Botox Vs. Fillers: Uses, Effects, And Differences - Medical News Today

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Medical News TodaySubscribeWhat is the difference between Botox and dermal fillers?

Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — Written by Jennifer Berry — Updated on July 10, 2025

Key differences
Botox
Dermal fillers
Summary

Botox and dermal fillers are both minimally invasive cosmetic treatments given through injections. However, they differ in that Botox relaxes muscle and fillers add fullness.

Botulinum toxin (Botox) and dermal filler treatments are both popular to manage the physical effects of aging.

Botox contains purified bacteria that freeze muscles. In doing so, Botox can help minimize the appearance of lines and wrinkles that occur due to facial expressions.

Dermal fillers contain ingredients that add fullness to areas that have thinned due to aging. This thinning is common in the cheeks, lips, and around the mouth.

Key differences

A black and white image of a syringe with droplets around it.-2 — Mariya Borisova/Getty Images

According to the American Society of Plastic Surgeons (ASPS), there were around 2.6 million dermal filler injections and 7.4 million Botox injections in the United States in 2018.

The table below summarizes the key differences between Botox and fillers:

Botox	Fillers
Purpose	to reduce muscle movement that can cause new wrinkles and creases	to add plumpness to areas that have lost volume and smoothness
How it works	the injections contain purified bacteria that relax the muscles	the injections use hyaluronic acid and other substances to “fill in” areas
How long it lasts	3 to 4 months	6 to 9 months
Cost	around $400 per treatment, but depends on how much used and the areas treated	$500 to $900 per syringe
Permanence	not immediately reversible, but results will fade with time	professionals can inject an enzyme to dissolve filler within a day

Because Botox and fillers are different substances with different uses, people may combine them in one treatment. For example, someone may use Botox to reduce lines between the eyes and a filler to reduce lines around the mouth.

What is Botox?

Botox is a purified form of the botulinum toxin that professionals obtain from bacteria. Botox is just one form of botulinum toxin. There are several other forms with FDA approval for use to manage wrinkles and skin lines.

Though it is toxic in larger amounts, practitioners have safely used the tiny, regulated amount of Botox given to reduce the appearance of wrinkles for decades.

Botox works by blocking nerve signals in the muscles at the injection site. Interrupting the nerve signals causes the affected muscle to become temporarily paralyzed or frozen.

Without movement of these selected muscles in the face, certain wrinkles may appear softened, reduced, or even removed.

Botox and other treatments made with botulinum toxin are sometimes called neuromodulators or neurotoxins.

Treatments made with botulinum toxin have the brand names Botox Cosmetic, Dysport, and Xeomin.

What can Botox correct?

Botox only works on wrinkles that occur due to muscle movement. These are known as dynamic wrinkles and are often called “expression lines.”

The most common dynamic wrinkles that Botox can treat are lines on the upper face, such as the “11” between the brows, horizontal lines on the forehead, and crow’s feet around the eyes. These occur due to smiling, frowning, squinting, and other facial expressions.

Botox will not work on fine lines and wrinkles caused by sagging or loss of plumpness in the face. These are known as static wrinkles. Static wrinkles include lines in the cheeks, neck, and jowl areas.

Botox is not a permanent treatment. Repeated treatments are necessary for the wrinkle-reducing effects to continue. Most people find that the muscle-relaxing effect of Botox lasts for 3 to 4 months.

Botox side effects and considerations

The ASPS considers Botox to be generally safe. However, some people may experience side effects. Since Botox wears off over time, most side effects are only temporary.

Possible side effects of Botox include:

weakness or paralysis of nearby muscles
pain, bleeding, or bruising at the injection site
headache
flu-like symptoms
nausea
skin color changes, such as redness

If anyone experiences symptoms such as difficulty swallowing and breathing, they should seek urgent medical help.

The treatment may also fail to work due to antibodies that fight the toxin. However, a 2019 review suggests this only happens in 5% to 10% of people who have repeat, high dose, long term Botox treatments.

