Difference between Botox and Dermal Fillers

By Mariam Alimi, RN, BSN
Impressions MediSpa

As we age, natural collagen and elastin in the skin decreases which in turn causes fine lines and wrinkles to form. The skin also has hyaluronic acid and as we age this diminishes over time and the face will begin to lose volume and sag.

Botulinum toxin, Botox® is a purified protein which is used to temporarily relax facial muscles that cause the formation of lines and wrinkles.

Dermal fillers are products that contain hyaluronic acid or calcium hydroxlapatite and are used to help lift, restore volume and fill in lines. The chart below indicates a quick snapshot of the difference between Botox and dermal fillers.


Botox is a Muscle Relaxing agent

Fillers are Injectable gels comprised of hyaluronic acid or calcium hydroxlapatite

Brands include Botox, Dysport and Xeomin

Brands include Restylane, Juvederm, Beletoro, Radiesse and Sculptra

Smooths fine lines and wrinkles

Lifts, stimulates collagen, restores facial volume and shape

Most commonly treated areas are: frown lines, crow’s feet and forehead lines

Most commonly treated areas are: cheeks, nasal folds, lips, marionette lines and pre-jowl sulcus

Results last 3 to 5 months

Results last 6 to 18 months

No downtime

Slight bruising and swelling

Treatment time 15 to 20 minutes

Treatment time 30 to 60 min




The anti aging breakthrough of the decade, according to WebMD and leading Dermatologists, is a skin-resurfacing treatment known as Fractional CO2. Combining the effectiveness of traditional carbon dioxide lasers - long thought to be the gold standard in wrinkle removal - with a new application technique, it delivers powerful results without the traditionally harsh side effects and downtime.

So, how does the Fractional CO2 work?

The laser works by vaporizing the tissue and drilling microscopic beams into the epidermis. The wavelength for the Fractional CO2 is carbon dioxide. For years Carbon Dioxide lasers have been recognized as the "gold standard" for treating deep fine lines, sun damage, wrinkles and acne scars. However, in the last 5 years there has been a real shift to fractionated lasers because Fractional CO2 treatments involve less complications and downtime.

"Essentially, you are getting all the benefits of laser resurfacing, still the best way to remove wrinkles, but you're getting it without the downtime and without the horrendous complication rate," says David Goldberg, MD, director of Skin Laser and Surgery Specialists of New York and New Jersey and clinical professor of dermatology at the Mt. Sinai School of Medicine in New York City.

The most common conditions that the Fractional CO2 address: Fine lines and wrinkles of the face
Scars, especially acne scars
Eyelid laxity and lines around the eyes
Pucker marks (smoker's lines) and frown lines
Brown spots and splotchy, uneven skin tone

What Will I look like immediately after my Treatment?

Patients typically experience swelling and a mild sunburn sensation for about 1-2 hours following the treatment. The first 3 to 5 days your face will have a red complexion with swelling. Typically a Post-Ablative kit is included to speed up healing by exfoliation of the dead skin cells and to enhance results. Mineral makeup is can be used typically on Day 4 to help cover any redness.

In Conclusion-

Due to the heating of dermal collagen during the laser treatment tightening of skin laxity and improvement of rhytids (fine lines) continue for up to 6 months. The results of the treatments are dramatic and with proper sun protection, effects are thought to last 8 to 10 years. Most effects of treatment become visible right away, whereas such as new collagen formation build up gradually and result in continued smoothing over time.

6 Ways to Look and Feel 6 Years Younger

As our body begins to age we start noticing a little line here and sag or bag there which makes us look and feel older than we really are. There are many factors that contribute to the breakdown of elastin and collagen in our skin including excessive sun exposure, poor diet, genetics, sleep deprivation, loss of fat in the face and the list goes on. Fortunately, there have been so many advancements in the field of cosmetic dermatology to help alleviate these common trouble spots.

1. Thinning Lashes and Brows: Hormone levels and over tweezing of eyebrows over time thins out our eyebrows and lashes. Tweezing can also damage hair follicles which make it harder for them to grow back hairs.
Solution: Latisse and Revitalash are solutions to help stimulate growth of lushes lashes and eyebrows. Results are often seen within 2-4 weeks.

