What is the difference between Botox and Fillers?

What is the difference between Botox and Fillers?

What is the difference between Botox and Fillers? This is a very common question posed to many of the top facial plastic surgeons as well as any cosmetic surgeon. In my practice, I get asked this question at least once a week. Although it may seem complicated, there is only one thing in common between Botox and Fillers like Juvederm or Esthelis; they both can treat wrinkles. Apart from that, questions like, “how Botox and Fillers work?” “how long they last?” and “where can you use them on your face?” are different.

Botox is what we would call a Neuromodulator, a medication that alters the function of nerves in our body. Botox reduces wrinkles two ways. One, in stops muscles that form wrinkles from contracting and moving so the wrinkles are less visible. The second, based on research I’ve conducted and published in a medical journal (http://www.ncbi.nlm.nih.gov/pubmed/24664544) Botox also seems to affect the skin directly, increasing its elasticity.  In Canada, Botox is approved to treat wrinkles in the forehead, between the eyes (the glabella) and the sides of the eyes (crow’s feet). Some doctors treat other areas of the face with Botox, like the chin, the lips and nose (bunny lines), although these treatments may not be as successful as the treatments for the upper face around the eyes.

Fillers on the other hand, do just that, fill. They don’t have any effect on the body other than take up space. In Canada, there is only one type of filler approved by Health Canada, Hyaluronic Acid based fillers, this includes both Juvederm and Esthelis. When you inject filler into the skin, it takes up space in the skin and creates some tension. This results in lines becoming smoother and less deep. Over time, the body slowly dissolves the filler.

So where can we use Fillers and Botox and is there a difference? When I talk to patients, I usually tell them that they can think of where you use Botox and Fillers in one simple way. Botox Treats the wrinkles around your eyes and forehead while fillers like Juvederm and Esthelis treat wrinkles on your face below your eyes.  This is a simplification, but it is basically true.

So if you are ever curious what is right for you, ask yourself, are you wrinkles below your eyes or above your eyes? If above, then it’s probably Botox you are looking for, if below your eyes, it’s probably filler. However, the only way to know what is best for you, Botox or Filler, is to talk to a physician and a nurse in our clinic in person as some people cannot use these products.

So, you can see there are major differences between Botox and Fillers. Its important to discuss the differences with your Facial Plastic Surgeon to ensure the product is right for you.

James Bonaparte, MD, MSc, FRCSC