The ASPS advises people not to rub or massage the area of the injection after having Botox treatment. Doing so could spread the toxin to surrounding skin, causing muscle drooping and other problems.

The average cost of a Botox injection is $435.

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What are dermal fillers?

Dermal fillers, sometimes called soft tissue fillers, are substances that professionals inject beneath the skin’s surface to add volume and fullness.

Substances used in dermal fillers include:

calcium hydroxylapatite, a mineral-like compound that also occurs in bones
hyaluronic acid, which also occurs in some fluids and tissues in the body that add plumpness to the skin
polylactic acid, which stimulates the skin to make more collagen
polymethyl-methacrylate microspheres (PMMA), a semi-permanent filler

The time they take to work and how long they last also varies. According to the ASPS, fillers last from 9 to 12 months, on average.

People should discuss their individual needs and expectations with their doctor to determine what filler would be the best choice for them.

What can dermal fillers correct?

The Food and Drug Administration (FDA) approves dermal fillers for the following uses in people ages 22 and above:

increasing fullness in the:
- lips
- cheeks
- chin and jawline
- under-eye hollows
- back of the hands
correcting moderate to severe facial wrinkles and skin folds
correcting cheek acne scars
restoring facial fat loss in people with HIV

People should speak with a doctor if they want to address issues that are not on the above list. Dermal fillers may not be the most suitable treatment for them.

Dermal filler risks and considerations

The FDA approves certain dermal fillers as medical devices. However, side effects are still possible following treatment.

A licensed healthcare professional should perform all dermal filler procedures using only FDA-approved fillers injected with a syringe. The most common problems include:

skin rash or redness
pain and tenderness
swelling
bruising
itching

People may also experience more severe side effects, such as infection, allergic reaction, or tissue death, but these are less severe. Anyone who experiences side effects should speak with a healthcare professional.

The cost of dermal filler treatments varies. It may depend on the provider performing it, the treatment area, and the type of filler. On average, hyaluronic acid fillers cost $715 and nonhyaluronic acid fillers cost $901, according to the ASPS.

Summary

Though Botox and fillers are minimally invasive, they still carry some risks. People should be aware of all possible risks and benefits before having these treatments.

People should also speak with a healthcare professional about what Botox and fillers can realistically do for their appearance. They can enhance a youthful look, but the results may not be as powerful as a surgical procedure, such as a facelift.

Using a qualified medical professional, such as a board certified dermatologist, plastic surgeon, or cosmetic surgeon, helps ensure the procedure safe and effective.

Dermatology
Cosmetic Medicine / Plastic Surgery
antiaging
Cat 1

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Biello A, et al. (2023). Botulinum toxin treatment of the upper face.https://www.ncbi.nlm.nih.gov/books/NBK574523/
Botulinum toxin. (n.d.).https://www.plasticsurgery.org/cosmetic-procedures/botulinum-toxin
Chang E. (2019). Taking the mystery out of Botox and dermal fillers.https://www.plasticsurgery.org/news/blog/taking-the-mystery-out-of-botox-and-dermal-fillers
Dermal filler do's and don'ts for wrinkles, lips and more. (2023).https://www.fda.gov/consumers/consumer-updates/dermal-filler-dos-and-donts-wrinkles-lips-and-more
How much do dermal fillers cost? (n.d.).https://www.plasticsurgery.org/cosmetic-procedures/dermal-fillers/cost
Padda IS, et al. (2023). Botulinum toxin.https://www.ncbi.nlm.nih.gov/books/NBK557387/
Witmanowski H, et al. (2019). The whole truth about botulinum toxin – a review.https://pmc.ncbi.nlm.nih.gov/articles/PMC7874868/

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Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — Written by Jennifer Berry — Updated on July 10, 2025

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Tag » Where Can You Get Botox On Your Face

Botox Vs. Fillers: Uses, Effects, And Differences - Medical News Today

Key differences

What is Botox?

What can Botox correct?

Botox side effects and considerations

What are dermal fillers?

What can dermal fillers correct?

Dermal filler risks and considerations

Summary

How we reviewed this article:

Latest news

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