Smoothing out facial lines with injectables has become incredibly popular over the last decade. While Botox has reigned supreme, dermal fillers are quickly rising to the top. Both are long lasting treatments for wrinkles, but there are several differences between the two.

What Is Botox?

Botox is the brand name of a specific botulinum neurotoxin of which there are four in the United States including Botox, Dysport, Xeomin, and Jeauveau. All of these neurotoxins work by temporarily weakening or paralyzing the muscles in the treatment area. While they all work the same, each neurotoxin brand has slightly different formulations and areas in which they are FDA approved to treat. Botox specifically is used to treat dynamic facial lines in the forehead, crow’s feet, glabellar lines (the 11’s), and neck wrinkles. Botox is not used for treating wrinkles that are a result of collagen loss.

What Are Fillers?

Fillers are a variety of substances approved by the FDA that can be either permanent or temporary that are used to fill in lines and provide volume with hyaluronic acid fillers like Restylane, Juvederm, and Belotero, and calcium fillers like Radiesse being the most common types. Dermal fillers are used primarily to treat smile lines or to plump up lips or cheeks.

Sometimes dermal fillers are used to reduce the appearance of scars, rejuvenate hands, and even reshape the face. However, dermal fillers are not approved for adding volume to other areas of the body, like breasts. Below are the dermal filler options approved by the U.S. Food and Drug Administration along with how long each one lasts.

  • Calcium hydroxylapatite (Radiesse), a temporary gel solution that lasts for 18 months

  • Collagen, a temporary material that lasts up to four months

  • Hyaluronic acid, a temporary material that loses its effect after 6 to 12 months

  • Poly-L-lactic acid (Sculptra, Sculptra Aesthetic), a man-made material that lasts about two years

  • Polymethylmethacrylate beads, the only permanent type of dermal filler available

Let’s Talk About The Efficacy Of Both Injectables

Both Botox and dermal fillers are effective wrinkle treatments. However, the effectiveness of both will depend on how they are used (and perhaps who injects the products).

Botox can be used for prejuvenation treatments, which are referred to as “baby Botox” for those in their late 20s and 30s. Results for Botox take about a week to fully be noticeable and they last roughly 3-4 months. Additional touch-up treatments are required to maintain the results. On the other hand, dermal fillers are used more prevalently to fill in areas under the eyes, cheeks, and jawlines.

The simple rule amongst injectors is that lines of expression (dynamic muscle movements) need botulinum toxin, whereas lines of rest where there is no muscle movement need dermal fillers. Like Botox, dermal fillers will need to be touched up accordingly on a schedule determined by how long they last.

Possible Side Effects

The most common side effects from Botox or dermal fillers are pain and bruising at the injection site that may last up to two weeks. With Botox, abnormal reactions include drooping eyelids, drooling, a crooked smile, and eye dryness.

If these occur, a call to your injector needs to be made immediately. One side effect from fillers specifically that can occur is known as the Tyndall effect, which can occur if thicker hyaluronic acid fillers are injected too superficially beneath the surface of the skin, which gives the skin a bluish tint. Luckily, the Tyndall effect can be treated with a hyaluronidase injection in the affected area, which is an enzyme that dissolves the hyaluronic acid. In rare instances, fillers can also cause acne-like bumps on the skin. However, it should be noted that side effects like Tyndall and acne-like bumps under the skin aren’t true side effects, rather they are complications from improper injections.

The easiest way to minimize side effects from Botox or fillers is to have a highly skilled and trained injector perform the service.

Bottom Line

Botox and dermal fillers are effective at treating wrinkles. However, they address slightly different issues that cause wrinkles and are used in different areas of the face. They can also be used as complementary treatments. Botox temporarily treats wrinkles by paralyzing the muscles around the injection site, while fillers do exactly what the name implies and fills the areas that they are injected into. Both fillers and Botox come with their own set of advantages and risks, but both are considered generally safe. Dermal fillers offer longer results, but also come with the risk of more side effects. The best way to avoid side effects is to have a licensed skincare professional perform the injections.