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Botox vs. Fillers: What’s the Difference?

Over the past decade, injectables have gained a lot of popularity and become one of the go-to cosmetic corrections. 

While cosmetic Botox injections still dominate the category, various dermal fillers are starting to be included in treatment plans for their own specific benefits. 

So when it comes to treating fine lines or smoothing out your skin, which option do you go for? What’s the difference between Botox and dermal fillers? And can you use them at the same time? Knowing the answer to these and other questions will help dissipate confusion and prepare you for your first injection consultation.

What Are Botox and Fillers?

You’ve probably heard quite a few things about Botox already, as it’s become a common word for the whole category. In reality, Botox® is the brand name that relates to a commercial form of botulinum neurotoxin, a neurotoxic protein. 

Functionally, Botox works by temporarily relaxing or weakening specific muscles, which helps avoid or prevent dynamic wrinkles that are often the result of various facial expressions: frown lines, crow’s feet, parallel lines between the eyebrows, etc. 

Most popular dermal fillers are based on hyaluronic acid, calcium hydroxyapatite or poly-l-lactic acid (PLLA) and are essentially gels used to replenish volume or fill various folds and creases. They are great at helping with contouring the face. 

Having different types of fillers available makes it easier for a dermatologist to pick one that fits your skin type the best. Fillers generally differ in thickness and hence duration, lasting anywhere from a few months to a few years. 

Even though Botox and dermal fillers are frequently used together, they solve different problems and work on different areas and lines. While cosmetic Botox injections can do wonders for lines that are in constant motion, dermal fillers beautify the areas at rest.

Where Is Botox Used?

As mentioned above, the most common areas for cosmetic Botox injections are forehead and around-the-eyes areas. Botox can also be applied to the neck, lips and corners of the mouth (to fix frowning).

Some non-cosmetic Botox usage is also widely practiced, including armpits (against excessive sweating) and jaw to stop teeth grinding. 

At the same time, Botox can be used to enhance certain features. You can, for example, alter the arch of your eyebrows, the angle of your jaw or even the way you smile. 

Finally, using Botox preventatively is gaining more popularity as well. Starting as early as their 20s, some patients want to prevent wrinkle formation in certain areas, and Botox can certainly help with that. 

How Is Botox Injected? 

Cosmetic Botox injections are done right in the central part (the belly) of the specific muscle. Since lots of face muscles overlap, a proper amount of Botox needs to be injected directly in the right muscle at the right depth to ensure the correct result is achieved, without other nearby muscles being affected.

There’s also no way to reverse an unwanted result other than waiting for a few months for Botox to dissolve. This means carefully selecting a board-certified doctor with many years of experience should be your top priority. 

After the injection, you can start seeing results in as little as a few days, with full effect taking place after one week. 

What Are the Most Popular Dermal Fillers?

As mentioned above, there are a few types of dermal fillers in use: hyaluronic acid fillers, calcium hydroxyapatite fillers and poly-l-lactic acid (PLLA) fillers. 

Hyaluronic acid fillers are the most common, used under brands such as Juvederm, Restylane and Belotero. These fillers are not permanent since our bodies will break them down over time — they last around one to two years, on average — but they could also be dissolved right away if needed. 

Calcium hydroxyapatite fillers, such as Radiesse, also last between one and two years, but can’t be dissolved. 

Poly-l-lactic acid (PLLA) fillers, such as Sculptra, stimulate collagen production and help restore the fullness of your skin gradually, with results developing over several months and lasting up to two years. The filler also can’t be dissolved prematurely. 

Permanent dermal fillers also exist, but their usage by professionals is quite limited due to potential long-term consequences.

Only a highly qualified dermatologist can correctly choose a filler based on the type of concern and the area to be treated. 

Where Are Fillers Used?

Filler injections are common in most areas where aging causes changes in volume: cheeks, lips and smile lines. Injections under the eyes are often used to improve the tired look. Jawline and chin injections are also becoming increasingly popular in the “Zoom era” — people want to show a youthful and strong appearance even on video conference calls. 

Can Botox and Filler Work Together? 

Since Botox and dermal fillers produce different effects, they are often used together to get very specific and granular results.

For example, Botox and fillers can be both applied to magnify lips. While Botox relaxes the muscles around the mouth and rolls the lip forward (without adding any volume), fillers can be used to actually make the lip bigger. 

Similarly, when you want to refine the contour of your chin, filler can add physical volume and a better profile, while Botox can relax the muscles around to reveal the full effect of the filler. 

Do Botox and Fillers Have Side Effects?

Botox and fillers used by dermatologists are safe treatments that have been extensively studied and approved by both the FDA and Health Canada. 

That said, some minor side effects like swelling or bruising might occur. As always, the best way to minimize any adverse reactions is to seek a certified dermatologist who specializes in injections. 

In the end, both Botox and fillers have their own advantages and, with professional use, can produce outstanding results in terms of improving facial appearance. Botox, in particular, can even go beyond cosmetic modification and be used in treating excessive sweating, teeth grinding and even migraines. 

Have more questions regarding Botox or dermal fillers? Don’t hesitate to book a Dermetics appointment, where either Dr. Muhn or Dr. Rosen will listen to all of your concerns, assess your skin and create a plan tailored specifically to your situation. 


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