Is most often used in the top half of the face, to treat areas like frown lines and crow’s feet. However, it can also be used in the lower face, such as to define the jawline.

Dermal fillers:

• Treat static wrinkles that are still visible when muscles aren’t moving, such as smile lines and lines underneath the eyes.
• Use hyaluronic acids to add volume to hollow areas of the face, creating fuller, more youthful-looking skin.
• Treat wrinkles anywhere on the face and some areas of the body, such as the hands.

Botox and Dermal Fillers: Quick Comparison Table

	Botox	Dermal fillers
Age	Most commonly used by people in their mid-thirties and above.	Most commonly used by people in their thirties and above.
Commonly treated areas	Frown lines, forehead lines, crow’s feet, some areas in the lower face, jawline.	Fillers can be used on the whole face, including wrinkles around the eyes, hollow cheeks, nose-to-mouth lines, down-turned mouth.
Typical patients	Individuals looking for a quick way to reduce wrinkles, often for a special occasion.	Anyone who is concerned that they look like they are ageing. Highly active individuals such as runners.Very thin people who have low fat levels in their body and therefore naturally hollow facial features.Results are visible immediately
How long does the treatment last	3-4 months.	Up to 12-18 months.
Treatment time	20-30 minutes.	30-60 minutes.
Other areas of the body that can be treated	Botox can be used to treat excessive sweating, headaches and teething grinding.	Can be used on the neck décolletage, hands, ear lobes and now also the body – to treat crepey arms for example.
Approximate cost	Prices start from £200	Prices start from £350
Who can inject dermal fillers and Botox?	A qualified experienced medical practitioner – if injected by a non-medical person there is a risk of infection, irregularity and skin necrosis.

Do I need Botox or fillers?

This will depend on the type of wrinkles you want to treat and where they are on your face. You can also have a combination of the two.

If you want to treat deeper wrinkles that show when you frown, Botox may be more appropriate. If you’re looking to treat wrinkles that are present whether or not you move your face, fillers are the best choice.

Although fillers can be injected directly into lines, just treating the lines alone could actually make you look worse, for example your jowls could look heavier and your face shape may change.

Dermal fillers are used to restore the skin’s natural volume, rather than treating individual lines, as Botox does. For example, if you have dermal fillers to treat the cheek and chin areas, then you can expect nose-to-mouth and mouth-to-chin lines to improve as well.

What makes you look younger Botox or fillers?

Both can help to create a more youthful appearance. They can be used together to great effect as Botox can reduce frown lines and fillers can pump up areas of the face that have lost volume due to age, such as the cheeks and tear troughs (the groove where the lower eyelid and cheek meet).

However, the aim of both treatments is not necessarily to make you look younger, but to help you appear refreshed and rejuvenated.

Are dermal fillers better than Botox?

This depends on what results you’re expecting and the area you want to treat.

• Dermal fillers are best for filling in fine wrinkles and adding volume to areas of the face that have become hollow with age.
• Botox is best for treating prominent individual wrinkles.

The advantage of fillers is that they can be used to lift and fill the whole face, and stimulate the growth of your own collagen to further enhance the plumpness of your skin.

Botox is generally just used to treat specific lines and wrinkles, rather than being suitable for use across the face.

Common areas that can be treated

Common areas Botox can treat:

• Forehead lines
• Frown lines
• Crow’s feet
• Jawline definition
• Sagging brows
• Neck cords
• Lines beside the nose (bunny lines)
• Downturned mouth (marionette lines)
• Pebbly chin

Common areas dermal fillers can treat:

• Eye wrinkles
• Hollow cheeks
• Nose-to-mouth (nasolabial) lines
• Downturned mouth (marionette lines)
• Neck
• Hands
• Ear lobes
• Arms (for crepy skin)
• Hollow temples
• Short chins

Which areas of the face respond best to Botox and fillers?

Botox vs. dermal fillers for lips

Area	Botox	Fillers	Best choice
Lip volume	X	✔	Fillers
Lip lines	✔	✔	Fillers
Smoker’s lines	✔	✔	Fillers

Dermal fillers are used to improve the size and shape of thin lips and reduce fine wrinkles around the mouth. To find out more about how and why lip fillers are used to enhance lips, click here.

Botox injections can treat wrinkles around the lips. However, using Botox so close to the mouth can make the mouth droop or cause an asymmetric smile if it isn’t administered correctly.

FAQs

What’s a ‘lip flip?

Botox is now being used to create the illusion of plumper lips with a ‘lip flip’. In this treatment, Botox is used to relax tiny muscles around the lips, causing the lip line to ‘roll’ outwards.

