Botox vs. Fillers: What’s the Difference?

lip injections

Botox, fillers, and injectables are becoming increasingly popular, but what is the difference between Botox and fillers? 

Botox and fillers are two common but very different aesthetic skin treatments. Let’s talk about the similarities, differences, and benefits of Botox vs fillers before you decide to go through with one or the other.

Botox® – A Breakdown

Almost everyone has heard of Botox, but not everyone knows what it is. Some people seem to use it as a catch-all term for any cosmetic facial treatment that they see.

In reality, Botox is just a brand name for a type of cosmetic injection. There are others, but Botox is the first and most popular of its kind.1

These injections all rely on the same active ingredient: botulinum toxin. It’s sometimes called a “miracle poison” because the bacteria it comes from (Clostridium botulinum) is one of the most dangerous poisonous biological substances ever discovered.2  

Wow, hold on a sec. Poisonous bacteria? Those aren’t usually the words you want to hear associated with your injectable treatment. 

However, this particular bacteria has been carefully harnessed for use in specific FDA-approved treatments, Botox among them.3 There have been very low incidences of adverse effects, especially for cosmetic uses 4 .

How Botox Works

Before you even step foot in a doctor’s office, it can help to know what you’ll be getting yourself into.

Here’s how Botox works and what you can expect:5

  • The Botox injection – Your doctor will inject a small amount of Botox directly into the target muscles: in the forehead, around the eyes, etc. This is a simple, relatively painless injection, but some providers may apply a bit of numbing cream or ice beforehand. 
  • The results – Botulinum toxin is a potent neuromodulator that paralyzes the target area by blocking any nerve signals to and from the muscle. Even as you speak, laugh, frown, and more, the specific muscles won’t be able to contract. Don’t worry: you’ll still be able to make all the same facial expressions. The only difference is that the targeted muscles will remain lax, allowing the fine lines or wrinkles to soften instead of deepening. 
  • The timeline – The full effects of your Botox may take up to 14 days. Many doctors recommend staying upright for about four hours after the injection, skipping your usual exercise routine on the day of the procedure, and avoiding rubbing or touching the site for at least 24 hours. After anywhere from three to six months, you’ll notice a steady return of muscle movement—most regular Botox users schedule their next appointment around this time.
  • Potential side effects – Botox injections are FDA-approved and considered overwhelmingly safe, but that doesn’t mean you can’t experience possible side effects such as:
    • Temporary bruising
    • Headaches during the first few days
    • Weakness in nearby muscles
    • Upset stomach
    • Mild pain, swelling, or numbness

Fillers – The Facts

At the very least, you’ve probably heard about Botox before. But you may be wondering, “What are dermal fillers?”

Fillers are another cosmetic treatment used to eliminate things such as smile lines or wrinkles. As you age, your skin and facial muscles lose some of their elasticity. This results in looser, saggier skin, and wrinkles. Fillers can counteract some of these aging effects by reinjecting volume back into these areas 6 —like pumping air into your tires (or putting on your tried and true favorite push-up bra). 

Fillers are surprisingly similar to the extra padding in push-up bras, except that dermal fillers are injected under the skin for a facelift. Comparing different types of dermal fillers can help identify the correct solution for you and your specific needs. These gel-like substances can be either natural or synthetic, depending on which you opt for:7

  • Hyaluronic acid (HA) – This naturally-occurring substance is something our body makes naturally. Hyaluronic acid is unique because of its ability to hold water molecules, keeping your skin hydrated and plump.8 As a filler, it’s typically soft and gel-like. The results last 6 to 12 months before the body absorbs the particles.
  • Calcium hydroxylapatite (CaHA) – This is another substance that naturally occurs in our bodies. Calcium hydroxyapatite is produced in our bones. The microscopic calcium particles are contained within a smooth gel that is thicker and more permanent than HA fillers, lasting closer to 12 months for most people. 
  • Poly-L-lactic acid (PLLA) – This synthetic polymer may not occur organically, but it is safe to inject and will break down naturally, much like dissolvable stitches. Your body will absorb the filler gel rather quickly, but PLLA continues to stimulate your body’s natural production of collagen—a vital protein that provides structure to your skin and muscles. The results can last up to two years.

How Facial Fillers Work

Dermal fillers are not that different from Botox injections when it comes to the process:

  • The injection – Your doctor will clean your skin, potentially apply a topical anesthetic, then inject a specific amount of facial filler under the desired area. 
  • The results – The gel-like substance will fill out sunken cheeks, deep wrinkles, and fine lines by restoring some of the facial volume you’ve lost over time. 
  • The timeline – You’ll likely notice the effects immediately. Some doctors recommend taking it easy on the day of your procedure, avoiding strenuous exercise. Depending on your choice of filler, it can last anywhere from 6 months to 2 years. 
  • Potential side effects – Be sure to use an FDA-approved dermal filler. Even then, you may experience mild, temporary bruising and swelling in the days after treatment.


