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Botox and dermal fillers are both minimally invasive cosmetic treatments given through injections. However, they differ in that Botox freezes muscle and fillers add fullness.

Botox and dermal filler treatments are popular, accounting for more than 9 million procedures in 2015, according to the American Society of Plastic Surgeons (ASPS).

Botox contains purified bacteria that freeze muscles. In doing so, Botox can help minimize the appearance of lines and wrinkles caused by facial expressions.

Dermal fillers contain ingredients that add fullness to areas that have thinned due to aging. This thinning is common in the cheeks, lips, and around the mouth.

People should be aware of the costs and risks of treatments and have realistic expectations of what they can do.

What is Botox?

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Botox may help to correct dynamic wrinkles, such as crow’s feet around the eyes and horizontal lines on the forehead.

Botox is a purified form of the botulinum toxin that is obtained from bacteria. Though it is deadly in larger amounts, the tiny, regulated amount of Botox given to correct wrinkles has been used safely for decades.

Botox works by blocking nerve signals in the muscles where it is injected. When those nerve signals are interrupted, the affected muscle is temporarily paralyzed or frozen. Without movement of these selected muscles in the face, certain wrinkles may be softened, reduced, or even removed.

Botox and other treatments made with botulinum toxin are sometimes called neuromodulators or neurotoxins.

Treatments made with botulinum toxin are sold under the brand names Botox Cosmetic, Dysport, and Xeomin.

What can Botox correct?

Botox only works on wrinkles that are caused by muscle movement. These are known as dynamic wrinkles, and are often called “expression lines.”

The most common dynamic wrinkles that Botox can treat are lines on the upper face, such as the “11” between the brows, horizontal lines on the forehead, and crow’s feet around the eyes. These lines are caused by smiling, frowning, squinting, and other facial expressions.

Botox will not work on fine lines and wrinkles caused by sagging or loss of plumpness in the face. These are known as static wrinkles. Static wrinkles include lines in the cheeks, neck, and jowl areas.

Botox is not a permanent treatment. Repeated treatments are necessary for continued wrinkle-reducing effects. Most people find that the muscle-relaxing effect of Botox lasts for 3 to 4 months.

Botox side effects and considerations

The ASPS considers Botox to be safe, and 6.7 million procedures were performed in 2015. As Botox wears off over time, most side effects are only temporary.

Possible side effects of Botox include:

• drooping of the eyelid or brow if injected near the eye
• weakness or paralysis of nearby muscles
• hives, rashes, or itching
• pain, bleeding, bruising, swelling, numbness, or redness
• headache
• dry mouth
• flu-like symptoms
• nausea
• trouble swallowing, speaking, or breathing
• gallbladder problems
• blurry vision or vision problems

The treatment may also fail to work due to antibodies that fight the toxin. This happens in less than 1 percent of people who have repeated Botox treatments, however.

The ASPS advise people not to rub or massage the area of the injection after having Botox treatment. This could spread the toxin to surrounding skin, causing muscle drooping and other problems.

The average cost of a Botox injection is $385, according to 2016 statistics from the ASPS.

What are dermal fillers?

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Dermal fillers may help to plump up thinning lips.

Dermal fillers, sometimes called soft tissue fillers, are substances designed to be injected beneath the surface of the skin to add volume and fullness.

Substances used in dermal fillers include:

• Calcium hydroxylapatite, which is a mineral-like compound found in bones.
• Hyaluronic acid, which is found in some fluids and tissues in the body that add plumpness to the skin.
• Polyalkylimide, a transparent gel that is compatible with the body.
• Polylactic acid, which stimulates the skin to make more collagen.
• Polymethyl-methacrylate microspheres (PMMA), a semi-permanent filler

Each one of these is designed to treat different signs of aging or other cosmetic issues.

The time they take to work, as well as how long they last, also vary. Some fillers last 6 months, while others last up to 2 years or longer.

People should discuss their individual needs and expectations with their doctor to determine what filler would be the best choice for them.

Additional reading:
Fillers giving patients better, longer-lasting results

For more information, please visit Cheap Dermal Fillers.

What can dermal fillers correct?

Different types of dermal fillers are designed to treat varying signs of aging. Depending on the filler selected, they may:

• plump up thinning lips
• enhance or fill in shallow areas on the face
• decrease or remove the shadow or wrinkle under the eyes caused by the lower eyelid
• fill in or soften the look of recessed scars
• fill in or soften static wrinkles, especially on the lower face

Static wrinkles include those around the mouth and along the cheeks. These wrinkles are usually a result of a loss of collagen and elasticity in the skin.