Unlike fillers, Botox doesn’t add volume to the lips, but simply changes the shape of the lip line so the lips appear bigger.

Are lip injections and Botox the same thing?

No. Lip injections usually means dermal fillers used to improve the volume and shape of lips by injecting filler directly into them. Although Botox can treat areas around the lips, it’s more readily used for wrinkles around the eyes and on the forehead.

Botox vs. dermal fillers for eye area

Area	Botox	Fillers	Best choice
Crow’s feet	✔	X	Botox
Under-eye wrinkles	✔	X	Botox
Under-eye bags	X	✔	Fillers
Frown line between eyes	✔	✔	Botox
Hollow tear trough	X	✔	Fillers

Both can treat lines around the eyes. However, there are some important points to be aware of:

• Crow’s feet are best treated with Botox.
• Under eye wrinkles in the lower eyelid can be treated with Botox, but only if there is good skin elasticity. Wrinkles here cannot be treated with fillers since there is a risk of swelling and eye bags.
• Under-eye bags cannot be treated with Botox as it can make the bags look worse due to fluid retention. Dermal fillers are used to fill the tear-troughs.
• Botox is used to treat prominent wrinkles such as frown lines and crow’s feet, which worsen when the muscles in these areas move.

Botox vs. dermal fillers for forehead and frown lines

Area	Botox	Fillers	Best choice
Deep forehead wrinkles	✔	✔	Botox
Minor forehead wrinkles	✔	X	Botox
Frown lines between eyes	✔	✔	Botox

Botox is the first line treatment for forehead and frown lines. This area is only injected if absolutely necessary with a thin filler to smooth things out since there is a very high risk of vascular occlusion (blood vessel blockage) and skin necrosis (tissue death) in this area.

Which treatment is better for frown lines?

Deep-set frown lines between the eyebrows are best treated with Botox to relax the muscles and smooth out the skin. If the line is too deep to be treated solely by Botox, fillers can be applied 10 to 14 days later to smooth out the line.

Botox or fillers for the jawline and jowls

Best treatment? Both

• Botox is used to relax muscles at the jawline so its shape appears tighter and lifted. It can also slim and soften the jawline by relaxing the masseter muscle, which can make the jawline look heavy. You can find out more about jaw slimming here.
• Fillers are used to improve the shape of the jawline by adding volume to the cheeks and lifting and tightening the jowls and jawline. You can find out more about how fillers are used to enhance the jawline here.

Botox or fillers for the chin

Best treatment? Both

• Botox is used to smooth out a dimpled or creased chin by relaxing the chin muscles.
• Fillers are used to give the chin more definition and create a more balanced profile. They are useful for naturally weak chins or chins which have lost definition with age. You can find out more about chin enhancement here.

Botox or fillers for laugh lines

Best treatment? Fillers

Fillers are the best choice for precision treatment near the mouth as these are designed to add volume to the area, making the skin look more youthful. Using Botox in this area can affect your smile if it’s not administered correctly.

Botox or fillers for marionette lines

Best treatment? Fillers

Fillers are used to treat marionette lines by filling in wrinkles and lifting the lower face. For deep-set wrinkles, fillers can be combined with small amounts of Botox.

Can I have both treatments together?

Yes, Botox is usually administered first before fillers. Depending on the area being treated, your practitioner may suggest waiting for two weeks to see the results of the Botox injections before administering dermal fillers to the same area.

Having Botox and fillers around the same time can actually prolong the effects of fillers, as the more active your facial muscles are, the quicker dermal fillers break down. Botox temporarily restricts the movement of your facial muscles, which can prevent wrinkles in these areas from getting worse.

Do dermal fillers last longer than Botox?

Yes.

• Botox lasts three to four months
• Dermal fillers can last up to 18 months

The results of both treatments can vary and depend on:

• the type and brand of filler used
• the type and brand of botulinum toxin (Botox) used
• how much filler or Botox is injected
• how much your muscles move in the area you’ve had treated

Below is a quick guide to approximately how long you can expect each brand of filler or wrinkle-relaxing treatment to last.

Type of treatment	Brands	How long results last
Collagen stimulating fillers	Radiesse	Up to 15 months
Hyaluronic acid fillers	Juvederm, Restylane and Emervel	4–6 months
Botulinum toxin injections	Botox, Azzalure and Xeomin	3 months

How much do the treatments cost?

• Prices for treatment with a premium filler such as Juvederm start from £350 per 1ml syringe.
• Prices for wrinkle-reducing injections with Botox start from £200 for one area .

