What’s the difference between fillers and Botox?

Patients often ask us what is the difference is between fillers and Botox… and that is a very good question! We completely understand the need to know the difference and how they are used, so let’s dive straight in!!


Botulinum toxin. More commonly known as “Botox” is a toxin that can be used in medicine to stop the activity/movement of muscles. It can be used throughout the body and has multiple medical uses.

Over the last 20 years, the more common uses are for aesthetic purposes. This includes removing wrinkles, getting rid of lines and scars, and helping people to look and feel younger. It is also commonly used to stop Excess sweating, especially in the hands, feet and armpits, and is an excellent remedy when tackling headaches and jaw pain.

The majority of people will find it useful to remove wrinkles on the forehead, frown, smile lines/crows feet wrinkles of the night, and under the eyes.

Botox works best on skin that is tied down. This is what works so well on the forehead. It is administered by a series of tiny injections that may be a little nippy, but numbing cream can be applied to the areas to help!

The effects of Botox usually only last around three months. In some cases, it can be slightly more in some cases, and it may be slightly less in others. More and more people are using it to prevent lines from appearing. A nice side effect of Botox is that it stops your skin from looking oily, too!


There are three main types that are used in UK – Azzalure, bocature and allergen (Botox). Each one has a slightly different recipe but work in the same way. Some people have a particular preference for each brand. However, Allergen (Botox) is often more expensive than the other two.


Is it safe? 

Another common question. A lot of people feel uneasy about injecting toxins into their body. This is a reasonable question and people are quite right to be suspicious. 

In truth, large amounts of botulinum toxin can lead to botulism. This is a very rare condition that can affect any of the muscles in the body, leading to a complete loss of function. Very scary indeed. 

The amount of toxin used for cosmetic and medical Botox is tiny, in fact, it is so low that a bigger issue is that a top-up may be required because the original Botox has not been strong enough! The risk of any serious side effects remains present, as it does with any drug or medication. If you are unsure because you have any specific conditions, speak to your facial aesthetics practitioner.

Overall in multiple studies and 40 years of use, we can conclude that Botox is safe to use. 

What are Fillers?

Filler differs from Botox quite significantly. Fillers are used to fill gaps or plump up areas (hence the name fillers). They can be used to augment lips, cheeks, chins, noses, jawlines, scar removal, and reshape other parts of the body.

Hyaluronic acid is the main ingredient in most fillers. This is found naturally in the body between the cells and in fatty (adipose tissue). As such, it is broken down by the bodily relatively easily. It usually lasts between 6-12 months, this can be slightly longer or shorter depending on location. 

It is placed with either an injection or a cannula (a long tube that can reduce bruising). 

The most common areas to administer fillers are the lips, cheeks, nasolabial folds and jawline. We are seeing more and more patients opting for fillers. In the past few years it has become super popular. 

Is Filler safe?

As Hyaluronic acid is a natural substance, and it can be dissolved by using a product non as hyaluronidase, filler is a very safe product. Hyalurondiase can break down fillers within a few hours getting rid of any unwanted effects. 

In some case the administration of fillers can be an issue. If injected into the lip or any area with a high number of blood vessels, care needs to be taken to ensure that they are injected correctly to avoid any excess bruising and bleeding. In rare cases, a Vascular occlusion can occur. This is when the filler is accidentally injected into the blood vessels. In most cases, red spots or areas develop and are painless. These can be dissolved by your aesthetics practitioner. In rare cases, if the filler has been injected deeper, a trip to the hospital may be needed to perform oral surgery on the lips to remove the problem-causing filler. (we have never actually seen this happen, however, we feel it is important to be aware of the risks)


What is migration or migrating?

This is when filler or Botox moves from where it should be to another area nearby. Sometimes it is not noticeable, and other times it can be quite distressing.

When it occurs in Botox, it usually leads to the wrong or extra muscles being unable to move. Often the eyebrow may seem heavy, or the lower eyelid may not have the same function as it did before. As Botox doesn’t last very long, the effects are short-lived.

Migration in fillers is slightly different. The filler usually becomes small balls that move about. It can happen in the lips leading to sagging, or on cheeks leading to lumps at the side of the face. Hyaluronate can be used to get rid of unwanted filler. 


Silicone Fillers

There was a time when people used silicone fillers regularly. That has long since stopped. Silicone was popular as their lips did not need to be repeatedly touched up. Unfortunately, they came with some significant side effects.

They had a higher level of migration, which lead to fillers in the wrong place and leading to lips and faces with clumping and small balls. They lead to skin irritation and often infections which could lead to scarring or deformity. 

To remove them involved surgery, even if there was only a small amount of migration. All of this has led to silicone filler no longer being used by most clinicians 


Anything else?

In some cases, we can use filler and Botox together to get rid of particular tricky lines or scarring. We often use a combination for smoker lines or the forehead to achieve great results.


To sum up, Botox and fillers work in completely different ways and do different things. We can use them together sometimes, and in general, they are safe. Fillers can be dissolved and Botox lasts for a few months. They are increasing in popularity, and we expect more men to start using them in the morning years as well. 


-Dr Abraham McCarthy

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