Botox vs Fillers – Which is right for you?

When it comes to facial wrinkles, it can be confusing trying to understand which is the best non-surgical treatment – Botox or fillers. Well, the answer is both! First, it’s important to understand the causes of facial wrinkles. There are two: wrinkles due to overactive muscles and wrinkles due to loss of collagen.


Wrinkles from overactive muscles are typically located in between the eyebrows, the forehead and the crows feet around the eyes. The best treatment for these wrinkles is a neuromodulator, more commonly known by the names Botox, Xeomin and Dysport. By injecting these products into these areas, the wrinkles will start to subside within 1-3 days and the effect will last for 3 to 6 months.


However, the wrinkles due to collagen loss – seen in the “parentheses lines” from the nose to the corner of the mouth and the marionette lines below the corners of the mouth – can be treated with fillers. There are two main categories of fillers. Fillers made of a synthetic hyaluronic acid that go by the names Restylane, Juvederm, Belotero and Perlane and filler with a calcium base, with only one major seller – Radiesse.


All of these fillers can be used in the parentheses and marionette lines but they can also be used under the eyes if they appear sunken. See photo below. One major benefit of the hyaluronic acid fillers is that they can be used to plump up the lips, whereas Radiesse can not. Conversely, one of the major “pros” for Radiesse is that it lasts up to 2 years whereas the hyaluronic acid fillers last anywhere from 6-12 months.



Left: Before filler, patient had darker circles under the eyes. Right: After filler was injected under the lower lids, bringing the lids out from under the shadow of the eyes.


If you have additional questions, I bet this video will answer them!



As always, before seeking treatment from any doctor, make sure they’re a board certified plastic surgeon by clicking here.


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