Botox versus Fillers—What is the Difference and Which One is Best?
Posted On May 26, 2021
Many people think Botox and fillers are the same thing. There are some similarities. Both are injected for cosmetic enhancement of the face. Both can be used together to get great results, or they can be used separately. But there are more differences than there are similarities!
Botox is a neuromodulator developed in the 1980’s that was found to reduce skin wrinkles by reducing muscle activity. Other brands have been developed since then including Dysport, Jeuveau, and Xeomin, all of which have actions similar to Botox, but vary slightly in their onset of action and area of effect. Botox and the other brands of neuromodulators work by slowing down muscle activity. They are used in specific areas where facial muscles are over active and creating wrinkles. Repeated muscle activity during frowning, scowling, or surprise leads to permanent wrinkles of the skin. You can still make those facial expressions after receiving Botox, the expressions just aren’t as intense. Using Botox prevents the wrinkles from forming, preserving smooth and wrinkle free skin!
Common treatment areas for Botox include the forehead, glabella (between the eyebrows), around the eyes, sides of the nose, chin, and cheeks. Botox lasts around three to six months. Repeat treatments are required to maintain the results. Other uses for Botox include reducing grinding of the teeth, preventing migraine headaches, and reducing sweating of the armpits or hands.
Fillers, in contrast, do not have any effects on muscle activity. They are used to add volume, most commonly in the lips and cheeks. Early versions of fillers were derived from animal collagen in the 1970’s. Most current fillers are derived from a natural skin component called hyaluronic acid. The first was Restylane in 2005 and numerous others including Juvederm, Voluma, Vollure, Volbella, Belotero, and RHA have come to market since then. All of these hyaluronic acid fillers lead to temporary results that last anywhere from a few months to a few years. A benefit to these types of fillers is that the results can be reversed within minutes if you are not satisfied with the appearance or if there is a complication.
Other fillers are available with more permanent results, but they are not reversible. The most common brands are Radiesse and Sculptra. Permanent results can also be achieved with silicone injections, but this is generally discouraged due to risks of infection. Fat injection is an alternative to fillers and there are ways to either have your own fat injected or have allograft fat injected to get a permanent result as well.
The most common sites for filler injection are the lips and cheeks, but filler can be injected anywhere in the face or body to restore volume. Filler can be used to plump up the skin where there are wrinkles as well. Some other areas that are frequently treated with filler include the eyelids, the jawline, and the buttocks.
So which one is best for you? I generally recommend Botox (or any other brand of neuromodulator) to every patient. That is the building block of facial rejuvenation and the best way to prevent wrinkles. Everyone should use it including both men and women. Starting young, around the age of 30, is best in order to catch those wrinkles before they become permanent.
Fillers are an optional addition for those that want more volume in their face or want their wrinkles filled out after they have maximized the benefit they can get from Botox. I generally recommend that women start to consider fillers around age 40 and men around age 50. However, many young women decide to get filler to the lips or cheeks in their 20’s and 30’s as well.
Regarding which type of filler to choose, that is a discussion you should have with your medical provider. He or she can pick the best type of filler for your specific goals. I generally recommend starting with one of the hyaluronic acid fillers since they are reversible, then you can move on to something more permanent like fat injection in the future if you like the results!
For more information on Dr. Newman visit www.drnewmanbeverlyhills.com.