Cosmetic injectables like dermal fillers and Botox® are easier to access and more popular than ever. You likely know someone who swears by them.
Volume loss and wrinkles are a natural part of the aging process. But that’s where fillers and Botox can help your skin defy the signs of aging. So, how do you choose which is best for you?
Depending on your goals, whether it’s increased volume, wrinkle reduction or something else, one treatment might stand out as the best option. But in some cases, you may choose both. Read on to learn more.
The difference between dermal fillers and Botox: One relaxes muscles, the other adds fullness
Botox and fillers are sometimes confused because both treatments work to ease the signs of aging. Also, they’re both nonsurgical, minimally invasive and administered in a clinical setting. But aside from the quick pinches you might feel as you get them, they work very differently.
Botox is what’s called a neuromodulator. It’s designed to temporarily relax the underlying muscles that cause dynamic wrinkles, which are the lines formed by repetitive facial expressions like squinting, smiling or frowning. These wrinkles tell the story of your lived experiences, but Botox helps you not give away more than you want to.
Fillers, on the other hand, are gel-like substances that act by physically filling in volume under the skin. Fillers are usually used in the cheeks and lips to add fullness. They’re great for smoothing out static wrinkles, the wrinkles visible even when your face is at rest. These kinds of wrinkles are often caused by natural volume loss as you age.
Myth busting the “aging effects” of dermal fillers and Botox
You might have heard the myth that once you start Botox or fillers, you can’t stop or you’ll look even older than before you started treatment. It’s a common misconception that your skin will look worse or age faster once the effects of these treatments wear off.
However, neither Botox nor fillers have been shown to accelerate the aging process. For example, preventive Botox aims to slow or prevent the formation of wrinkles over time. Neither is the fountain of youth, but Botox and fillers can help your skin stay resilient and resistant to wrinkles with regular use.
Fillers are best for treating static wrinkles or scars
Fillers usually contain hyaluronic acid, calcium hydroxylapatite or poly-L-lactic acid. These compounds are injected beneath the skin to restore lost volume, diminish lines and soften creases. With the added volume from fillers, skin and facial features can look refreshed and more youthful, like you’ve had fewer sleepless nights and more spa days over the years.
Fillers are often used to plump lips, cheeks and nasolabial folds
These are places most likely to show obvious volume loss as you age. It’s most common for people to start using filler as an anti-aging treatment in their late 30s and early 40s. But some people take a more proactive approach, getting what’s referred to as “baby filler” in smaller amounts or fewer areas in their 20s. Of course, filler is also used by people of all ages to enhance the fullness of certain areas.
Fillers work right away, so you’ll see immediate results
When a filler is injected, it instantly occupies that space. While the restored volume is visible right away, it is common to experience minor swelling or bruising at the injection site. This means that while you may see results immediately, you’ll probably feel your best after a few days when swelling subsides. So if you’re getting fillers, be sure to make your appointment for about a week before any major events or special occasions.
Results from fillers are long lasting, but can vary
Dermal fillers generally offer longer-lasting results than Botox, typically ranging from six months to two years. The exact longevity depends on factors like the specific filler used and the part of your face that’s being treated.
Don’t feel pressured to stick to a maintenance timeline. You and your cosmetic dermatology expert can work together to decide the best treatment.
Bruising, swelling and tenderness are the most common filler side effects
Side effects aren’t common, but they can include:
- Allergic reactions
- Infection risk
- Potential for asymmetrical results
- Vascular complications (rare)
You should always discuss your health history and any concerns you have with your doctor before you start fillers.
Fillers are typically not covered by insurance
While filler fans might consider them absolutely necessary, they’re rarely medically necessary. This means that your insurance will most likely not cover them. In cases of severe facial trauma and reconstruction, insurance could cover fillers to help restore symmetry to the face and compensate for volume loss. But it’s best to assume that in everyday circumstances, you’ll be paying out of pocket for treatment.
What you can expect to pay for fillers
Fillers are priced by syringe with the average treatment requiring one to three syringes. The cost can vary between $1,500 to $4,500 depending on how many syringes are required and where you’re getting the injections.
Botox is best for treating dynamic wrinkles like crow’s feet or frown lines
Botox works by temporarily relaxing the muscles responsible for repetitive movements that cause wrinkles by blocking nerve signals to the targeted areas. When muscles can’t contract as forcefully, the skin above them relaxes. This results in less visible expression lines.
Botox can be used to prevent or smooth wrinkles
Botox works well for forehead wrinkles, including “11s” between eyebrows, frown lines and crow’s feet. Some people choose to start using Botox in smaller amounts, often called “baby Botox,” in their mid- to late-20s. For those looking to correct wrinkles that have already formed and prevent new ones, Botox often starts in their 30s or 40s.
People can continue to get Botox as they mature into their 60s or older. However, Botox does get less effective as we age because of the volume loss most people experience. This is where fillers can be used in combination or on their own.
Botox results aren’t instant, but you won’t need to wait long
Results typically begin to appear within 3-5 days, with full results visible after two weeks. Plan accordingly if you have any special occasions within that timeframe.
How long Botox lasts depends on a few factors
Most patients find that Botox typically lasts between 3-4 months. It varies from person to person based on their metabolism, the dosage used and which muscles are being treated.
Bruising, swelling and tenderness are the most common Botox side effects
Botox is considered very safe with few side effects. While rare, they may include:
- Temporary muscle weakness
- Mild bruising
- Drooping eyelids, which is very rare
Be sure to talk with your doctor if you’re concerned about any of these before getting the injections.
Botox is typically not covered by insurance
When used cosmetically, Botox is not considered medically necessary. You will more than likely pay out of pocket for Botox treatments.
The cost of Botox depends on several factors
The cost of Botox varies based on the number of units required and the provider's expertise. The average treatment session costs between $300 and $600.
Can you get Botox and filler at the same time? Yes.
In fact, they are often used together in a combination approach sometimes referred to as a liquid facelift. By using Botox to relax expression lines and fillers to restore lost volume simultaneously, your doctor can address multiple signs of aging in a single session.
People who should not get Botox or filler
Botox and filler are safe for most people, but they are generally not recommended for individuals who are pregnant or breastfeeding. Additionally, those with certain neuromuscular conditions or a history of severe allergies and anaphylaxis should avoid them.
Get the results you hope for with the help of a cosmetic medicine expert
Deciding between Botox, filler or both comes down to your specific goals. Whether you want to smooth out expression lines or restore a youthful fullness to your face, the right choice is highly individual. By understanding how each treatment works, you can make an informed decision that helps you look and feel your best.
At HealthPartners, you can access Botox, filler and other cosmetic medicine services through our cosmetic dermatology and cosmetic surgery practices. Choosing whether to see a cosmetic dermatology or cosmetic surgery clinician mostly depends on your care preferences, timeline and other personal factors.