Tuesday, May 17, 2022

Main Differences, Prices, Best Results, and More

  • Botox injections effectively reduce the appearance of fine lines and wrinkles in the face
  • Dermal filler injections plump and smooth areas of the face to restore lost volume
  • Botox lasts about three to six months; dermal fillers six months to five years
  • Botox can be safely used in combination with dermal fillers to address multiple issues

Botox and dermal filler injections are popular cosmetic treatments that can successfully minimize the signs of aging on the face and restore a youthful appearance. These treatments can address fine lines and wrinkles, add or restore lost volume, and provide a rejuvenating effect. When determining your aesthetic goals, it is advantageous to compare Botox vs. dermal fillers to determine which is right for you. 

What Is Botox?

Botox is a neurotoxin, called botulinum toxin, which is injected into the face to target crow’s feet and fine lines as well as facial creases. This neurotoxin smooths and relaxes the facial muscles to soften the appearance of lines and wrinkles. 

These injections temporarily paralyze facial muscles by blocking nerve signals that enable muscles to contract. 

Botox injections are minimally invasive, have no downtime, and can be completed within 1 hour in an outpatient setting. Other botulinum toxin injections within this category include brand names Xeomin and Dysport.

Of all cosmetic procedures performed in the United States, Botox injections are the most frequently performed, attesting to its popularity.

What is Botox used for?

Botox injections are primarily used to reduce the appearance of fine lines and dynamic wrinkles, resulting in skin that appears smoother and more youthful. Dynamic wrinkles are caused by repeated facial expressions, such as smiling, frowning or squinting. 

Injections are typically placed around the mouth and eyes, on the neck, between the eyebrows and on the forehead – those areas where dynamic lines most frequently develop. 

Botox is sometimes used for other cosmetic purposes, such as slimming the appearance of the face and softening a square jawline – called a lower face reduction.

Injections are placed in the masseter muscle, one of the muscles responsible for chewing. This relaxes the muscle and inhibits movement while still allowing for normal function of the jaw and facial expression.

How long do the results last?

It takes about 1 week before you see significant results from these treatments. While results can last as long as 6 months, they usually begin wearing off gradually after 3 months. Your practitioner will advise you as to when you should schedule repeat treatments in order to maintain your desired look.

Cost of Botox

The cost of Botox will depend on the number of injections you receive and the provider you choose. On average, each treatment costs between $325 and $600 per area.

As Botox is considered an elective cosmetic procedure it isn’t covered by insurance. To remedy this, many providers offer low-interest financing options and flexible payment schedules; ask your practitioner for details.

Side effects

Mild and transient side effects, and potentially serious side effects are associated with these treatments. As with any injection, a typical response is temporary pain and bruising at the injection site.

The most effective preventative measures include performing a complete medical history, and using the correct dose and technique. Doing so results in a low incidence of side effects.

Mild and temporary side effects include:

  • Drooping eyelids
  • Dry mouth and eyes
  • Headache or flu-like symptoms
  • Itching
  • Nausea
  • Numbness
  • Rash
  • Redness
  • Swelling

Serious side effects include: 

  • Loss of bladder control
  • Muscle weakness or paralysis 
  • Trouble breathing, speaking, or swallowing
  • Vision issues 

Serious side effects are usually the result of the toxin migrating within the body. This can occur within hours or several weeks later. Contact your care provider immediately if you notice these symptoms.

To reduce these risks, Botox is recommended only for those in good physical health. To avoid the risk of severe bruising, blood thinners must be avoided several weeks before treatment. 

If you are pregnant, breast-feeding, taking antibiotics or have neuromuscular issues, you may not be a good candidate for these injections. 

What Are Fillers? 

Dermal fillers are another injectable cosmetic treatment used to address static wrinkles and other visible signs of aging on the face. They can plump up and define targeted areas of the face, and replace lost volume. This reduces the appearance of wrinkles and firms up sagging areas of skin. 

In addition to the filling effect, some fillers can stimulate collagen production to boost skin’s strength and elasticity. 

Dermal fillers are formulated with a variety of materials which affects longevity as well as texture. Your practitioner may choose one over another based on the treatment area. Hyaluronic acid fillers are very popular and chosen for their availability, safety record and predictable outcomes. They are used most often to plump and define lips, as they provide natural-looking results.

Types of dermal fillers include:

What are fillers used for? 

Dermal fillers are typically used to augment the lips and cheeks, treat marionette lines and add volume to areas of the face and hands that show signs of aging. 

Fillers, especially hyaluronic acid fillers, are proven treatments for atrophic (depressed) acne scars. They can be used alone or combined with other treatments for greater benefits.

How long do the results last?

Most dermal fillers last between six months and two years; PMMA fillers are considered to be semi-permanent and last two to five years. Fat injections are considered permanent.

Your practitioner will discuss with you when you should repeat treatments in order to maintain your results – usually this is six to nine months.

