Botox vs. filler: when to use which
Six years of injectables practice distilled into four clear rules.
The most common confusion I see in consults is mixing up Botox and filler. The difference is surprisingly simple: Botox calms a muscle; filler restores lost volume.
When Botox is the answer
If the line only shows when you make an expression (smile, raised brows, frown), it's a dynamic line and Botox is the right tool. Classic zones: forehead, glabella (between brows), crow's feet.
When filler is the answer
If the line or hollow is there even at rest — under-eyes, smile lines, deflated cheeks — that's volume loss and filler is the right tool.
The common mistake: using one for the other
If we inject filler into a dynamic line, the line stays and the skin above it just gets thicker. If we inject Botox into a volume loss, we weaken a muscle that has nothing to do with the issue.
Sometimes we use both
In more advanced ageing, we start with filler to restore volume, then add Botox to soften dynamic lines. Order matters — volume first, muscle softening second.
My golden rule
Start with the smallest possible dose. You can always add more after two weeks, but you can't remove what's already in. A good injector always suggests a conservative starting dose.
Finally: if your injector didn't photograph you before, or didn't sit with you for five minutes to understand what you want, politely leave. Injecting is a long-term decision.
Your skin deserves a calm conversation.
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