Dermal filler risks and considerations

Dermal fillers are considered to be safe but side effects can occur. A licensed healthcare professional should perform all dermal filler procedures using only FDA-approved fillers injected with a syringe. The most common problems include:

• skin rash, itching, or pimple-like eruptions
• redness, bruising, bleeding, or swelling
• undesirable appearance, such as asymmetry, lumps, or overcorrection of wrinkles
• skin damage that causes a wound, infection, or scarring
• ability to feel the filler substance under the skin
• blindness or other vision problems
• death of skin cells due to loss of blood flow to the area

The cost of dermal filler treatments varies and depends on the provider performing it, the area being treated and the type of filler selected. The ASPS 2016 statistics list the following cost per syringe:

• calcium hydroxylapatite, such as Radiesse: $687
• hyaluronic acid, such as Juvederm, Restylane, or Belotero: $644
• polylactic acid, such as Sculptra: $773
• polymethyl-methacrylate microspheres, such as Bellafill: $859

These costs may be more or less, depending on how much filler is used. Using less than a full syringe of filler may be cheaper than using a full syringe or more than one.

The provider may also charge additional fees for their professional services, office visit, or other costs.

Key differences

In summary, the differences between Botox and fillers are:

• Botox: This freezes muscles to stop creases and wrinkles caused by facial expressions. These are typically found in the upper face, such as the forehead and around the eyes.
• Dermal fillers: These use hyaluronic acid and similar substances to “fill in” or plump areas that have lost volume and smoothness. This includes wrinkles around the mouth, thin lips, and cheeks that have lost fullness. They may also be used on forehead wrinkles, scars, and other areas that need extra volume for a smoother look.
• Botox results last 3 to 4 months. Dermal filler results vary, depending on which filler is used.

Because Botox and fillers are different substances designed for different uses, they can sometimes be combined in one treatment. For instance, someone may use Botox to correct lines between the eyes and a filler to correct smile lines around the mouth.

Takeaway

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Botox and fillers are considered safe, with side effects occurring in less than 1 percent of recipients.

Millions of Botox and filler procedures are performed each year, and they have a good track record of safety.

A study in JAMA Dermatology found that Botox and filler procedures are very safe when performed by experienced board-certified dermatologists. Side effects occurred in less than 1 percent of recipients, and most of these were minor.

Though Botox and fillers are minimally invasive, they still carry some risks. An individual should be aware of all possible risks and benefits before having these treatments.

Botox and fillers are not recommended for women who are pregnant or breastfeeding. People who have certain health conditions or who take any medications should discuss whether Botox or fillers are safe for them.

People should also discuss what Botox and fillers can realistically do for their appearance. Though they can enhance a more youthful look, the results are typically not as powerful as having a surgical procedure, such as a facelift.

Using a qualified medical provider, such as a board-certified dermatologist, plastic surgeon, or cosmetic surgeon helps ensure the procedure is done safely and properly. People should discuss the provider’s experience and training in dermal fillers and Botox before making a decision.

Your Guide to Injectable Dermal Fillers

As we age, the fat, muscles, bone, and skin in our face begin to thin, often leading to a sunken or sagging appearance. Dermal fillers have gained popularity for their ability to quickly and easily restore this lost volume without downtime. In fact, nearly 2,677,000 dermal filler injections were performed in 2018 alone.

If you have ever been curious about dermal fillers, including their composition, uses, and the various brands available, this post is for you.

What are dermal fillers?

Dermal fillers, also called facial fillers, are gel-like substances that are injected under the skin to restore lost volume, improve static lines and wrinkles (those visible when the face is at rest), and lift sagging tissues. In addition to rejuvenating the skin, dermal fillers are commonly used to accentuate certain facial features, like the cheekbones and jawline; augment the buttocks and lips; rejuvenate the hands; and correct a cosmetic nasal deformity (a treatment known as non-surgical rhinoplasty). 

Dermal fillers are gel-like substances that are injected under the skin to restore lost volume, improve lines and wrinkles, and lift sagging tissues.

How long do dermal fillers last?

On average, dermal fillers remain beneath the skin for approximately 6-12 months, depending on their ingredients and how they were formulated. Learn more about how long individual types of filler last below.

What are dermal fillers made of?

While dermal fillers all provide volume, lift sagging tissues, and increase collagen, they differ slightly in their mechanism of action and how they are formulated. Additionally, some fillers are composed of naturally occurring substances while others are synthetic. Here is a list of the most popular dermal fillers organized by their primary active ingredient:

Hyaluronic acid fillers

Hyaluronic acid (HA) is a gel-like substance that naturally occurs in the body and helps keep our skin looking plump, hydrated, and youthful. Most hyaluronic acid fillers last for 6-12 months before naturally integrating into the body. The following brands of dermal fillers all utilize hyaluronic acid to enhance different parts of the face and body:

