If you’re considering getting Botox® or fillers to address facial wrinkles or fine lines, the best choice depends on the areas you’re looking to improve. Lines of expression typically require Botox, while lines that usually sit at rest work better with dermal fillers. There are also other factors that can play into your decision, including the longevity of your results, cost, and more.
Different areas of the face are usually treated differently in terms of Botox vs. fillers. Sometimes, fillers and Botox are used together to get specific aesthetic results. Botox and fillers are designed for different uses and are made of different substances, which allows them to be combined for certain treatments. Depending on what you’re looking to achieve, your dermatologist can recommend the right type of treatment for you.
What is the difference between Botox & Fillers?
Botox works to “freeze” muscles by limiting their movement, effectively stopping creases and wrinkles caused by repeated facial expressions. It’s typically used for the upper part of the face, such as on the forehead or around the eyes. The results of Botox last about 3 to 4 months and then can be rejuvenated with follow-up injections.
Dermal fillers use hyaluronic acid and substances similar to it to add volume to areas of the face that aren’t as smooth as they could be. It’s generally used around the mouth, for lips, and for cheeks. Dermal fillers are also frequently used to treat forehead wrinkles, scars, and other problem areas around the face.
Dermal fillers can have longer-lasting results, with longevity depending on the filler, but they also have more common side effects than Botox injections.
Here is a quick-reference breakdown of the key similarities and differences between these types of injectables.
| Comparison | Botox | Fillers |
| Duration of Results | 3-4 months | 6-12 months |
| Pain Level | Minimal, possible side effect | Little to no pain |
| Downtime | None required | None required |
| Onset | Immediate | Immediate |
| Follow Up Required | After results fade (3-4 months) | After results fade (6-12 months) |
| Location | Upper face | Any facial area |
| Side Effects | Pain at the injection site, infection, inflammation, swelling, redness, bleeding, and bruising. | Rash, redness, bleeding, bruising, swelling, inflammation, blindness, migration, pain, infection |
| Reversible | No | Yes |
| Price Range | $300 – $500 | $650 – $1500 |
What is Botox?
Botox, a neuromodulator, is a generally effective and safe wrinkle reduction treatment. It works by disrupting nerve impulses that trigger facial muscles, which helps to reduce dynamic wrinkles.
Botox is most effective when treating dynamic wrinkles, which are wrinkles caused by repetitive movements. Typical treatment areas include:
- Crow’s feet
- Forehead wrinkles
- Vertical lines between the brows
- Wrinkles around the mouth
Is Botox Safe?
Botox is overwhelmingly considered to be safe and effective. These injections were approved by the FDA in 2002 for eyebrow lines, in 2013 for crow’s feet, and in 2017 for forehead wrinkles. It’s also been approved for medical therapeutic use since 1989. No long-term adverse effects have been reported, and no systemic safety issues have resulted from FDA-approved use.
However, there are still possible side effects, including:
- Drooping of the eyelid or eyebrow
- Weakness or paralysis of muscles close to the injection site
- Hives, rashes, or itching
- Pain, bleeding, bruising, swelling, numbness, or redness at the injection site
- Headache
- Dry mouth
- Flu-like symptoms
- Nausea
- Difficulty swallowing, speaking, or breathing
- Gallbladder complications
- Vision problems
These side effects are rare and usually don’t require medical attention.
What are Fillers
Dermal fillers are a new development compared to Botox. They include a broad range of products, substances, and applications. Most of these are used to treat the cheeks, mouth, lips, or underneath the eyes.
Dermal fillers physically fill wrinkles and fine lines with injectable substances like hyaluronic acid. Hyaluronic acid is a naturally occurring substance that helps skin retain its moisture, and injections help to supplement it and have a plumping effect. This is the most widely used substance for dermal fillers. Products with this substance vary between factors such as cross-linking, concentration, and particle size.
Dermal fillers are typically used for the following treatments:
- Plumping thin lips
- Filling shallow facial areas
- Improving shadows or wrinkles under the eyes
- Filling in recessed scars
- Filling static wrinkles on the lower part of the face
- Improving the jawline
Dermal fillers can also be used for dynamic wrinkles but are most commonly used for static wrinkles — wrinkles that aren’t caused by constant movement. Their main purpose is to plump facial skin, creating a more youthful appearance.
Are Fillers Safe?
Fillers are generally considered to be safe. Most adverse reactions are mild and dissipate on their own with time. There is a small risk of long-lasting functional or aesthetic impairments, but the risk is significantly reduced by choosing an experienced, board-certified dermatologist.
Some side effects are present immediately after treatment, while others can occur well after an appointment. Some side effects that can have a delayed onset are bruising, swelling, abscess formation, and tissue necrosis.
These are the possible side effects that could manifest include:
- Skin rash, itching, or pimple-like eruptions
- Redness, bruising, bleeding, or swelling at the injection site
- Skin damage resulting in a wound, infection, or scarring
- Vision problems or blindness
- Loss of blood flow to the injection site
A board-certified dermatologist can limit the risk of these occurring.
Which is better – Botox or Fillers?
When it comes to dermal fillers vs. botox, the best option for you depends on the areas you’re looking to treat, aesthetic goals, budget, and risk factors. As with all cosmetic treatments, no product is likely to be a one-size-fits-all solution. You may need both of these injections to get the results you’re looking for, or you might choose to have a surgical procedure for longer-lasting results instead.
Generally, dermal fillers are better fitted to treat static, or non-muscular, wrinkles. They can also be used to improve textured skin, depressions, and deep-set wrinkles. Fillers can also tackle issues that Botox simply can’t. For example, Botox can’t be injected into the lips. Limiting the movement of your lips with a neuromodulator wouldn’t lead to a positive functional outcome.
Botox is better for dynamic wrinkles because they’re caused by movement. By limiting this movement, future wrinkles and fine lines aren’t allowed to develop. Preventative injections work to stop wrinkle formation before it begins; Botox also works effectively on wrinkles and fine lines that have already formed.
Consider Botox or Fillers at our New York City Office
Our board-certified dermatologists at Spring Street Dermatology can help you if you’re struggling to decide between face fillers vs. Botox. We’re SOHO & Uptown’s premier dermatology group, here to help you reach your aesthetic goals. We offer same-day appointments for people who want immediate results with procedures that don’t require downtime, such as injectables.
We’re dedicated to providing a doctor-patient relationship that surpasses the norm. Come to our experts with your aesthetic desires, and we’ll work with you to find the best way to make them a reality. We offer state-of-the-art facilities, personalized service, and unmatched compassion for our patients that leads to exquisite results.
Our office caters to medical and cosmetic needs so you can have healthy, beautiful skin that lasts. See how our accredited dermatology group has been featured in the press for more proof of the efficacy of our work. Reach out to us today to start your journey to more youthful-looking skin.