Botox vs Fillers: What’s the Difference, and Which Do You Need?

Botox relaxes the muscles that fold the skin, so it treats lines of expression: forehead lines, the frown lines between the brows and crow's feet. Fillers replace volume the face has lost and fill lines that are there at rest: the lips, the cheeks, the nasolabial folds, the hollows under the eyes, the chin and the jawline. The test is a mirror. If the line disappears when your face is completely still, it is a Botox line; if it stays, it is a filler line, or a sign that skin has fallen and needs something neither injectable can do. Most patients over 35 benefit from both, in different places, and the plan we write for a face is usually a map of where each one goes rather than a choice between them.

At the Rodeo Drive office of Dr. Cat Begovic, MD, FACS, board-certified plastic surgeon, who injects what follows the area. Dr. Cat herself injects Botox or Dysport of the forehead and around the eyes, and filler in the lips, the nasolabial folds and the neck lines. Every other area of the face and neck, from the masseter, the chin and the platysmal neck bands to the cheeks, jawline, temples, under-eye hollows and the nose, is treated by our board-certified facial plastic surgeon. When a nurse injector or physician assistant is engaged, they treat the forehead and around the eyes with Botox or Dysport only, under the practice's supervision; a mid-level provider never injects filler here, Dr. Cat's rule. The prices are the same whichever provider injects, and because the practice also performs facelifts and fat transfer to the face, you are told when neither injectable is the right answer.

Botox vs Fillers at a Glance

What Botox Does, and What Fillers Do

Botox in Beverly Hills is a purified protein injected into a muscle in a tiny dose, where it blocks the signal that tells the muscle to contract. The muscle relaxes for three to four months, the skin above it stops folding, and a line carved by expression softens because the expression has been switched off. Dysport does the same job with a slightly different formulation; Botox vs Dysport covers that choice. Neither adds anything to the face.

Dermal fillers in Beverly Hills add. A filler is a gel placed under the skin, above or below a muscle and never in it, to replace the fat and bone volume a face loses with age and to fill a fold that is there at rest. Most are hyaluronic acid, a sugar the body already makes, which is why Juvederm and Restylane can be dissolved with an enzyme if the result is wrong. Radiesse is a firmer calcium-based gel used for support along the jawline and in deep folds, and Sculptra is a collagen stimulator that builds volume over months; neither can be dissolved. Fillers do nothing for a line that only appears when you move.

How to Decide Between Botox and Fillers

Lines that move against lines that stay

Raise your brows, frown, squint, then let your face go completely slack in the mirror. Lines that appear with the expression and vanish at rest are dynamic, and Botox treats them. Lines still there at rest are static: the skin has creased so many times that the fold has set, or the fat pad under it has thinned. A static line in the upper face usually started as a dynamic one, so it gets Botox to stop it deepening and, if it is etched, a thread of filler in the crease. The folds of the lower face, nasolabial and marionette, are volume problems, not muscle problems; Botox there weakens the muscles you smile and speak with.

Volume you have lost

From the mid 30s the fat pads of the cheeks and temples thin and slide, the bone around the eye sockets and jaw recedes, and the face changes shape before it changes texture: flatter cheeks, hollows under the eyes, a heavier lower face. No muscle relaxant touches any of that. Filler restores it, and in a face that has lost a lot, fat transfer to the face restores it for the long term with your own tissue.

A map of the face

Forehead lines, the frown lines between the brows and crow's feet are Botox areas, and filler in the forehead is both unnatural and dangerous, because the arteries there run close to the surface. The lips, cheeks, temples, under-eye hollows, nasolabial folds, chin and jawline are filler areas. Lip lines take both: Botox to stop the pursing that makes them and a fine filler to smooth the ones already there. A square, heavy jaw from a strong chewing muscle is a Botox area (masseter Botox); a weak jawline from a receding chin or a soft jaw edge is a filler area (jawline filler). Vertical bands in the neck are made by the platysma muscle, so they are a Botox area too. A gummy smile is Botox; a thin lip is filler.

Budget and maintenance

Botox is a smaller bill repeated three to four times a year; filler is a larger bill once or twice. Over a year one Botox area and one syringe of filler cost about the same. The calendar is the other difference: Botox needs a two-week lead before an event, filler two to four weeks for swelling to settle. Both cost less over time when maintained rather than restarted, because a muscle kept relaxed needs fewer units and a cheek topped up before it empties needs less gel.

