Botox vs Dermal fillers: What is the difference?

Botox and filler treatment, Hampstead London

If you’re starting to explore aesthetic treatments, one of the first questions you’ll likely come across is: should I have Botox or fillers? They’re two of the most popular non-surgical treatments for softening lines and rejuvenating the face, but they work in very different ways. And choosing the right one depends entirely on what you’re hoping to achieve.

Let’s break down what each treatment does, how they differ, and how we might use them individually or together to get natural, refreshed results here at Dr Marc Aesthetics, Hampstead London.

Understanding Botox: Relaxing the muscles that cause wrinkles

Botox is a purified form of botulinum toxin that works by temporarily relaxing specific facial muscles. When we use Botox, we’re targeting the dynamic wrinkles, those lines that form as a result of repeated movement. Think frown lines between the eyebrows, forehead lines, and crow’s feet at the outer corners of the eyes.

By gently softening the muscle activity in these areas, we can prevent the skin from creasing so deeply. Over time, this not only smooths existing lines but can also help prevent new ones from forming. The result? A fresher, more rested appearance that still looks like you - just a little less tense or tired.

Botox typically starts to take effect within a few days and reaches full strength at around two weeks. Results usually last between three to four months, depending on the area treated and how your body responds.

Understanding dermal fillers: Restoring lost volume and contour

Where Botox treats movement-based lines, dermal fillers address volume loss. As we age, we naturally lose fat, bone and collagen in the face, which leads to sagging, hollowness and the appearance of deeper static wrinkles, those etched-in lines that remain even when your face is at rest.

Dermal fillers are gel-like substances, most commonly made of hyaluronic acid, that are injected beneath the skin to restore volume, shape and support. They’re often used to soften nasolabial folds, lift the cheeks, restore plumpness to the lips, or contour the jawline.

When placed strategically, fillers can restore youthful structure to the face without looking “done”. In fact, the most effective filler treatments are subtle, no one should know you’ve had them, only that you look healthier, brighter and more well-rested.

So, how do I know which one I need?

This is where expert guidance comes in. It’s not always an either/or situation. In many cases, Botox and fillers work beautifully together to address different layers of facial ageing.

For example, you might have crow’s feet from squinting, which respond well to Botox, but also notice that your cheeks have started to flatten and your smile lines are more prominent, which may be better suited to filler. During a consultation, we’ll assess your facial anatomy, your skin quality, and your goals to build a plan that’s completely tailored to you.

The key is subtlety. The best aesthetic work doesn’t chase every line or fill every shadow. It respects your natural features and enhances what’s already there.

What about safety and downtime?

Both Botox and fillers are safe treatments when performed by an experienced practitioner using high-quality products. In most cases, you’ll be in and out of clinic within 30 to 45 minutes, with minimal downtime. Some patients experience a bit of redness, swelling or bruising at the injection sites, but this usually settles quickly.

We always recommend avoiding intense exercise, alcohol and facial treatments for 24 hours post-treatment to allow the product to settle properly and reduce the risk of bruising.

A personalised approach always gets the best results

Ultimately, Botox and dermal fillers are tools, and like any tool, it’s how they’re used that matters most. There’s no one-size-fits-all approach in aesthetic medicine. The right treatment for you depends on your unique facial structure, how your skin is ageing, and the kind of result you want to achieve.

My approach is always to listen carefully, assess thoroughly, and treat conservatively, enhancing your features without altering your expression or identity. You should look in the mirror and still feel completely like yourself, just the version that’s had a great night’s sleep and a boost of confidence.

If you’re curious about how Botox or fillers could work for you, I’d be happy to talk it through with you in a consultation. Let’s find the treatment that feels right for your face, your goals, and your comfort level. Click here to enquire or to book a consultation at Dr Marc Aesthetics, Marylebone, London.