Botox vs Filler

By Peachy

What is Botox®?

Botox® is one brand of botulinum toxin serotype A; other brands include Xeomin®, Jeuveau®, and Dysport®. All four brands are neuromodulating proteins that limit the release of a neurotransmitter called acetylcholine, which causes muscles to contract. After the protein is injected, it gradually binds to receptors that uptake acetylcholine, meaning the targeted muscle can’t contract as fervently. Please note that this doesn’t prevent you from emoting normally! Over time, your body metabolizes, or breaks down, the Botox® protein and muscle contractions slowly return to their previous range. 

The relaxation of the muscle is key to wrinkle prevention: it prevents dynamic wrinkles from transitioning to static wrinkles.  

Is Botox® safe?

Yes! Botox® is a therapeutic protein that is used to treat a variety of medical conditions. No long-term adverse effects have been reported, and no systemic safety problems have been associated with FDA approved uses of Botox® (such as the 3 Peachy approved facial injection sites).

What is filler?

Fillers are gel-like substances that are designed to be injected beneath the surface of the skin to add volume and fullness. Hyaluronic acid (HA) derivatives are the most widely used biodegradable fillers and vary based on the extent of cross-linking, concentration, and particle size of each product. Fillers are traditionally used in facial enhancing procedures. Examples include lip augmentation, midfacial volumization, cheek augmentation and tear trough correction. Most FDA-approved fillers are temporary and achieve a smoothing or “filling” effect, which lasts for about six months or longer in most people.

Is filler safe?

While most adverse reactions are mild and transient, more serious adverse events can occur, leaving patients with long-lasting or permanent functional and aesthetic deficits. Some reactions occur immediately after treatment, whereas some have a delayed onset. Examples include bruising, swelling, abscess formation, and tissue necrosis.

What are the main differences between Botox and Filler?

Botox® and Filler are very different. Botox® is effective for wrinkle prevention and minimization of fine lines that have already occured and do not alter one’s natural appearance. Filler can also be used to fill severe dermal furrows (deep set wrinkles) but is most commonly used in cosmetic enhancing ways as detailed above.   

Duration of onset:

  • Botox®: Recipients can start to see effects in 5-10 days, with full results at two weeks
  • Filler: Recipients see immediate results

Composition:

  • Botox®: Comes in powder form and is reconstituted with saline into a clear liquid
  • Filler: Viscous gel that comes in prepackaged syringes; viscosity varies based on desired product and placement

Metabolism:

  • Botox®: Body naturally metabolizes the protein in 3-6 months
  • Filler: Body naturally metabolizes the gel in 6-18 months (longevity varies by product); reversal agent available for HA products

Botox vs Filler Infographic

Botox vs Filler

Citations

Small R.Botulinum toxin injection for facial wrinkles. Am Fam Physician. 2014 Aug 1;90(3):168-75. 


Carruthers JA, Lowe NJ, Menter MA, et al.; BOTOX Glabellar Lines I Study Group. A multicenter, double-blind, randomized, placebo-controlled study of the efficacy and safety of botulinum toxin type A in the treatment of glabellar lines. J Am Acad Dermatol. 2002; 46:840-9. doi:10.1067/mjd.2002.121356 

Binder, W. Long-term effects of botulinum toxin type A (Botox) on facial lines. Facial Plast Surg. 2006 Nov-Dec; 8(6):426-31. doi:10.1001/archfaci.8.6.426


Funt D, Pavicic T. Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig Dermatol. 2013;6:295–316. Published 2013 Dec 12. doi:10.2147/CCID.S50546

Gold MH. Use of hyaluronic acid fillers for the treatment of the aging face. Clin Interv Aging. 2007;2(3):369–376. doi:10.2147/cia.s1244


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