When We Use Each, and When We Use Both

Every plan starts with a facial analysis, not a product. Dr. Cat, or our facial plastic surgeon for his areas, watches the face move to find which lines are muscle and which are volume, checks the asymmetries (nearly every face has a stronger side), and asks patients to bring photos of faces they like and faces they do not, because natural means something different to everyone. Botox goes to the upper face and, in selected cases, to the small muscles around the mouth, the masseter and the neck bands; filler goes to the lips, cheeks, under-eye hollows, folds, chin and jawline. The forehead, the eyes, the lips, the nasolabial folds and the neck lines are Dr. Cat's; the masseter, the chin, the neck bands, the cheeks, the jawline, the temples, the under-eye hollows and the nose are our facial plastic surgeon's. Dr. Cat calls fillers a technical art, and she fills lips to look naturally fuller and never overstuffed into the "duck" shape, building volume with a multi-layer, multi-directional technique so it blends rather than sitting in lumps; the practice's rule for under-eye filler is that it is placed conservatively so a patient does not look puffy or overfilled. Filler in the forehead is on Dr. Cat's list of things she has seen go wrong in other hands, along with overstuffed upper lips and lumpy cheeks.

After 35, most patients get both, in different places: Botox for the forehead, frown lines and crow's feet, filler for the cheeks, folds and lips. The pairing is sometimes sold as a liquid facelift, which overstates it: it refreshes a face but does not lift fallen skin. When the areas allow, both are treated in one visit; when a face needs only one, we say so.

When Surgery Is the Better Answer

Injectables have a ceiling, and because Dr. Cat does the surgery, the practice would rather name it than sell a fourth syringe. Jowls and a loose neck are tissue that has fallen: jawline filler sharpens a jaw that has lost its edge, but it does not lift fallen tissue, and on a heavy lower face it adds weight; the answer is a facelift, and the sagging jowls page explains where the line falls. Hooded upper eyelids are excess skin, and neither injectable removes skin; an eyelid lift does, as the hooded eyes page describes. A long upper lip looks longer with filler; a lip lift shortens it, and the practice's lip lift vs lip filler post walks through that choice. For a face that has lost a great deal of volume, fat transfer is Dr. Cat's preferred method: fat harvested by liposuction from the belly, thighs or flanks and layered into the face in a two- to four-hour procedure under anesthesia, often with a facelift through the same incisions. It costs more up front and asks for a week of swelling, and the fat that survives is lasting; the fat grafting vs fillers guide compares the two. Many patients try filler first as a preview of a permanent change.

Where Skincare Fits

Skincare works on the surface, and the surface matters: a retinoid builds collagen and speeds cell turnover, vitamin C brightens and protects, and daily broad-spectrum sunscreen prevents the photoaging behind most texture, pigment and fine static lines. What no cream can do is relax a muscle or replace a fat pad, so a good routine is the layer between injectable visits, not a substitute for them. The order that works is sunscreen every day, injectables for what skincare cannot reach, and surgery for what injectables cannot; Dr. Cat's own line, MD GLAM, is built for the first layer, and the maximizing filler results post explains how hydration and sun protection stretch the life of a syringe.

What to Expect at the Appointment

A Botox visit is short: the areas are agreed, the skin is cleansed, and the injections take about 15 minutes through a very fine needle. A filler visit takes 30 to 60 minutes, because numbing cream sits for 15 to 30 minutes first and the placement is slower; Dr. Cat also uses ice and a special probe that reduces the sting, and cleanses the skin with more than one solution because infection is the avoidable risk. For a week beforehand, with your prescriber's approval, stop aspirin, ibuprofen and other anti-inflammatories, alcohol and herbal supplements to limit bruising; stop retinol 48 hours before filler; arrive with a clean face. Neither is given during pregnancy or breastfeeding, and filler waits until any cold sore has healed.

Afterwards, Botox asks only that you stay upright for four hours and skip strenuous exercise for 24 hours. Filler asks for no makeup or exercise for 24 hours, ice for the first two days, two nights with your head raised, and no saunas or hot yoga for a few days; the practice's lip filler swelling guide follows the lips week by week, because they swell more than any other area. A two-week follow-up checks both, and a touch-up, if needed, happens then.

Results and How Long They Last

Botox shows its first softening at three to five days and its full effect at about two weeks, then holds for three to four months; the practice's guide to how long Botox takes to work has the day-by-day. Filler is visible as soon as the needle comes out, looks bigger than the final result for a few days, and settles into its true shape over two to four weeks. How long it lasts depends on the area more than the brand: the lips move constantly and use up filler in 6 to 12 months; the nasolabial folds hold it 9 to 15; the cheeks, jawline and under-eye area 12 to 18; Sculptra, built up over a series, up to two years. Touch-ups usually need less product than the first treatment, because the area keeps some of its improved contour, and the lip filler guide covers the lips, the area people ask about most.

The galleries show the two jobs side by side. In the Botox and Dysport before and after photos, look at the forehead and crow's feet in expression: the lines soften and the brow still moves. In the filler before and after photos, look at the lips and cheeks at rest: the shape changes and nothing looks added.

