Which one is right for me?
This is actually a very common question for people who are inexperienced with the aesthetic world.
Despite Botox and Fillers both being very popular cosmetic treatments that address signs of aging, they work in very different ways and are used to target very different pieces of the aging process.
What are they made of?
Botox is a neurotoxin derived from the bacterium Clostridium botulinum (yes, the same bacterium that causes Botulism). But don’t worry, it’s been purified and there have been ZERO cases in history of someone getting Botulism from Botox.
It comes in powder form in a vial, which we reconstitute with saline prior to injection. How much saline we use is referred to as the “dilution”, which can vary based on provider preference for a desired effect.
There is also Dysport, Xeomin, Jeuveau, and Daxxify, which are all different brands with different manufacturing processes, but all still use the same botulinum toxin.
*Side note: I often hear people talk about previous treatments not being very affective and accuse the injector of “diluting the Botox”. Technically we all dilute Botox. What matters is whether you got the number of units they say they gave you. Your treatment may have been ineffective for a variety of reasons (including the injector), which I’ll go into in a future blog post.*
Fillers are most often made of Hyaluronic Acid (HA), a molecule found naturally in our own tissue that has been processed in a way that transforms it into a gel-substance that is then injected into the tissue.
Juvederm and Restylane are the most common examples of hyaluronic acid fillers. There are also calcium based fillers (Calcium Hydroxylapatite) (i.e. Radiesse), fillers made of polymethyl methacrylate (PMMA) (i.e. Bellafill), and biostimulatory fillers made of Poly-L Lactic Acid (PLLA) (i.e. Sculptra).
Each of these types of fillers can serve a different purpose, but for the sake of this blog post, I’ll be referring only to HA fillers.
How do they work?
Botox blocks the release of transmitters that cause muscles to contract, which causes the muscle to be temporarily “paralyzed” or relaxed. This relaxation of the muscle helps soften Dynamic Lines, which are lines and wrinkles caused by repeated movement of the muscles.
Eventually, dynamic lines can become Static Lines (lines that are still there when the face is at rest) due to the natural aging process that results in collagen loss and loss of elasticity of the tissue. This is why repeated treatments are needed to maintain your results. If the muscles start moving again for too long, the static lines will return.
Fillers are injected into the tissue to add volume and fill in wrinkles, folds, or hollow areas to create a smoother, more youthful appearance.
As we age, we lose volume in the deep fat pads of our face, our skin due to collagen and elasticity loss, and even in the bones of our skull.
Different fillers can be used to address each of these areas of volume loss. That is why it’s important to choose a provider who has expert knowledge of facial anatomy and the aging process, so that they can choose the proper filler to help solve your particular problems.
How long do they last?
Botox typically takes 3-4 days to start working and up to 2 weeks to reach it’s peak effect. These results last for about 8-10wks before the muscle gradually starts regaining movement (So no, your botox didn’t suddenly wear off overnight 3 days ago). Repeat treatment is usually recommended at 3-4 months as this is when most people have regained most of their movement.
It’s usually best to wait until your movement has almost fully returned to get another treatment. I know, you don’t want the lines, but there is evidence to suggest that getting retreated TOO often can contribute to becoming resistant to the toxin over time, which you DEFINITELY don’t want to happen.
Don’t worry! With consistent, routine treatments, those dynamic lines are not going to become static lines again, even if you have a bit of movement coming back!
And remember that with any neurotoxin brand, dose=duration. More units does mean longer duration, but some people feel that more units leaves them “too frozen”, especially if they work in TV, film, or even psychology. In this case, they opt for being treated with a lower dose in order to retain some movement, knowing that their results won’t last quite as long and will need to be retreated slightly more often (but usually only by a couple of weeks).
Filler duration varies depending on the type of filler used. Heavier, more solid fillers, like Juvederm Voluma, have FDA approval to last up to 2 years, whereas softer fillers, like Juvederm Volbella, are only approved to last up to 1 year. There are many different factors that affect how long a filler lasts.
This doesn’t mean that you can just use a longer lasting filler anywhere, however. Different fillers are meant for different areas and you should let your provider decide which ones are best suited to accomplish the task.
The results of both Botox and Filler, however, can vary largely between individuals. In some people, it lasts longer, in some it doesn’t last as long. Some people are more sensitive to Botox and some are less sensitive to it. Everyone is different. If you feel like your results aren’t lasting as long as they should, your injector should be able to help you figure out why that may be!
Where are they used?
Botox is most commonly used in the forehead for horizontal forehead lines, between the eyebrows for frown lines, and around the eyes for crow’s feet.
However, Botox can be used in countless other areas, such as in the nose (for bunny lines, nasal flaring, or tip drooping), in the lips (to fix a gummy smile or as a lip flip to increase vertical show of the upper lip), in the chin to prevent dimpling, or in the neck to smooth out playstmal bands. The list could go on and on…and on.
Filler can be used in areas of volume loss both deep and superficial, such as the cheeks, undereyes, nasolabial folds (smile lines), marionette lines (frown lines), and lips (my personal favorite). It’s also become very popular in jawlines, temples, and even noses (aka liquid rhinoplasty)!
So while Botox and Fillers are both incredibly diverse non-surgical treatments, they serve very different purposes, and a combination of BOTH may be needed for comprehensive facial rejuvenation. The choice between Botox and dermal fillers and what to use where depends on your specific concerns and goals.
If you’re not sure where to start, give us a call or schedule a free consultation and we’ll help map out your treatment plan!