Cost of fillers 

The cost of dermal fillers depends on several factors: the number of injections you’ll need, the filler materials used, your provider’s fees and your location. The following are average costs per treatment:

  • Calcium hydroxylapatite (CaHA) injections, $650–$800 
  • Collagen injections, $1,900 
  • Fat injections, $3,000–$6,000 
  • Hyaluronic acid injections, $400–$1,000 
  • Poly-L-Lactic acid injections, $700–$1,000 
  • Polymethyl methacrylate (PMMA) injections, $1,000  

When planning your budget, factor in follow-up treatments, as most dermal filler injections need to be repeated to maintain results.

Side effects

Dermal filler injections are generally considered to be safe, but still carry the risk of side effects; these are typically mild to moderate and usually resolve within two weeks. To avoid any potential allergic reactions, your provider will likely perform a patch test before administering any injections.

To minimize the risk of side effects, ensure you choose a licensed provider who is experienced in this domain.

Mild side effects include: 

  • Bruising
  • Filler migration
  • Itching
  • Lumps under the skin
  • Numbness
  • Pain
  • Pustules
  • Redness
  • Scarring

Serious, but rare side effects include:

  • Infection at the injection site
  • Skin cell death 
  • Vision loss or blindness

Should You Choose Botox or Fillers?  

Deciding whether to choose Botox or fillers depends on the specific skin issues you want to address. With that being said, you can also consider a combination for more dramatic results.

Main differences 

Botox treats deep lines and wrinkles by inhibiting movement of facial muscles, specifically lines and furrows on the forehead, frown lines and crow’s feet.  

Dermal fillers are available in a number of formulations, and also treat lines and wrinkles but do so by adding filler solution beneath the skin. They do not affect muscles but instead add volume to plump and smooth cheeks, and add definition to the lips and jaw.


Botox and fillers are both considered safe, effective ways to address visible signs of aging in the face. Both types of injections help to restore a youthful appearance, although they each address different concerns. With the exception of fat injections, these fillers are temporary.

Botox is an ideal solution to treat dynamic wrinkles such as marionette lines, crow’s feet and forehead wrinkles as it can effectively paralyze the facial muscles responsible for creating these lines.

Dermal filler injections can effectively treat static wrinkles, define and plump the lips, and add volume to the cheeks and chin. Both types provide anti-aging effects.

When looking at cost, it is important to consider the cost of the treatments, the location, provider fees and number of required injections. You will also need to factor in the cost of follow-up treatments.


  • Small R. Botulinum toxin injection for facial wrinkles. Am Fam Physician. 2014 Aug 1;90(3):168-75. https://pubmed.ncbi.nlm.nih.gov/25077722/
  • Susmita A, Kolli NN, Meka S, et al. An Evaluation of Use of Botulinum Toxin Type A in the Management of Dynamic Forehead Wrinkles – A Clinical Study. J Clin Diagn Res. 2016;10(10):ZC127-ZC131. doi:10.7860/JCDR/2016/21904.8695
  • Wu WT. Botox facial slimming/facial sculpting: the role of botulinum toxin-A in the treatment of hypertrophic masseteric muscle and parotid enlargement to narrow the lower facial width. Facial Plast Surg Clin North Am. 2010 Feb;18(1):133-40. doi:10.1016/j.fsc.2009.11.014
  • Witmanowski H, Błochowiak K. The whole truth about botulinum toxin – a review. Postepy Dermatol Alergol. 2020;37(6):853-861. doi:10.5114/ada.2019.82795
  • Wang F, Garza LA, Kang S, et al. In Vivo Stimulation of De Novo Collagen Production Caused by Cross-linked Hyaluronic Acid Dermal Filler Injections in Photodamaged Human Skin. Arch Dermatol. 2007;143(2):155–163. doi:10.1001/archderm.143.2.155
  • Luthra A. Shaping Lips with Fillers. J Cutan Aesthet Surg. 2015;8(3):139-142. doi:10.4103/0974-2077.167269
  • Baspeyras, M, Dallara, J-M, Cartier, H, Charavel, M-H, Dumas, L. Restoring jawline contour with calcium hydroxylapatite: A prospective, observational study. J Cosmet Dermatol. 2017; 16: 342– 347. https://doi.org/10.1111/jocd.12335
  • Fitzgerald R, Bass LM, Goldberg DJ, Graivier MH, Lorenc ZP. Physiochemical Characteristics of Poly-L-Lactic Acid (PLLA). Aesthet Surg J. 2018 Apr 6;38(suppl_1):S13-S17. doi:10.1093/asj/sjy012
  • Hussain SN, Goodman GJ, Rahman E. Treatment of a traumatic atrophic depressed scar with hyaluronic acid fillers: a case report. Clin Cosmet Investig Dermatol. 2017;10:285-287. Published 2017 Aug 3. doi:10.2147/CCID.S132626
  • Lafaille P, Benedetto A. Fillers: contraindications, side effects and precautions. J Cutan Aesthet Surg. 2010;3(1):16-19. doi:10.4103/0974-2077.63222
  • Rohrich RJ, Ghavami A, Crosby MA. The role of hyaluronic acid fillers (Restylane) in facial cosmetic surgery: review and technical considerations. Plast Reconstr Surg. 2007 Nov;120(6 Suppl):41S-54S. doi:10.1097/01.prs.0000248794.63898.0f

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