Side Effects, Stated Plainly

Botox: small bumps for an hour, a bruise, a headache in the first days, and, when product reaches a muscle it was not meant for, a heavy brow or a drooping eyelid that lasts weeks and fades on its own. Asymmetry is corrected at the two-week check. It is not given in pregnancy or breastfeeding or to anyone with a neuromuscular disease.

Fillers carry more. The ordinary risks are swelling and bruising for several days, tenderness, lumps, asymmetry, filler that migrates outside the lip border, a bluish tint when hyaluronic acid sits too close to the surface under thin skin, cold sores reactivated by lip injections, and delayed nodules months later. The serious one is vascular occlusion: filler injected into an artery blocks the blood supply to the skin it feeds, which can kill that skin, and in the rarest cases a filler that reaches the vessels behind the eye costs vision. The defenses are knowing where the arteries run, injecting slowly in small amounts, using a blunt cannula in the risky zones, avoiding the forehead, and keeping hyaluronidase in the room so that a hyaluronic acid filler can be dissolved within minutes if the skin blanches. A non-dissolvable filler removes that safety net, one more reason the injector matters more than the product.

Frequently Asked Questions About Botox vs Fillers

What's the difference between Botox and fillers?

They do opposite jobs. Botox relaxes the muscles that fold the skin, so it softens lines made by expression: forehead lines, frown lines and crow's feet. Fillers are gels placed under the skin to replace volume the face has lost and to fill lines that are there at rest: lips, cheeks, under-eye hollows, nasolabial folds, chin and jawline. Botox treats movement; fillers treat volume. A line that vanishes when your face is still is a Botox line; a line that stays is a filler line.

Can you get Botox and fillers together?

Yes, and after 35 most faces do better with both: Botox for the movement lines of the upper face and filler for the volume and folds of the mid and lower face. The pairing is sometimes sold as a liquid facelift, which overstates it; it refreshes a face but does not lift fallen skin. We plan both around your anatomy and treat them in one visit when the areas allow.

What makes you look younger, Botox or fillers?

Whichever treats what actually aged your face. In your 30s that is usually movement lines, so Botox does more. From the mid 40s it is usually volume loss and folds at rest, so filler does more, and the combination does most. The wrong product in the wrong place ages you: an overfilled cheek or a frozen forehead reads as work, not youth.

Is there a downside to fillers?

Yes. The ordinary ones are swelling and bruising for several days, lumps, asymmetry, and filler that migrates, most often in the lips. Overfilling changes the proportions of a face, and filler cannot lift skin that has sagged. The serious risk is filler entering an artery, which can kill skin and, very rarely, cost vision; it is prevented by anatomy, slow injection, a cannula in the risky zones and hyaluronidase on hand to dissolve hyaluronic acid filler at once.

What happens after 20 years of Botox?

Muscles that have been relaxed for years get thinner and weaker, so the lines they made stay soft and the dose needed usually falls. The drug does not damage skin, and at cosmetic doses there is no evidence of cumulative harm. Two things can go wrong over decades: heavy dosing that flattens the forehead and drops the brow, and, rarely, antibodies that stop a product working, fixed by switching products.

Which costs more, Botox or fillers?

Per visit, filler: at our office a syringe of Juvederm or Restylane is $1,250 and a 20-unit Botox area is $500. Per year, it is close: Botox is repeated three to four times a year, filler once or twice, so one Botox area runs about $1,500 to $2,000 a year and one syringe of filler $1,250 to $2,500. A multi-area filler plan costs the most.

Is Juvederm the same as Botox?

No. Juvederm is a hyaluronic acid filler and Botox is a muscle relaxant; the confusion comes from Allergan making both. Juvederm adds volume to lips, cheeks and folds for six to eighteen months depending on the area; Botox relaxes the muscles behind expression lines for three to four months. Both are offered at our office, at $1,250 per syringe and $25 per unit whichever provider injects.

Talk to Dr. Cat About Botox or Fillers

The right choice between these treatments depends on which lines move, how much volume you have lost and whether your skin has fallen, which is why it is made at an in-person evaluation, never from an article. Book a free discovery call or call (310) 858-8808 to arrange your appointment with Dr. Cat or, for the areas that are his, with our facial plastic surgeon; injectable visits are booked directly. Your appointment is reserved with a $500 deposit credited to your treatment; new patients are evaluated and treated at the same visit, and the $500 stays as a credit if treatment is not right for you. The $500 surgical consultation fee and its credit toward surgery are a separate arrangement that does not apply to injectable visits. Before you call, look through the filler gallery and the Botox and Dysport gallery, and read the Botox, Dysport and fillers pages.

Medically reviewed by Dr. Cat Begovic, MD, FACS, board-certified plastic surgeon. Last reviewed September 2026.