BOTOX relaxes facial muscles, softening expression lines like forehead creases, frown lines, and crow’s feet. In contrast, dermal fillers restore lost volume, enhance facial contours, and smooth out deeper folds.
While these treatments are often compared, they are not interchangeable—and they are not competitors. When selected and placed with precision, BOTOX and fillers serve distinct roles that together can create refreshed, balanced, and natural-looking results.
At Rousso Adams Facial Plastic Surgery, injectable treatments are guided by the same surgical-level expertise that defines our practice. We specialize exclusively in the face and neck, and board-certified facial plastic surgeons develop every injectable plan with decades of experience restoring natural facial harmony.
In this blog, we draw on that experience to help you determine whether BOTOX, fillers, or a combination of both will best achieve your aesthetic goals.
What BOTOX Actually Treats
BOTOX Cosmetic (onabotulinumtoxinA) is an injectable neuromodulator that temporarily reduces muscle activity in targeted areas. In aesthetics, it’s used to soften expression-related wrinkles by relaxing the muscles that create them. The FDA-approved cosmetic indications include forehead lines, frown lines (glabellar lines), and crow’s feet in adults.
BOTOX Is Best for “Dynamic” Wrinkles
These are lines that appear or deepen when you animate your face, such as:
- Raising your brows
- Squinting
- Frowning
- Smiling
How Long Does BOTOX Last?
For many patients, results last about 3–4 months, then gradually wear off as muscle activity returns.
Will BOTOX Make Me Look “Frozen”?
It shouldn’t when it’s placed with restraint and anatomical precision. The goal is not to erase your expression; it’s to keep your face looking refreshed and authentically you.
What Fillers Can Do
Dermal fillers are injectable materials placed beneath the skin to:
- Restore volume
- Smooth lines
- Refine contours
The FDA maintains an overview of approved dermal fillers, including common categories such as hyaluronic acid and calcium hydroxylapatite.
Fillers Are Best for “Static” Lines and Structural Changes
These are lines you can see even when your face is at rest, plus age-related changes such as hollowing or flattening in areas like:
- The cheeks
- The temples
- Around the mouth
Think of fillers as tools to soften creases and restore fullness, with hyaluronic acid being among the most commonly used options because it’s a natural component found in skin.
How Long Do Fillers Last?
It depends on the filler type and its placement. The FDA notes that many hyaluronic acid fillers typically last 6–12 months (though longevity varies), while other filler materials may last longer depending on the product and the anatomy.
Will Fillers Look Puffy or Obvious?
They can if they’re overdone, poorly placed, or chosen without respect for the patient’s structure. They can also look exceptionally natural when done with a conservative, facial-anatomy-first approach that prioritizes balance and proportion.
Why Injector Choice Matters
Both neuromodulators and fillers have strong safety histories when performed appropriately, but technique and anatomical knowledge are not optional—especially with fillers. While most filler side effects are mild and temporary, rare serious complications can include vascular occlusion leading to skin injury or vision-threatening events.
This is precisely why our practice treats injectables as facial medicine, not a commodity service. Proper evaluation, product selection, conservative dosing, and precise placement are what protect naturalness and safety.
BOTOX vs Fillers: Which Do You Need?
So, which is best for you?
- If your primary concern is forehead lines, frown lines, or crow’s feet that worsen with expression, BOTOX is often the starting point
- If your concern is hollowing, flattening, deeper folds, or lip/cheek definition, fillers may be the better tool
- If you want the most natural, comprehensive refresh, a customized combination is often ideal
Rousso Adams Facial Plastic Surgery ensures your injectable care is guided by board-certified facial plastic surgeons who live in facial anatomy every day. Our refined aesthetic standard is built around balance and symmetry, making us the perfect choice for your aesthetic journey. If you’re ready for expert guidance, schedule your consultation with us today.