What Is the Difference Between Botox and Fillers?

You may have heard that fillers and neuromodulators (botulinum toxin, or BTX) are great for reducing wrinkles and helping your skin look younger. But is there a difference between BTX and fillers? And if so, which one is right for you?

Here’s what you need to know about BTX vs. fillers.

Fillers Vs. BTX

BTX and fillers are both injectable procedures. That means a cosmetic dermatologist injects substances into your skin to help smooth wrinkles or add plumpness to your face. The result is a fresher, younger-looking complexion with little or no downtime.

But doctors use fillers and BTX for somewhat different reasons. A cosmetic dermatologic surgeon can tell you which is best for your needs.

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What Is a Neuromodulator?

BOTOX®️ and Dysport®️ are brand names for botulinum type A injections. Doctors use small doses to temporarily relax overactive facial muscles and help reduce facial wrinkles.

BTX also has other medical uses, including treating excessive sweating, migraine headaches, and bladder problems.

BTX temporarily relaxes the muscles where it is injected. In the face, it can reduce the appearance of frown lines and wrinkles. The most common areas for BTX treatment are the forehead, the space between the eyebrows (“the 11s”), and around the eyes.

The effects of BTX usually last a few months. Many people feel it gives them a rejuvenated look without having to undergo more invasive procedures.

What Are Fillers?

Fillers are also injectable treatments. Doctors may refer to these treatments as dermal fillers, soft-tissue fillers, and soft-tissue augmentation.

Fillers add fullness to areas of your face that may have changed with age, such as hollow areas under the eyes. Fillers can smooth out wrinkles or plump your lips, adding to a more youthful look. Doctors also use fillers to diminish scars or restore volume to hands.

There are different types of fillers. They are all made in a laboratory, but the substances are similar to those our bodies make naturally.

Sometimes, doctors perform fat transfers or fat augmentation. They take fat from one part of your body and inject it into certain parts of the face to restore lost volume.

Depending on your type of filler, results can last from a few months to a few years. Like BTX, fillers are less invasive than other cosmetic treatments like surgery.

Where Should I Get Injectable Treatments?

You should always see a cosmetic dermatologist for any injectable treatment. Cosmetic dermatologists are medical doctors with extensive training and knowledge about the skin and its underlying nerves, muscles, and blood vessels. They have years of experience treating people with BTX and fillers.

Another reason to see a cosmetic dermatologist is that they can diagnose and treat any underlying medical issues with the skin. For instance, a seemingly harmless-looking blemish could be an early stage of skin cancer. Only a doctor can treat skin cancer and other skin diseases.

You should never get neuromodulators or fillers from:

  • A cruise ship or travel abroad
  • A nonmedical spa.
  • A party.
  • A salon.
  • Someone’s home.

How Are Filler Treatments Performed?

Your procedure may depend on what part of the body your doctor is treating and what kind of filler they use. Some fillers require allergy testing before treatment. But most treatments require only one office visit and take 15 to 30 minutes.

What to expect:

  1. Your doctor will apply an anesthetic or nerve block to the site.
  2. Your doctor will inject filler into the area. They may need to give you several injections for good results. It may sting or burn a bit when the doctor injects the filler.
  3. You’ll ice the area for 15 to 20 minutes before you leave the office to reduce redness and swelling.
  4. You should stay out of the sun and wait a day before doing any strenuous exercise.

With most fillers, you should avoid touching the treated area for several days. Other fillers require gentle massage for a few weeks. Your doctor will give you specific instructions on caring for the affected area.

Note: If your body fat is the filler, doctors will use liposuction to remove it from the original area. The medical team processes the fat before injecting it into another part of your body. The entire treatment takes about an hour.

What Happens When You Get BTX?

When you go into the doctor’s office for BTX treatments, here’s what happens:

  1. Your doctor will rub an anesthetic cream onto the area to get injected.
  2. They’ll inject the medicine into certain facial muscles.
  3. The whole procedure only takes a few minutes. You should be able to return to normal activities right away.

You should notice results within a week or so as the muscles begin to relax.

What to Expect at Your First Appointment With a Cosmetic Dermatologic Surgeon

It’s important to consult a cosmetic dermatologic surgeon to decide whether BTX or dermal fillers — or a combination of the two — are right for you. They’ll take a medical history and examine the area where you’re seeking treatment.

It’s a good idea to bring photos of yourself from a time when you were happy with your appearance. That’ll help the doctor know your desired results and areas of focus.

Questions to ask the cosmetic dermatologic surgeon

  • Are any complications or side effects likely? Infection, bleeding, and bruising are possible after any cosmetic procedure.
  • How long will the results last? Neuromodulators typically last a few months. Dermal fillers may last anywhere from a few months to a few years, depending on which type your doctor used.
  • How many of these procedures have you done? You want to find a doctor who has done many injections.
  • What results can I expect? You can ask to see before-and-after photos of other people the doctor has treated.
  • What will it cost? Insurance doesn’t cover most cosmetic procedures because they’re not medically necessary.

What to tell a cosmetic dermatologic surgeon

Your doctor needs to know your medical history and any medicines or herbal remedies you take. Certain substances can interact with injectable treatments. So be ready to share information about:

  • Any medicines you currently take.
  • Herbal remedies, vitamins, or other over-the-counter products you take.
  • Other surgeries or cosmetic treatments you’ve had.
  • Whether or not you’re pregnant.

American Cosmetic Association, Review of Cosmetic Dermatology Procedures, Link

American Board of Cosmetic Surgery, Botox-Type Injectables Guide, Link 

American Academy of Dermatology Association, Botulinum Toxin Therapy: Overview, Link 

American Academy of Dermatology Association, Fillers: Overview, Link

American Academy of Ophthalmology, How Does Botulinum Toxin (Botox) Work? Link

About Dermatology

The UPMC Department of Dermatology diagnoses, treats, and manages numerous hair, skin, and nail conditions and diseases. We care for common and uncommon conditions, and our treatments include both surgical and nonsurgical options. We operate several specialty centers for various conditions. The UPMC Cosmetic Surgery and Skin Health Center is a comprehensive dermatologic laser facility, offering a full range of cosmetic services and procedures. With UPMC Hillman Cancer Center, we offer a Skin Cancer Program that provides complete care from screenings, diagnosis, treatment, and beyond. Find a dermatology provider near you.