BOTOX® Cosmetic and dermal fillers are popular cosmetic injectables. Both are used to rejuvenate the skin and balance out facial features. Each treatment is minimally invasive, which means it is performed in our office and doesn’t require downtime.But although these treatments are similar in many respects, there are also quite a few differences between them. If you are thinking about getting cosmetic injectables, you probably have questions about each and wonder when you should choose one over the other. Here is everything you need to know about Botox vs. fillers.

What Is Botox?

BOTOX® Cosmetic is a popular brand name for botulinum toxin type A. This is a purified neurotoxin produced by the Clostridium botulinum bacterium. In its purified form and in the doses found in Botox, this toxin is not dangerous -- in fact, it's not just harmless, it's beneficial.Botox has been approved by the FDA since 2002 as a temporary treatment for moderate to severe frown lines. Since then, this injectable has been approved for a dozen more uses, many of which are therapeutic. And with over 4,700 articles in peer-reviewed journals demonstrating its safety, Botox is one of the safest injectables today [1].In addition to Botox, other botulinum toxin injectables approved in the US include Jeuveau, Dysport, Xeomin and Daxxify.

Botox Uses

Botox is mainly used to diminish wrinkles in the upper half of the face, such as:

• Frown lines
• Forehead lines
• Crow’s feet

However, Botox can also be used to:

• Diminish bunny lines
• Treat a dimpled chin
• Diminish neck wrinkles
• Slim down the jawline
• Lift the eyebrows
• Treat TMJ
• Alleviate symptoms of Bruxism (teeth grinding)

Botox Effects

Botox works by temporarily paralyzing muscles that contribute to wrinkles. Its active ingredient, botulinum toxin type A, blocks nerve signals between muscle cells, which keeps muscles from contracting. With diminished muscle movement, existing wrinkles begin to fade away, and new ones are prevented from forming.The effects of Botox become noticeable after three to seven days. These effects include reduced movement of upper facial muscles and visible reduction in fine lines and wrinkles, resulting in a more youthful and relaxed appearance.The results of Botox last three to five months on average. However, research shows that the duration of efficiency increases with each new round of Botox injections [2]. In other words, you might enjoy your Botox results for longer after each treatment.

What Are Fillers?

Dermal fillers are substances injected underneath the skin to smooth out wrinkles and add volume to the face and hands. While Botox and other Botox-type injections have the same primary ingredient, dermal fillers are more varied. The ingredients used in dermal fillers include:

Hyaluronic acid (HA)

HA is a sugar molecule that is a natural component of your skin. It keeps the skin hydrated and plump by binding to water. Brands that use this ingredient include Restylane® and Juvéderm®.

Calcium hydroxylapatite

This mineral-like like compound is suspended in a gel to add immediate lift. Over time, this ingredient continues to improve the skin’s appearance by stimulating collagen production. Radiesse® is currently the only FDA-approved filler with this ingredient.

Polyacrylamide

This transparent hydrogel is an ingredient in semi-permanent fillers like Aquamid®, which is not yet available in the United States. It works by triggering collagen to form around it. Although it can be permanent, you can remove this filler if necessary.

Polymethyl-methacrylate microspheres (PMMA)

Another semi-permanent filler ingredient used by brands like Bellafill® and Artefill®, this ingredient also works by stimulating collagen production around PMMA beads.

Poly-L-lactic acid

This ingredient is a synthetic but biodegradable polymer. It also works by gradually stimulating collagen production over several months, and results can last years. The most popular brand that uses this ingredient is Sculptra®.

Filler Uses

Fillers have been trending lately for their ability to add natural fullness to the lips, but their benefits extend way beyond that. Dermal fillers can also rejuvenate the face and hands by:

• Smoothing out wrinkles
• Filling in hollows
• Restoring facial contours

Unlike Botox, which is mostly used to diminish wrinkles in the upper half of the face, fillers are mainly used in the lower two-thirds of the face. Because they don’t affect muscle movement, you will still maintain your natural expressions.

Filler Effects

Fillers add volume to the skin by binding to water or stimulating collagen production. Because volume loss is a major cause of facial aging [3], restoring volume with fillers helps create a more youthful appearance. Another common cause of aging is loss of skin elasticity due to reduced collagen levels, which fillers can also help address.The effects of fillers are usually temporary, although some fillers are semi-permanent or even permanent. Most fillers, however, last six to 12 months on average. Some fillers can be removed with enzyme solutions if you are not satisfied with the results or the treatment leads to complications.

Botox vs. Fillers: Key Differences

Botox and fillers have many similarities: they’re both minimally-invasive injectables, they address common signs of aging, and their effects are usually temporary. But there are important differences between Botox vs. fillers:

• Botox is mostly used to diminish wrinkles; fillers address volume loss, wrinkles and uneven contours
• Botox is primarily used in the upper half of the face; fillers address issues in the bottom thirds of the face
• Botox works by freezing muscle movement; fillers work by boosting skin volume
• Botox lasts three to five months; fillers last from six months to indefinitely
• The active ingredient in Botox and Botox-type injectables is a neurotoxin; fillers include a wide range of different ingredients

If you are interested in exploring how injectables can help you reach your cosmetic goals, contact the Vein & Cosmetic Center of Tampa Bay today. Our team can guide you through the selection process and help youfind the injectable that works best for you.References:

1. Celebrating 20 Years of BOTOX® Cosmetic. Botox Cosmetic. Accessed January 2022: https://www.botoxcosmetic.com/what-is-botox-cosmetic/celebrating-20-years-of-botox-cosmetic
2. Lecouflet M, Leux C, Fenot M, Célerier P, Maillard H. Duration of efficacy increases with the repetition of botulinum toxin A injections in primary axillary hyperhidrosis: a study in 83 patients. J Am Acad Dermatol. 2013;69(6):960-964. doi:10.1016/j.jaad.2013.08.002
3. Coleman SR, Grover R. The anatomy of the aging face: volume loss and changes in 3-dimensional topography. Aesthet Surg J. 2006;26(1S): S4-S9. doi:10.1016/j.asj.2005.09.012