There’s no doubt that the popularity of injectables is on the rise, but there’s still a lot of confusion when it comes to the difference between Botox and filler. Here, Dr Dower explains what each treatment is used for, so that you’re better equipped to make a decision.

The difference between Botox and filler

Botulinum toxin (also known as ‘Botox’) is a natural, purified protein that is injected directly into the facial muscles to temporarily relax them. This prevents the muscle contractions that would otherwise result in wrinkling of the skin. Botox is therefore an excellent treatment to help minimise the appearance of wrinkles, while preventing the formation of new ones. An experienced hand and skilful technique is essential to ensure a softer, more rested appearance and to avoid the dreaded ‘frozen’ look. A trained practitioner can achieve a natural, discreet result by injecting careful volumes in the correct anatomical pattern. No one should suspect that you’ve had Botox. In fact, you should receive compliments on how rested you look, not questions about what you’ve had done! One can also use Botox to treat a number of medical conditions, like excessive sweating (or hyperhidrosis), or jaw clenching.

An important note: Botox is actually the brand name of a specific Botulinum toxin. Other FDA-approved neurotoxins include Dysport and Xeomin.

Filler is used to bring harmony to the face by optimising ideal proportions, which the human eye recognises as youthful and beautiful. This is done by enhancing the volume in areas such as the cheek and jaw line, and by smoothing out contours around the eyes or mouth. It’s also ideal for filling in creases and fine lines, and to plump up thin lips.

The different types of fillers

There are a number of different types of dermal fillers, with the most common being hyaluronic acid derived fillers. Hyaluronic acid injections are typically used to improve facial contours and to fill out any depressions due to acne scars, injuries, or lines and wrinkles. They are also ideal for treating crow’s feet around the eyes, nasolabial furrows, and marionette lines around the mouth, as well as redefining lip borders. Brand names include Juvederm and Restylane. For the beauty of it blogger, Chereen Strydom recently had lip filler for the first time. Watch here to see what she had to say about it!

Calcium hydroxylapatite is a mineral compound that is found in human bones. It is biosynthetically produced, which means that no animal products are used during production. This lowers the risk of allergic reaction, and it also results in a very natural appearance with little to no side effects (and no migration). You can also use calcium hydroxylapatite to enhance fullness and improve volume, particularly in areas such as the cheeks and other facial contours. This is also a good option to plump up wrinkles and fine lines. Brand names include Radiesse.

Newer generation fillers contain polylactic acid, which is a synthetic filler. Polylactic acid helps to boost your body’s own production of collagen for a plumper, firmer appearance. Unlike other dermal fillers, polylactic acid doesn’t produce immediate results, but works over time to stimulate collagen production. This helps to reverse the appearance of fine lines and wrinkles, particularly around the mouth and nose. You can also opt for polylactic acid fillers to plump up thin lips. You’ll need about three treatments, and it can take up to six weeks to see visible results. Brand names include Sculptra.

The potential side effects

When it comes to getting injectable treatments like Botox and fillers, complications are rare – but they do happen. Botox has one of the best safety profiles compared to other treatments used in medical aesthetics. The unintended spread of the neurotoxin is the biggest risk you face when getting Botox. This could result in the paralysis of unintended muscles, for example, a drooping eyelid. Fortunately, this effect is short lived and will wear off over time, along with the treatment effect.

The biggest concerns when getting fillers include the risk of infection, possible bleeding and bruising, lumps, skin necrosis (loss of skin from disruption in blood flow), and even blindness. Fortunately, although very serious, the last two complications rarely occur. It’s vital that you talk to your doctor and understand the red flags to look out for after your treatment.

Botox or fillers… or both?

Botox works for the glabeller region (the area between the eyebrows), the forehead, around the eyes, and on ‘bunny lines’. For the right candidates, it’s also helpful when used in the lower third of the face. This can help to lift the angle of the mouth or to correct a gummy smile. Botox is also an excellent preventative measure to halt the formation of more wrinkles.

Fillers are best used to restore volume to the face, and soften creases such as nasolabial folds or marionette lines. You can also use fillers to improve facial contours and to plump up your lips.

With the right technique, both Botox and filler treatments can offer striking results in a natural way.