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Should I Get Botox or Dermal Fillers? What’s the Difference?

Older female receiving cosmetic injection of dermal filler above eyebrow


Both injectable dermal fillers and botulinum toxin (botox) are cosmetic procedures that can be performed right in your doctor's office. While minimally invasive, each treatment option works in different ways. 

For the purpose of this article, we use "botox" interchangeably with "botulinum toxin type A" and are not referring to or endorsing the brand name Botox Cosmetic®. 

Botox contains a purified bacteria that works to freeze muscles. The result is a minimized look of lines and wrinkles caused by facial expressions. 

Dermal fillers add fullness to areas that may have thinned due to aging or damage. They are commonly used in the cheeks, lips, and areas around the mouth. 

Is Botox Right for Me?

The American Society of Plastic Surgeons agrees botox is generally safe, and patients can resume normal activities immediately after treatment. Some of the side effects or complications can include bruising at the injection site, flu-like symptoms, headaches, nausea, redness, or a temporary weakening of facial muscles. 

While the potential side effects and low-risk factors of botox are similar to dermal fillers, they work in entirely different ways. Since botox has a freezing effect on facial muscles, it can only treat fine lines or wrinkles directly caused by muscle movement. 

These types of signs of aging are referred to as dynamic wrinkles or expression lines. Often focused around the upper face, some common treatment areas are lines between the brow, on the forehead, and crow's feet. 

These wrinkles are caused by smiling, frowning, squinting, and other muscle-related facial expressions. 

Due to the nature of how botulinum toxin type-A works, it will not help static wrinkles in the cheeks, neck, and jowls resulting from sagging or loss of volume in the skin. Botox is also a temporary treatment. Most patients find the effect lasts for three months. 

Should I Get Dermal Filler Treatments?

Unlike botulinum toxin type-A, dermal fillers or soft tissue fillers primarily act to increase your skin volume and fullness. They will successfully result in the lessening of wrinkles, fine lines and help reduce the appearance of some scarring in areas of the skin that aren't caused by muscle use. 

There are different types of injectable dermal fillers:

  • Calcium hydroxylapatite (CaHA)
  • Hyaluronic Acid (HA)
  • Polylactic Acid (PLA)
  • Polymethyl-methacrylate microspheres (PMMA)

Each injectable dermal filler substance has its benefits and best use cases. Each designed to treat different signs of aging or cosmetic issues like wrinkles, it is best to research and discuss with your doctor which one is ideal for your desired result. 

The time it takes to see results, how long the effect will last, and how many sessions are needed are all variable— depending on the type of dermal filler, the severity and type of your cosmetic issues, and the individual. 

Common uses for dermal fillers include plumping thinning lips, filling out the shallow areas of the face, decreasing wrinkles under the eyes, softening recessed scars, and improving static wrinkles on the lower face. 

Unlike the wrinkles best treated with Botox, static wrinkles on the lower face and around the mouth and cheeks result from collagen loss and decreased elasticity of the skin. 

These cases are where injectable dermal fillers excel. 

Dilworth Dermatology and Laser

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