What is the difference between Botox and dermal fillers?

This is something many people still struggle with so we’re going to clarify the difference in today’s blog.

How much are botox injections for the lips?

I would like to know about botox in the cheeks please.

If I don’t like my botox can you dissolve it?

Believe it or not explaining the difference between anti-wrinkle injections and dermal filler injections is still the most common clarification we need to make when people send us in treatment inquiries. For people who have never received a treatment before, it’s understandable. They’re both facial injectables and they are both anti-wrinkle in their own right but in different ways. In our view, the media has not been clear when reporting on ‘botched’ jobs and this has added to the confusion

With all this in mind we have written this short blog to once and for all explain the difference between the two, and the associated risks and complications of each treatment.

The difference between anti-wrinkle and dermal filler treatments

What is Botox?

Botox the most famous branded formulation of botulinum toxin type A or ‘anti-wrinkle’ product. It temporarily paralyses the muscles into which it injected. As skin rests over the top of muscles, this temporary relaxation smooths out the skin and the results is a smoother, softer appearance. This is why it is injected in areas of expressive movement.

How does a Botox treatment work?

The doctor assesses how your muscles move, and injects very specifically to reduce this movement. Everyone’s face is different so there is no catch all template. A more skilled injector will identify micro movements and patterns and adjust your treatment accordingly. Following a consultation and assessment, the treatment itself will take no longer than 10 mins.

The effects take some time to appear. You will feel tightness after 2-3 days and about 90% of effect will be seen at 2 weeks. Full effect is in place at 1 month and results can be expected to last 4-6 months.

What doesn’t a Botox treatment do?

An anti-wrinkle treatment does not replace volume or redefine your facial anatomy. It will not plump your lips and cannot correct deficits in the cheeks, nose or under eye.

 

anti-wrinkle injections
Anti-wrinkle injections are used around the side of the eye to stop movement and over expression

What are the possible complications of Botox treatments?

As you are being injected, there is a chance of bruising – especially if you’ve taken aspirin or are on blood thinning medication. Some redness will occur at the injection site.

The most common significant complication is what’s known as a ptosis (pronounced ‘toe-sis’). This is where the product migrates and too effectively paralyses the muscle causing it to droop. While it affects your appearance, there are no long term effects and the ptosis will correct itself as the product wears off.

If the dose of anti-wrinkle injection product administered is too high, your muscles may be paralysed exceptionally strongly which can give you a frozen look. This makes any type of expression very difficult. Again however, while your appearance will be affected, it is temporary and everything will return to normal as the product wears off.

In general complications from Botox treatment are inconvenient but temporary.

Can you dissolve Botox?

No. Once injected, the anti-wrinkle-product will take effect and it will work. There is no dissolving or reversing its effects – but they are temporary.

What are dermal fillers?

Dermal fillers are injectable gels that are generally made up of hyaluronic acid these days (some other types do exist). They work by replacing lost volume in the skin and fat pads of the face. When injected they attract and hold many times their own weight in water to the injection site. This results in a plumping up and volumising of the area. Dermal fillers are injected into the skin and lips,  never muscles.

 

The Juvederm Vycross Range of fillers we use are FDA approved and widely considered to be the highest quality product available today.

How does a dermal filler treatment work?

The doctor will assess your concern and examine the volume deficit, asymmetry or lack of definition in the area. Everyone’s face will be different and most importantly the volume deficit must be considered from a number of different angles to ensure the best results. A skilled injector will be capable of a number of techniques (needle or cannula) to treat each area and they will not be fixated on the volume of filler used. It is not a good thing to pay for filler treatments by the ml. You should pay for the result, not the amount used. After a proper consultation and assessment, depending on the area, treatment can take anywhere from 10 mins to 45 mins.

 

Results will be instantly noticeable with some swelling very likely. This should not be major, and should subside from a couple of hours, perhaps a day or 2. The injection of hyaluronic acid also stimulates some collagen production so overall the structure and volume of your face or lips should greatly improve.

What doesn’t a dermal filler treatment do?

A dermal filler treatment will not freeze your face or make you look frozen.

 

What are the possible complications of dermal filler treatments?

NOTE – This part is not meant to scare you, but we have to be honest and frank about the risks associated with each treatment.

The usual risk of bruising and injection site redness is always a possibility.

If the filler injected is of poor quality and the technique is poor then nodules of filler can result in a lumpy feel and appearance. If the filler is not injected deep enough, then the skin can take on a blue tinge – this is known as The Tyndall Effect.

 

The most serious complication associated with dermal filler injection is terms ‘vessel occlusion’. This is where the injected product blocks or partially blocks an artery. If the artery is blocked then blood can’t get to the tissue it’s supplying. Oxygen starved tissue dies. The medical term for this is ‘tissue necrosis’. If a blocked vessel is not seen to very quickly, the resulting tissue death can lead to life long disfigurement. If injected in the wrong point, permanent blindness may occur. Google ‘filler necrosis’ for an idea of what this looks like.

There are several major arteries in the face and lips so a very good knowledge of anatomy is required to plan out an execute a safe treatment. This requires a skilled and trained doctor or nurse.

Can you dissolve dermal fillers?

Yes. Hyalase is a pharmaceutical agent that very effectively and quickly dissolves HA dermal fillers. It is a lifesaver in the event that blood vessel occlusion occurs but speed is of the essence. Only a doctor or nurse prescriber can prescribe and inject Hyalase.

In summary…

Anti-wrinkle injections temporarily paralyse muscles and stop over expression and movement of muscles. This reduces fine lines and wrinkles and gives you a fresher, smoother appearance.

Dermal filler treatments replace volume deficits and so contour and add definition to the face.

If you were to sum up the comparative risks associated with botox and dermal filler treatment you might say –

Botox complications are low risk, inconvenient, but temporary. Dermal filler complications are higher risk and potentially life-altering if you do not see a trained aesthetic practitioner immediately. It is also always best to return to the practitioner who performed your initial treatment to have dermal filler dissolved.