What is Botox and how does it work?
Botox is the common name for botulinum toxin type A, a medical substance injected in very small amounts into specific muscles. It relaxes them temporarily by reducing the nerve signals that make them contract.
Botox therefore suits what are known as dynamic wrinkles, the lines that appear or deepen with facial expressions, such as forehead lines, frown lines between the brows and lines around the eyes when smiling. It is also used medically for other conditions such as excessive sweating and some cases of jaw-muscle tension.
What are fillers and how do they work?
A filler is a gel injected under the skin to replace lost volume or to define features. The most widely used type today is hyaluronic acid, a substance found naturally in the skin that helps it hold moisture.
Fillers suit static wrinkles and folds that are visible even when the face is at rest, and the loss of volume that comes with age. Uses include the lines between the nose and mouth, defining and adding volume to the lips, enhancing the cheeks, improving the under-eye area in selected cases, and defining the chin and jawline.
The difference in brief
In short, Botox relaxes the muscle that causes the wrinkle, while a filler fills a hollow or adds volume. Here is a practical comparison of the two:
How it works
Botox relaxes muscles temporarily; fillers add volume and support the tissues under the skin.
When results appear
Botox usually starts to work within 3 to 5 days and reaches its full effect in about two weeks, while filler results are visible almost immediately, with mild swelling that settles within days.
How long it lasts
Botox usually lasts 3 to 4 months, sometimes longer or shorter depending on the person and area. Hyaluronic acid fillers usually last 6 to 18 months depending on the product and the area treated.
Can it be adjusted?
Botox wears off gradually on its own. Hyaluronic acid filler can be dissolved with a special enzyme if needed, at the doctor’s discretion.
When are they used together?
In many cases the question is not “Botox or fillers?” but “What combination suits my face?” Ageing usually combines muscle movement that creates lines with a gradual loss of volume and elasticity.
For example, the doctor may treat frown lines between the brows with Botox and treat nose-to-mouth lines or loss of cheek volume with filler. The doctor sets the plan, amounts and timing after examining the face and assessing its features and proportions, aiming for a natural, understated result.
Side-effects and precautions
Botox and fillers are both medical procedures that should be carried out by a qualified doctor using approved products. Most side-effects are minor and temporary, but there are less common complications you should know about.
- Botox: mild redness or bruising at the injection site, a temporary headache, and occasionally a temporary drooping of the eyelid or brow or slight asymmetry that improves with time.
- Fillers: swelling, bruising and tenderness at the injection site, occasionally small lumps, and a possibility of infection.
- A rare but serious complication of fillers is blockage of a blood vessel if the product enters it, a situation that needs urgent medical treatment, which is why the doctor’s knowledge of facial anatomy is essential.
- These procedures are usually not advised during pregnancy or breastfeeding, or where there is active skin infection at the injection site. People with neuromuscular disorders such as myasthenia gravis, bleeding disorders, or who take blood thinners need a specific assessment.
- Avoiding strenuous exercise, massaging the area and high heat for a day or two after injection is usually advised, according to the doctor’s instructions.
When to contact the doctor, and what to ask at consultation
After filler injections, contact the doctor immediately if you notice severe, unexpected pain, whitening, bluish or mottled skin near the injection site, or any change in vision. After Botox, see the doctor if you develop difficulty swallowing, breathing or speaking, or unusual muscle weakness.
Useful questions at consultation include: What is causing the wrinkles or changes I see in my face? Does Botox, filler or both suit me? Which product is used and is it approved? How long does the effect usually last in my case? And what happens if I am not happy with the result? Remember that results vary from person to person.
Before your injection appointment
Tell the doctor about your medicines
Mention blood thinners, painkillers and supplements you take, as some increase the chance of bruising.
Choose the right timing
Avoid booking just before an important event, as bruising or swelling may need several days to settle.
Mention previous injections
Tell the doctor about any earlier Botox, filler or procedures in the same area, and the product type if you know it.
Set realistic expectations
Discuss with the doctor what injections can achieve and what may need a different procedure.
Not sure which suits you?
The doctor assesses your facial features and the nature of your wrinkles before suggesting any plan. Learn about Botox injections and dermal fillers, or book your consultation.