.Botox vs. Fillers: What’s the difference?

A fabulous #dermdiva recently emailed me and asked the golden question: What is the difference between #botox and #fillers ? I cannot tell you how many times a day I am asked this question.  I love my job (and all things botox and fillers) so it excites me when people want to learn more!

Botox is a drug name; so is Dysport and Xeomin.  They are all #neuromodulators that have proteins made from the bacterium Clostridium botulinum. These products are used relax the muscles that cause frown lines (“11’s”), wrinkled foreheads, and lines around our eyes (crows feet).

Botox is distributed from a company called Allergan.

Dysport is distributed from a company called Galderma.

Xeomin is distributed from a company called Merz. 

Think of it like this: we have Coca Cola and we have Pepsi. They both make “soda” but there is a difference, right? Same thing with these neuromodulators. Without getting into too much detail there are medical reasons (like packaging, reconstitutions and units) which differentiate between the three. Patients often come in asking for #botox because they’ve heard about it from friends or simply because it has been around the longest and people don’t know about the other two. Bottom line: patient preference and sometimes budget (not all the time) are how we can target which is right for you.

I have put together “TheDermDiva Q&A” from the most common questions my patients ask:

Q: Where do you inject botox/dysport/xeomin? Where can I have the injected?

Neuromodulators are injected directly into the muscle. The most common areas treated are:

Forehead (FRONTALIS)

Frontalis muscle*patient has consented to photo publicity

Glabella (Corrugator and Procerus)

Corrugator/Procerus *patient has consented to photo publicity

Crows Feet (Orbicularis Oculi)

Orbicularis Oculi *patient has consented to photo publicity

Q: How much product will I need? How much will this cost me? How long does it last?

A consultation is required in order to assess every patient as no treatment plan is the same.  During your appointment we will take photos of you smiling, not smiling and also at a few different facial angles. It is hard to say without an assessment how many “units” you will need to get the perfect outcome. Pricing depends on the “units” we will use or sometimes how many “areas” (think: forehead, etc.) we are treating. On average treatment lasts around 3 months.  This is why #prevention and #maintenance is key! Keep reading to find out why!

Q: Ok, but I am scared. Will I look “frozen?” I don’t want to look frozen! Will I look worse once it wears off?

I love this meme because it is SO TRUE!

A very common question.  My response – do not be scared!I personally feel people are more afraid of their friends, husbands or wives finding out than they are about the actual procedure. My patients appreciate when we discuss what bothers them the most, and together we come up with a treatment plan. If you don’t want to look “frozen” than you will not look frozen! You want the perfect eyebrow lift? No problem. Lets put this misconception to rest already – you will not look worse after the treatment wears off.  Your lines however will not be as pronounced, which is why maintenance is KEY! Make sure you keep up with your treatments every three or so months for best results.

Q: I am only in my 20s/30s. Am I too young to start?

PREVENTION. PREVENTION. PREVENTION. In your 20s if you are starting to notice those annoying 11’s starting or some mild lines in your forehead this is the best time to start an anti-aging regimen. If you start in your 20s/30s you will not need as many “units” to achieve the perfect outcome.  Also, you may notice only needing treatment once or twice a year.  The price isn’t so bad either because you aren’t requiring so much product.  If neurotoxin treatment isn’t for you that is fine. Make sure to wear SPF daily and invest in good medical grade skin care! (Hmm..I think I just found my next post!)

Q: What about fillers? How are they different?

Restylane and its family of injectables is distributed by Galderma

Juvéderm and its collection of fillers is distributed by Allergan

More commonly people know and will ask about #juvéderm and #restylane. There are other filler types, but for the sake of this post (and time) I will only mention these two. They are both made by two different companies just as discussed with Botox, Dysport and Xeomin. These fillers are #hyaluronicacid fillers.  These fillers give patients volume in areas where they may have lost it from the aging process.  Common areas for volume loss are the cheeks, lower face, around our mouths and even our lips.

Q: You mentioned volume loss. How do these fillers restore volume?

Hyaluronic acid is naturally found in our skin. As we age we lose collagen in our skin therefore losing volume.  HA fillers such as Juvéderm Ultra, Juvéderm UltraPlus and the Restylane family (just to name a few) are able to create a smooth, wrinkle free look.  I love treating patients with filler because the correction is immediate.  Talk about instant gratification!

Q: How will I know which filler is right for me? How much will I need.

The best way to determine which filler is right for you is by coming in for a consultation.  There we will discuss what bothers you and what you are trying to achieve. We will also take pictures and during the assessment decide how many syringes of product you will need. Everyone is different and every treatment area may require a different number of syringes. It also depends on the patients volume deficit and of course I try to keep budget in mind. If budget is a factor but multiple syringes are needed I always advise patients they will not achieve 100% correction.  I do this to to set proper treatment expectations.

Q: Where are the more common areas that fillers are used?

Most patients start to notice their smiles lines (lines around mouth)  first which prompts them to come see me. Others complain that they no longer have an upper lip or that they hate their jowls. Maybe you just want a little lip plumping. No problem!  It is my job to educate the patient on WHY this happens and HOW we can correct it.  Many are surprised on how simple it really is to correct their lips or lines, and they are immediately happy.

Happy Patients = Happy DermDiva!



Q: What about side effects for both treatments?

Patients can expect some redness, bruising and swelling at the injection site. These results are normal, temporary and will last from a few hours (redness, swelling) to a few days (bruising.)  Avoid alcohol, ibuprofen and aspirin at least 5 days prior to your procedure to decrease the chances of bruising. If you have some swelling icing every 15 minutes for the remainder of the day will help.  Minor discomfort is to be expected during the treatment despite having numbing cream applied prior to the procedure. Most fillers contain lidocaine which helps reduce the discomfort. If you have Botox, Dysport or Xeomin I advise patients not to lie down 4-6 hours post treatment, and avoid any physical activities for the remainder of the day. Mild headaches can also occur. Proper injection technique decreases the chances of ptosis; the dreaded “eyelid droop.” Unfortunately a true lid ptosis can happen in 1-2% of patients. Making sure your injector is properly trained will decrease that very small percentage even more. Again neuromodulators are not permanent so if that were to ever happen the effects will wear off within 3 months.

Intrigued yet? Thought so! Hopefully you all have learned a thing or two about these treatments.

I truly love what I do. It is so rewarding to not only educate you but to read all of your amazing emails and comments. Remember: I am here to make you LOOK and FEEL your best- always!

Questions or comments? Leave me some love below!




1 Comment

  1. Helen
    March 6, 2017 / 1:36 pm

    As always, your posts are well written, fun and informative! Thanks for the informations – it’s so helpful! Can’t wait for your next post!!

Leave a Reply

Your email address will not be published. Required fields are marked *