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  • Dr Claire Ashley

What's the difference between Botox© and fillers?

Before I got into the aesthetics industry, I have to admit that I was completely confused and flummoxed by the huge range of treatments on offer, and what each treatment can achieve for your skin. I also couldn't quite get my head around what sort of results you would get for the money you are paying- and let's face it, aesthetic medical procedures don't come cheap.


It appears that a lot of people feel the same, and so in this post I hope to explain the difference between 2 of the most commonly requested aesthetics treatments- botulinum toxin and fillers.


Botox© is a term that is commonly used to describe any wrinkle relaxing treatment, but is in fact a brand name of just one of several types of botulinum toxin. Botulinum toxin is a solution that is injected into the muscles of the face . Different brands of botulinum toxin include Azzalure, Boccouture and Botox© (which is the product I use in my clinic). They are all variations of the same neurotoxin, which when injected, causes muscle relaxation and therefore wrinkle relaxation. Botox© is commonly put into the forehead, frown lines and crows feet to help reduce the appearance of wrinkles and lines. One of the side effects is a reduction in sweating, so it can also be injected into the armpits to help with excess sweating. Botox© injections also can be used to target specific muscles of the face to achieve a particular goal, such as reducing a gummy smile, or doing a brow lift. Botox© is not permanent, and typically lasts 3-4 months before wearing off. When you start having Botox© you absolutely don't have to continue with it if that's what you choose, but repeated treatments over a period of time will reduce the appearance of wrinkles, and therefore you might be able to go longer between treatments. There is an argument for "preventative" Botox© as if you start relaxing the muscles before lines develop you are likely be preventing the formation of deep lines in the future. Botulinum toxin is a prescription only medication and is not reversible once it has been injected.


Fillers, on the other hand, are used to help restore or enhance volume in the face. As we age we lose volume from fat pads and bones in the face. Personally, I hate the term fillers because it conjures up images of builders with thick concrete or mortar in my mind (or maybe that's just me?!). But fillers are in fact made up of hyaluronic acid (HA), which is a clear substance that is found naturally in the body. You might find HA in your skin care products, as it is often used topically due to its hydrating properties. If it is used in skin care then generally it comes in a very liquid consistency to make it easy to apply to the skin. However, HA in fillers tend to have a thicker density and are more like gels. If you are looking to restore volume in the cheeks you need a HA that is stable and strong and isn't going to collapse or move. If you are looking to enhance volume in the lips you would use a HA that was softer and more fluid as lips are very mobile.


Fillers last longer than botox- anything from 6 months to 18 months depending on the site that has been injected. The good thing about HA is that should a complication develop it is possible to dissolve the filler immediately it with an injection of hyalase. The biggest downside to fillers is that they are not a prescription only medicine, and as such anyone, including non medics, can inject them. This means that the level of knowledge that your practitioner might have about injection technique, anatomy of the blood and nerve supply to the tissues, and how to prevent and treat complications can be extremely variable, and in some cases sub-standard. It is easy to over fill too, and I would generally advice to start with small volumes of filler and build up. It is better to be cautious than to run the risk of duck lips or the cheek puffiness that celebrities sometimes get when they are overfilled.


I hope that this has been a useful and helpful explanation of the differences between the 2 most commonly requested medical aesthetic treatments. Any questions please fire away and I will be more than happy to answer them.



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