Botox vs fillers comes down to one difference: Botox relaxes muscles, and fillers add volume. Botox is not a filler. It softens lines caused by movement, such as frown lines, and lasts about three to four months. Fillers replace lost fullness in areas such as the cheeks and lips, and last from a few months to a few years depending on the type.
This guide compares how each works, what each treats, how long results last, and the risks.
Botox vs fillers at a glance
| Botox and similar products | Dermal fillers | |
|---|---|---|
| What it is | Purified botulinum toxin | A gel or other material, most often hyaluronic acid |
| How it works | Temporarily relaxes targeted muscles | Adds volume under the skin |
| Best suited to | Lines made by facial movement | Lost volume, deeper folds, lips and cheeks |
| When results show | Within 3 to 7 days | Immediately for most types |
| How long it lasts | About 3 to 4 months | About 4 months to 3 years, by type |
The figures are from the American Academy of Dermatology (AAD) and a 2023 review of filler types.
How Botox works
Botox is one brand of botulinum toxin. Others include Xeomin and Dysport. The AAD explains that a very small amount is injected into targeted muscles, which temporarily relaxes them so that the lines above them diminish.
It is FDA-approved for frown lines between the eyebrows and for crow’s feet, among other uses. Most people see results within three to seven days, and the AAD says the effect lasts about three to four months, sometimes longer.
See our Botox and Xeomin page for how treatment is carried out.
How fillers work
Fillers are injected under the skin to add volume. The FDA has approved them for moderate to severe facial wrinkles and folds, and for adding volume to the lips, cheeks, chin and the back of the hands, in adults aged 22 and over.
There are several types. The AAD gives typical durations of 4 to 12 months for hyaluronic acid, 6 months to 1 year for calcium hydroxylapatite, and 1 to 3 years for poly-L-lactic acid. Our dermal fillers page explains the options.
Which lines does each treat?
It depends on what is causing the line.
- Lines from movement. Frown lines and crow’s feet form where muscles crease the skin again and again. Relaxing the muscle softens them, which is what Botox does.
- Lines and hollows from lost volume. Folds beside the mouth, thinner lips and flatter cheeks come from lost fullness. Filler replaces it.
Cleveland Clinic lists both among nonsurgical options for facial ageing, with botulinum toxin most often used between the eyebrows, in the forehead and at the corners of the eyes, and fillers used to add fullness to the cheeks and lips and to fill deep wrinkles.
Botox vs fillers: side effects and risks
Botox
The AAD says side effects tend to be mild and temporary: swelling, redness, soreness and occasional bruising. A mild headache is uncommon. Rarely, a nearby muscle weakens and causes a temporarily droopy brow or eyelid. Very rarely, symptoms of botulism such as trouble breathing or swallowing can occur.
Fillers
The AAD lists redness, swelling, tenderness and occasional bruising, which tend to clear within 7 to 14 days. The FDA describes the most serious risk as accidental injection into a blood vessel. The chance is low, but it can cause tissue death, vision problems including blindness, and stroke.
Fillers are also harder to undo. The FDA says it may be difficult or impossible to remove fillers that are not made of hyaluronic acid.
For both
The AAD warns against having either treatment in a non-medical setting such as a party, salon or someone’s home, and against buying either product online.
Can you have Botox and fillers together?
They do different jobs, so one does not replace the other. Whether a combination suits you is a question for a consultation, where your provider can look at which lines come from movement and which from volume loss.
Frequently asked questions
Is Botox a filler?
No. Botox relaxes muscles. Fillers add volume. They are different products with different effects.
Which lasts longer, Botox or fillers?
Fillers, in general. The AAD gives about 3 to 4 months for botulinum toxin and 4 months to 3 years for fillers, depending on the type.
Which is better for forehead lines?
Forehead lines are caused by muscle movement, which is what botulinum toxin treats. The FDA lists the forehead among areas where it recommends against injecting filler.
Which is better for lips?
Adding volume to the lips is an FDA-approved use of fillers.
Next step
To find out which treatment fits the lines that bother you, book a consultation. You may also want to read our guide to Botox, Xeomin and Dysport.
Sources
- American Academy of Dermatology. Botulinum toxin therapy: Overview and FAQs.
- American Academy of Dermatology. Fillers: FAQs.
- U.S. Food and Drug Administration. Dermal Fillers (Soft Tissue Fillers).
- Cleveland Clinic. Nonsurgical Facelift.
- Go BC, Frost AS, Friedman O. Using injectable fillers for chin and jawline rejuvenation. World Journal of Otorhinolaryngology – Head and Neck Surgery. 2023;9(2):131.
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Beauté Medical Aesthetics