Recovery tip: Our INhance Post-Injection Serum with TriHex Technology® is designed to help soothe irritated skin, accelerate recovery from any bruising and swelling, and aid in the natural production of new, healthy skin cells.

The Right Treatment for the Right Type of Wrinkles

When contemplating Botox vs fillers, the question isn’t, “Which is better?” but rather, “What problem am I treating?” followed by, “Which is better for that specific problem?” 

One primary difference between Botox and fillers is which type of facial wrinkles they treat:9

  • Dynamic – These wrinkles appear due to repetitive facial expressions and muscle movements, like laughing, crying, or squinting. These all involve contracting facial muscles. Once the muscles relax, the lines disappear. They can manifest in several different ways:10
    • Frown lines between the eyebrows
    • Forehead wrinkles from raising your eyebrows or furrowing your brow
    • Crow’s feet, or “laugh lines,” in the corner of your eyes from squinting


Botox helps treat dynamic lines by freezing the commonly contracted muscles and serving as a wrinkle relaxer. 

  • Static – Unlike dynamic lines, these wrinkles are always present, even when your face is at rest (when your expression is static). Dynamic facial lines may eventually become static as your skin loses its elasticity. 


Dermal fillers are often used to treat static lines because they reinject volume into sagging, wrinkled areas of the face. Static lines often require deeper treatment because they’ve been etched into the skin over a longer period.

In this regard, Botox and fillers are not two sides of the same coin. In fact, they don’t even work in the same slot machine. 

Anti-Aging with ALASTIN

No matter which you choose—dermal filler vs Botox—you’ll want to do everything you can to ensure a speedy, healthy recovery with long-lasting results. 

At ALASTIN we have a whole line of high-end, scientifically-tested skincare products designed to enhance and extend the results of your treatments. Our INhance Post-Injection Serum was named the best post-injection treatment by NewBeauty in 2020. Find a skincare professional near you who can help you identify the best products for your specific skin type.



1. “About Botox Cosmetic.” Botox® Injections,

2. Nigam, P K, and Anjana Nigam. “Botulinum toxin.” Indian journal of dermatology vol. 55,1 (2010): 8-14. doi:10.4103/0019-5154.60343. 

3. Torborg, Liza. “Mayo Clinic Q and A: Botox for Wrinkles – Is It Safe?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 27 Sept. 2016,

4. Coté, Timothy R et al. “Botulinum toxin type A injections: adverse events reported to the US Food and Drug Administration in therapeutic and cosmetic cases.” Journal of the American Academy of Dermatology vol. 53,3 (2005): 407-15. doi:10.1016/j.jaad.2005.06.011. 

5. “Botox Injections: Purpose, Procedure, Risks, Results.” Edited by Arefa Cassoobhoy, WebMD, WebMD, 24 July 2020,

6. Liu, Kristina. “Dermal Fillers: The Good, the Bad, and the Dangerous.” Harvard Health Blog, Harvard Medical School, 7 Jan. 2020,

7. “Injectable Fillers Guide.” American Board of Cosmetic Surgery, 1 June 2017,

8. Papakonstantinou, Eleni et al. “Hyaluronic acid: A key molecule in skin aging.” Dermato-endocrinology vol. 4,3 (2012): 253-8. doi:10.4161/derm.21923, 

9. “Dynamic Wrinkles and Static Wrinkles Treatment by Dr. Mimi Lee.” Mimi Lee M.D. PA, 31 Aug. 2020,

10. Baugh, William P. “Static vs. Dynamic Wrinkles – Fullerton, CA.” Full Spectrum Dermatology, 30 Dec. 2017,

Article Reviewed by Wendy Johnson
Wendy Johnson

Vice President, Marketing

Wendy Johnson brings to Alastin Skincare over 22 years of pharmaceutical, biotechnology, and aesthetics industry experience in various sales, training, marketing and thought leader development roles.

After spending 10 years in gastroenterology at Tap Pharmaceuticals and Prometheus Laboratories, with sales and marketing oversight for in-line and pre-launch products, Mrs. Johnson transitioned to an aesthetic career at SkinMedica in 2004. While there, she was responsible for marketing one of the top 2 branded prescription hydroquinones, launching a leading branded low potency steroid, and oversight of the acne franchise line extensions.

In 2010, Wendy joined Merz North America where she developed and managed the Physician Relations department in support of injectable, topical and device business units under Medical Affairs, before transitioning into managing a Regional Aesthetics Marketing team.

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