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Botox vs. Fillers: What's the Difference?

Kristin Hall

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 2/08/2021

So you want to make your wrinkles disappear, and you’ve heard a quick injection might do the trick. You’re not alone in that. Both Botox® and dermal fillers are chart toppers when it comes to younger skin, and it’s because they’re singing a catchy song: easy and effective.

Botox and Fillers are two of the most en vogue treatments for fine lines, wrinkles and signs of aging skin. And they’re so popular for a reason: a couple of relatively painless treatments, they’ve been proven safe and effective, with near immediate visible results.

But while both are popular and come from a syringe, they’re very different treatments for the same problem of aging skin. 

Are they right for you? Maybe. Both treatments have a lot of strengths, though there are some practical drawbacks that you should consider before engaging in a regimen of either. Before we get to the hard facts on botox and fillers, let’s talk about why you’d need them in the first place.

How Aging Wrinkles Happen

The two major theories of skin aging key in on two primary mechanisms for the appearance of wrinkles: intrinsic sources, like the decrease of function over time and reduced cellular lifespan; and extrinsic factors, i.e. the  external sources of damage, inflammation and the formation of free radicals.  

But what makes those things happen can vary pretty widely. They can come from a variety of sources, including the sun and air quality to your diet and sleeping position. Additional causes include poor nutrition, smoking, and insufficient water intake.

As you age, the collective sum of these things makes it harder for your skin to produce the same healthy cells time after time, and so wrinkles, dullness and dryness, and aging spots can occur as a result.

Of course, there are treatments to help your skin with these problems, as you’re probably here to learn about. So let’s get back to one of the most popular: injections.

Botox vs. Fillers

Botox and fillers are a little like apples and oranges. They’re not the same thing, but they both have been proven as fruitful treatments for fine lines, wrinkles and other signs of aging. 

The difference has to do with the type of wrinkle each treatment fights. There are two kinds of wrinkles: dynamic wrinkles like crows feet, which are caused by muscle activity; and static wrinkles like laugh lines, which are present when the face is relaxed, and are caused by the loss of collagen and elasticity. Botox is best for dynamic wrinkles, and static wrinkles can be treated with both botox and fillers.

Fillers are an injectable compound that can address these problems by lifting and volumizing—filling—the area under your skin. The most common type of dermal filler is hyaluronic acid, which occurs naturally in your skin. We’ve written about it extensively here.

Hyaluronic acid helps your skin retain moisture, which helps give it that youthful, bouncy firmness you lose as you age. Injecting a hyaluronic filler into the skin supplements your face with additional moisture retention, which will in turn fill the sunken spaces like wrinkles where the skin has lost its firmness and resiliency.

Many studies have confirmed that hyaluronic acid fillers are effective in helping to make folds and wrinkles in facial skin less visible.

In comparison, botox is a protein secreted by the bacterium Clostridium botulinum — which you may know as the source of the food poisoning botulism. 

Botox is a neurotoxin protein that attacks nerve cells and paralyzes muscles. That may be a bad thing when it’s part of your lunch, but as an FDA-approved injectable treatment, it’s an effective wrinkle reducer. 

Botox is injected into the muscles below the skin in low doses, causing the muscles that stretch and crease the skin to weaken, and stop creasing and stretching the skin.

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Can You Do Both?

Yes, you can do both, and many people do. The combination of both treatments is often recommended, as together they can reduce the effects and further wear on the skin from aging for the duration. 

Fillers can also be used in conjunction with other cosmetic surgeries, and both Botox and Fillers can be used in conjunction with other treatments such as retinoids, though you should talk to your dermatologist about the timing, as your skin can be extra sensitive after injections.

Because they use different mechanisms to treat wrinkles they can be used simultaneously, and many healthcare providers will offer them in the same treatment. Botox can also be used preventatively.

How Long Do They Last, and What Are the Risks?

Both Botox and fillers are temporary solutions, which will wear off and require follow up treatments. Both fillers and Botox can require follow up treatments in as little as three to six months. That said, dermal fillers will generally last anywhere from six to 12 months.

But even with a treatment a year, this can be expensive, as Botox treatments can run hundreds of dollars a piece, and fillers can cost anywhere several hundred to over a thousand dollars. 

And both injections have potential complications to be concerned about. In addition to allergic reaction, irritation, and rare cases of infection at the injection site, you should talk to a healthcare provider before using either treatment if you’re prone to bleeding, scarring, or are undergoing immunosuppressive therapy.

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Are They Right For You?

Injections may be popular among celebrities and your friends—even some of your parents—but they shouldn’t be your only consideration. Injections come with relatively serious potential complications and the risk of infection, plus they’re expensive. And to keep the look you get, you’re locked into treatments indefinitely. 

Put simply, there are cheaper solutions with fewer and less drastic risks for your skin. 

Hers’ anti-aging cream contains tretinoin—a retinoid medication that helps speed up rejuvenation by boosting the rate of the turnover of dead skin cells. It’s a retinol—a vitamin A compound with exfoliating properties.

Certain lifestyle and habit changes might be worth considering. Aging, excessive sun exposure and poor diet are potential causes of older and duller looking skin, and you may be able to reverse the appearance of some signs of aging with simple diet and lifestyle changes, or by quitting smoking. 

If you’re looking at options, consult a health care provider with questions. They may recommend topical or other treatments that can be administered at home before suggesting more serious procedures. 

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.