The above prices are what you can expect to pay if you choose to have treatment at Health and Aesthetic Clinic. Please contact the clinic for more information.

The cost of treatment varies greatly and can depend on:

• the area being treated and how difficult it is to administer Botox or fillers in this area
• the scope of the treatment—treating one wrinkle with Botox is much quicker and costs less than treating the face with dermal fillers
• the type of filler or wrinkle relaxant being used—premium brands cost more but generally produce better results
• the experience and qualifications of the practitioner—treatment with an experienced and qualified doctor who is registered with the General Medical Council (GMC) will cost more. This is because qualified doctors:
• can give you a full health assessment to check you’re fit to have the procedure
• can explain the risks and possible side-effects
• have a better understanding of facial anatomy so can provide more precise and longer-lasting results
• can offer immediate medical care if you experience any side-effects

What are the common side effects of the treatment?

The most common side effects of both Botox and fillers are:

• mild bruising
• light bleeding
• swelling and redness

in the areas where you were injected.

Below is a breakdown of the rarer side effects you may experience after having fillers or Botox.

Botox side effects	Fillers side effects
Drooping eyelids or brows (if injected near here)	Uneven appearance
Muscle weakness	Raised bumps under the skin
Rashes or itching	Rashes or itching
Frozen expression	Skin damage
Raised eyebrows	Vision problems
Headache	Infection
Flu-like symptoms	Nerve damage
Allergic reaction including breathing problems, facial swelling, vision problems, rashes, dizziness	Allergic reactions to fillers are extremely rare as hyaluronic acid is found naturally in the human body

If you choose to have treatment with a qualified and experienced practitioner, you’re much less likely to experience the side effects above. If you do have an allergic reaction to Botox or fillers, a professional practitioner will be able to give you immediate medical assistance.

You can find out more about Botox side effects and aftercare here.

You can find out more about dermal filler side effects and aftercare here.

Are dermal fillers safer than Botox?

Dermal fillers and Botox are both extremely safe, provided they’re administered by an experienced and qualified practitioner.

Botox has been used for decades to treat prominent wrinkles. It’s a prescription-only medicine and is certified for medical and cosmetic treatment.

The majority of fillers used today are made of hyaluronic acid. This is a substance cells in the skin produce to help the cells retain moisture, making the skin look plumper. As hyaluronic acid is found naturally in the body, it is highly safe to use as a filler.

If injected by a non-medical person there is a risk of infection, irregularity and skin necrosis.

FAQs

Which is more painful Botox or fillers?

Both treatments use a similar technique which causes a pricking sensation when the needles enter the skin, but neither procedure is more painful than the other.

Certain areas of the face—lines from the nose to the mouth, or from the mouth to the chin, for example—can be more painful to treat, as they have more nerve endings. Typically these areas are treated with fillers.

Your practitioner will offer to numb the area with a local anaesthetic to make the procedure as comfortable as possible.

Can you get either treatment while pregnant?

As there is no clinical evidence to prove that either treatment is safe for women who are pregnant or breastfeeding, it’s best to avoid treatment at this time.

Who can administer the treatments?

Botox is a prescription-only medicine, which means that by law it can only be administered by a medical professional such as a doctor, dentist or prescribing nurse. It should be prescribed face-to-face.

Dermal fillers don’t currently require a prescription and can be administered by anyone.

For a safe and successful treatment, it’s highly advisable that you only have Botox or fillers done by a qualified doctor.

You should expect to have an in-depth consultation before receiving any wrinkle treatment. During your in-depth consultation at Health and Aesthetics Clinic, Dr Rekha Tailor will take a full medical history, perform a full skin analysis and recommend a personal treatment plan.

Is there an alternative treatment to Botox or fillers?

Yes. Profhilo is a hyaluronic acid that looks like a filler, but instead of plumping the skin like fillers do, it helps restore the hyaluronic acid that is naturally present in the skin. It also helps to stimulate collagen production resulting in tighter and firmer skin. The results are smooth, hydrated skin, so lines and wrinkles appear less noticeable, and improved skin laxity. You can read more about Profhilo and view before and after images here.

What next?

Speak to the team at Health and Aesthetics Clinic to find out more about whether dermal fillers, Botox or an alternative treatment is best for you. Contact our Surrey clinic by calling 01252 933133 or email info@healthandaesthetics.co.uk

You can find out more about what to expect during a consultation for Botox treatment by reading our advice here.

Dermal fillers can be used to enhance the appearance of many different areas of the body—you can find out more here.