When to Consider Botox vs Dermal Filler

Introduction

It is not uncommon for people to get confused when they go in for an injectable appointment thinking they need Botox, when really they might need dermal filler, or vice versa. Sometimes misinformation can be given from social media, the internet, or even other injectors. 

This blog will help you understand the differences between what Botox is intended for, and what filler is intended for. 

Watch our YouTube video below for a visual representation of information that this blog will cover, too.

Table of Contents

How does Botox work?

Botox, or Botulinum Toxin, is a prescription medication used to treat fine lines and wrinkles. Botox, or other brands of neurotoxin like Xeomin and Dysport, work to stop muscles from creating a repetitive movement that lead to unwanted lines and wrinkles. Botox injections are also preventative, to keep lines from worsening. 

For more information about Botox injections read our blog “Botox for Dummies” below.

How does filler work?

Most dermal fillers are made of a gel-like substance called Hyaluronic Acid (HA) that are used to restore lost volume, fill lines and wrinkles, sculpt areas of the face, and plump. When filler is injected properly into the desired areas, it instantly plumps or fills the areas of volume depletion, giving you a refreshed, natural, and youthful appearance. 

If you are curious about filler injections, and want to learn more, be sure to click on the pink button!

What areas can I get Botox injections?

The most common areas for Botox injections, or Botulinum ToxinA, are the glabella (11’s), forehead, and crows feet. There are several other areas that are considered “off label” that can be treated with neurotoxin, too, such as:

  • Bunny lines: lines on either side of the nose when you scrunch
  • DAO’s: depressor anguli oris muscle (around the mouth)
  • Platysmal bands: neck bands
  • Masseter muscle: jaw muscle  
  • Lip Flips

Bunny Lines

Masseter Muscles

DAO Muscles

Platysmal Bands

Photo Credit: dr.hilinski.com

What areas can I get filler injections?

The most common areas for filler injections are probably the lips and the cheeks but other areas include:

  • Under eyes
  • Jawline
  • Temples
  • Chin
  • Nasolabrial folds
  • Marionette lines
Certain types, like Radiesse, can also be used to help create collagen in the face, neck and body. 

Remember, filler is considered much more dangerous than Botulinum Toxin injections because the gel like substance is more like an implant (usually lasting around a year) and can also occlude vessels. Some areas are higher risk than others and you want to go to an injector that knows the risks and how to treat them. 

RN, Molly injecting neurotoxin in forehead

NP, Ali injecting lip filler

Does Botox or filler help forehead lines & wrinkles?

Botox helps with forehead lines and wrinkles, and is our recommendation here over filler due to to less risk (see below). When you inject neurotoxin into the forehead muscles, it stops the repetitive muscle movement that causes lines and gives a refreshed appearance. 

Forehead lines treated with neurotoxin

Can you inject filler in forehead lines?

We do not recommend injecting filler into deep forehead lines, because there is a risk for vascular occlusion (filler that gets into an artery) that can lead to blindness. 

Vascular occlusion can happen anytime filler is injected but in high risk areas such as the forehead, glabella, and nose blindness or even a stroke could occur. As far as we know there are no cases where the blindness was able to be reversed when it was caused by filler. 

Some clinicians will do these injections, and if you decide to have it done, make sure you ask about their experience doing it and what they would do in case of emergency. 

There are several other treatments that can help with forehead lines and wrinkles such as Botox, microneedling, laser treatments or a surgical referral. 

Does Botox or filler help with Glabella (11's) lines?

Botox is recommended for Glabella lines over filler. This is because  when you continually scowl or frown, the glabella muscles are activated to move, and over time those constant movements cause lines. Botulinum toxin injections, once injected into the muscle, stop the constant scowl or frowning and thus softens the lines and wrinkles.

11’s treated with neurotoxin

Can you inject filler in the Glabella (11's) lines?

Technically, you can inject filler in the 11’s, but we do not recommend it. Like mentioned above, injecting filler in this area has a high risk for vision complications. Safety is a priority when it comes to injectables. If you have deep 11’s lines that are there at rest, and Botulinum Toxin injections have not worked for you, book a consult to see what else can be done.

Can I get Botox injections for my smile lines?

No, you should not get Botox injections in your smile lines because it could cause your face to look distorted or drop your top lip. 

Specifically in the nasolabrial fold area, there is a muscle called the levator labii superioris alaeque nasi (LLSAN) that is injected intentionally for people with a “gummy smile” to drop the top lip. If you don’t have a gummy smile, you don’t want to inject this area or it can lengthen your philtrum column (more below). 

Getting Botox injections in your smile lines can cause a ducky lip.

As above, if you inject Botox into the smile lines, it’s possible to cause the philtrum column (the distance between the bottom of nose and mouth) to lengthen. A longer philtrum column can create a ducky upper lip appearance with or without lip filler. 

Ensure you are going to an experiened licensed injector so these types of side effects/risks are avoided. However, Botox is not permanent, so side effects will wear off in 3-4 months.

Can I get filler injections for my smile lines?

Yes, filler injections are an appropriate treatment for smile lines. Smile lines can become static and more defined as we age, and people tend to dislike these lines. Filler is the best option because we want to fill the lines and wrinkles with volume to restore a natural look in the area. 

Full face filler, including smile lines

Can I get Botox injections in my cheeks?

No, getting regular Botox injections in the cheek region can cause unwanted side effects. These side effects cause face distortion to your smile and talking movements. Sometimes microtox or “baby botox” can be used to smooth the skin but it can still cause unwanted side effects.

What happens if Botox is injected into cheeks?

If Botox was injected into the cheek muscles, there is a risk that your smile will look as if you had a stroke or Bell’s Palsy. This is because the muscles in the cheek connect to the corner of the mouth to lift it when you smile. If these muscles are disabled, you will not be able to lift the corner of your mouth.  

These risks should be discussed in a consultation with your provider, along with other treatment options intended for cheek wrinkles. Book Consultation Now!

To learn more about specific areas to avoid injecting Botox in, watch our YouTube Video here. Our NP injector, Ali, demonstrates a visual representation of what could happen if Botox is injected into unintended muscles.

Can I get filler injections in my cheeks?

Yes, it is very common to get filler injected into the cheek region. Filler can enhance the appearance of lost volume in the cheeks, contour the cheeks for definition, and add structure to the cheek for other areas of concern to be treated such as under eyes.

What does Botox treat that filler doesn't?

What if I don't know if I need Botox or filler?

Do not worry! Being unsure of what treatment may be best for you is not uncommon. In most cases, we recommend scheduling a consultation to talk with a trusted provider about your concerns and gather information about what treatments you are a candidate for. 

What can I expect in an aesthetic consultation?

The goal of a consultation is to provide you with as much information as possible for you to make an informed decision on which treatment you want to do. Areas of conversation may include:

  • Addressing concerns
  • Goals of the patient
  • Anatomy assessment
  • Risk factors with treatments
  • Are you a candidate for the desired treatment?
  • Pricing and packages
  • Any other questions you may have

For more information about what you can expect in an aesthetic consultation, read this article

Conclusion

If you are in the Lone Tree, CO area, be sure to stop by our office or schedule your free consultation by clicking on the pink “book now” button below. Our trusted providers will ensure they are there for you every step of the way. If you are not located in the area, make sure to schedule a consultation with a licensed injector whom you trust. 

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