Botox vs Fillers and Other Injectables

The most common and most expensive mistake in aesthetics is buying the wrong category of injectable. Botox and fillers are not competitors, they treat different problems, and no amount of one will fix what the other is for.

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There is a simple test. Make the expression that creates the line, then relax your face. If the line disappears when your face is at rest, it is a dynamic wrinkle caused by muscle movement, and a neurotoxin like Botox is the right tool. If the line is still visible when your face is completely relaxed, it is a static line caused by volume loss or skin change, and no amount of Botox will remove it.

That second group is where fillers, biostimulators and fat-dissolving injectables come in, and they work in genuinely different ways from one another, which the table below sets out.

At a glance

TreatmentWhat it doesBest forHow long it lasts
BotoxRelaxes the muscle so it stops creasing the skinDynamic lines: forehead, frown lines, crow’s feet3–4 months
Dermal fillersAdds physical volume beneath the skinStatic folds, hollows, lip and cheek volumeVaries by product and area
JuvedermHyaluronic acid gel that adds volume and can be dissolvedLips, cheeks, nasolabial foldsVaries by product
Restylane SkinboostersMicro-droplets of hyaluronic acid to improve skin quality rather than add contourSkin hydration and texture, not volumeVaries
SculptraStimulates your own collagen production over monthsGradual, overall volume restorationBuilds over months
ProfhiloSpreads under the skin to hydrate and remodel rather than fillSkin laxity and qualityVaries
KybellaDissolves fat cells permanentlyFat under the chin specificallyPermanent once the fat is gone

How to choose

Your line shows only when you move
That is a dynamic wrinkle. Botox is the right treatment, and filler will not help it.
Your line is there when your face is completely still
That is a static line. It needs volume or collagen, filler, Sculptra or Profhilo depending on the cause, not a neurotoxin.
You want the option to undo it
Hyaluronic acid fillers such as Juvederm and Restylane can be dissolved with an enzyme. Sculptra, Profhilo and Kybella cannot be reversed that way, so they demand a more experienced injector.
You are treating fullness under the chin
Kybella destroys fat cells permanently in the treated area, which is a different proposition entirely from anything Botox or filler does.
You have both kinds of line
Most people do, and combining treatments in one appointment is standard practice. Botox in the upper face and filler lower down is the most common pairing.

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Frequently asked questions

What is the difference between Botox and fillers?
Can I have Botox and filler at the same appointment?
Which injectables can be reversed?

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