• Juvéderm® fillers include Juvéderm XC, Ultra, Ultra Plus, Vollure, Volbella, and Voluma. Juvéderm XC and Vollure are ideal for “filling in” nasolabial folds (the lines that run between the nose and mouth). XC can help restore lost volume in the chin and mouth, while Voluma and Ultra Plus are meant for deep injection into the cheeks and chin. Vollure can help with marionette lines, a.k.a. the “parenthesis” that form around the mouth. Ultra is often used to augment the lips, while Volbella is great at improving vertical lip lines.
• Restylane® fillers include Restylane, Restylane Silk, Restylane Lyft, Restylane Refyne, Restylane Defyne, Restylane Kysse, Restylane Contour. Restylane Refyne is ideal for improving more subtle nasolabial folds and marionette lines, while Defyne is great for smoothing deep-set folds around the mouth. Contour is most often used to correct sunken cheeks. Kysse was formulated specifically for lip augmentation, and Silk is ideal for correcting vertical lip lines and wrinkles around the lips.
• Belotero Balance® is a thicker filler specifically designed to improve the appearance of moderate to severe nasolabial folds.
• Revanesse Versa® can also be used to treat moderate to severe nasolabial folds, as well as parenthesis lines.
• Revance’s RHA® collection of fillers is the first and only line of fillers that are FDA-approved to treat dynamic facial wrinkles and folds (those that move with your natural facial expressions) and includes RHA 2, 3, 4. RHA 2 is ideal for treating vertical lip lines, glabellar lines (a.k.a. the “elevens”), and crow’s feet. RHA 3 is used to correct nasolabial folds and the corners of the mouth, as well as to augment the lips. RHA 4 is the thickest of the RHA fillers and is used to correct severe volume loss in the cheeks, chin, and jawline. “RHA” stands for “resilient” hyaluronic acid because these fillers are designed to smooth even the most dynamic and wrinkle-prone areas of the face. 

Calcium hydroxylapatite fillers

Calcium hydroxylapatite (CaHA) is a mineral-like compound found naturally in our bones. Calcium hydroxylapatite filler is thicker than hyaluronic acid fillers and typically lasts around 12 months for most patients.

• Radiesse® is the only FDA-approved calcium hydroxylapatite filler. It is made of CaHa ‘microspheres’ that are suspended in a gel to provide structural support for skin and underlying tissues. Radiesse is typically used to correct deeper lines and wrinkles associated with more advanced facial aging, as well as to rejuvenate the hands. 

Poly-L-lactic acid fillers

Poly-L-lactic acid (PLLA) is a synthetic filler. Instead of sitting beneath the skin like other fillers, poly-L-lactic acid stimulates your body to produce its own collagen, meaning that final results will develop gradually over the course of 4-8 weeks and last for about 2-3 years.

• Sculptra® Aesthetic is the only FDA-approved poly-L-lactic acid filler. It was originally developed to treat severe fat loss in the face. Sculptra uses PLLA microparticles rather than a gel to replace lost collagen and reinforce skin’s structure. It is commonly used to reverse advanced volume loss in the face and for augmentation in the buttocks.

Polymethylmethacrylate fillers

Polymethylmethacrylate (PMMA) is a synthetic, biocompatible substance that has been used in reconstructive surgery for decades. As a filler, polymethylmethacrylate is recommended when a more permanent solution to facial wrinkles is desired, as results can last indefinitely.

• Bellafill® (formerly known as Artefill) is the only FDA-approved polymethylmethacrylate filler. It combines polymethylmethacrylate with collagen to create microspheres that become encapsulated within new collagen fibers, providing continued support for tissues. Bellafill is typically used to smooth deep wrinkles and folds, as well as to fill out pitted scars. 

Fat injections

Also referred to as fat grafting or fat transfer, autologous fat injections are an alternative to dermal fillers for those who desire a natural, long-lasting filler. During this procedure, fat is harvested from the hips, buttocks, or stomach via liposuction, then purified and injected into the face to help restore volume and contours. Fat injection can also be used to augment the breasts, hands, lips, and buttocks (a.k.a Brazilian butt lift surgery). Results can last for many years as long as a stable body weight is maintained.

How much do dermal fillers cost?

On average, hyaluronic acid fillers such as Restylane and Juvéderm typically cost about $550-$850 per syringe. Radiesse is about $550-750 per syringe and Sculptra comes in at approximately $900 per vial (most patients require 2-3 vials per session), while Bellafill costs around $1,000 per syringe. While dermal fillers can vary in cost based on your provider and locale, note that pricing that is too far below average is a red flag: your safety or results could be compromised.

Choose a board-certified cosmetic surgeon for your filler treatment

To help ensure optimal results and safety during your dermal filler treatment, be sure to always choose a board-certified facial cosmetic surgeon or a trained medical injector working under their supervision. He or she will utilize the most advanced injection techniques, and exclusively use authentic FDA-approved, brand-name fillers. To locate a facial cosmetic surgeon near you and get a quote on dermal filler treatment, use our Find A Surgeon tool.

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