2. Turkey Neck: Age, hereditary and years of sun damage may lead to lax skin around the neck which is the dreaded "turkey neck".
Solution: Coating the neck with a moisturizing sunscreen will help protect the skin from the harmful rays of the sun. Fractional CO2 laser treatment does wonders in tightening the delicate skin around the neck and improving the texture and tone. Radiofrequency devices such as Pelleve or AccentXL also help stimulate the production of collagen in the neck, therefore, creating a tighter neck.

3. Aged Hands: Years of sun damage may cause wrinkling of the skin, age spots (solar lentigines) and uneven skin tone.
Solution: Laser treatments such as IPL/BBL and Fractional CO2 help repair sun damage skin and remove any discoloration. Dermal Fillers such as Restylane, Juvederm or Radiesse can help plump up the hands to give it a more youthful appearance.

4. Tired Eyes with Bags and Discoloration: Our skin is the thinnest around our eyes and often times our first place to see the signs of aging. At home using a daily eye cream that has growth factors or peptides does wonders for lightening the eye and keeping the skin around the eyes plump. For wrinkles around the eyes, Botox or Dysport can be used to give it a nice smooth appearance. The "Madonna Lift" which uses the Fractional CO2 Resurfacing laser effectively tightens the skin on the upper and lower lids.

5. Wrinkles and Dull Skin: Loss of collagen and elasticity reduces skin volume causing fine lines and wrinkles. Factors such as hereditary, sun exposure, smoking and dynamic muscle movements affect how fast we age. Using our facial muscles such as laughing, frowning and squinting form lines on our face. Solution: At home daily use of Sunscreens helps to protect the skin; retinoids, peptides and vitamin C are also great solutions to help keep the skin looking radiant. Botox, Fillers such as Restylane and Juvederm and Laser treatments do wonders in tightening the skin, providing volume, lifting the cheeks and tightening the jowls.

6. Loose Skin and Cellulite: As lose collagen while we age, gain and lose weight (post pregnancies) and the surge of hormone levels may cause loose skin and cellulite around the abdomen, thighs and buttocks. Solution: Pelleve or AccentXL is Radiofrequency device that is FDA approved to treat Rhytids (wrinkles) and may be used for the abdomen, thighs, face and neck to tighten loose skin.

Radiofrequency Face and Body

The revolutionary way to tighten and firm any loose, wrinkled or dimpled skin ANYWHERE on your face and body.

The Accent XL is a radiofrequency device that is FDA-Approved and designed to improve the thin, delicate skin that develops on the face, neck, and upper arms as well as the abdomen, thighs and buttocks.

Accent Your Body Dual-layer RF Thermotherapy stimulates the production of new collagen and improves skin surface texture. Treatments with the Accent system are quick and do not require anesthesia or a prolonged recovery time. Patients can resume their normal activities immediately. Best of all, Dual-layer RF Thermotherapy provides steady improvement with excellent, skin tightening results.

On What Parts of the Body does Accent Treat?

Dual-layer RF Thermotherapy Accent Your Body treatments can be performed to treat loose wrinkled skin anywhere on the body. The procedure is frequently used for toning thin, loose and crepe-like skin often found on the aging face, neck and under the upper arms. Accent XL can be used for body contouring, cellulite reduction and skin tightening. It is also excellent for firming skin on the post-surgical or postnatal abdomen or thighs.

What are the Benefits of Dual Layer Thermotherapy?

The Bipolar module focuses on the surface layer of the skin, while the Unipolar penetrates further for deep dermal thermotherapy. The Bipolar treatment is well suited for areas where the skin is thinner and more delicate, such as the face, helping to smooth fine lines and wrinkles. The Unipolar treatment generates alternating electromagnetic fields that cause friction and heating in the deeper tissues, which help in body contouring. Taken together, the Accent promotes collagen production in the skin.

4 Peels for the Common Skin Problems

While Chemical Peels sound like a skin lab experiment gone wrong, in the world of facial rejuvenation chemical peels can help brighten and freshen the skin in a fairly quick and painless procedure. Most often peels are used to treat sun-damaged skin with mild wrinkling, uneven skin tone and acne scar pigmentation. Peels are safe to use around the face, neck, chest, back, arms and hands. Chemical peels can also be used for patients dealing with Post Inflammatory Hyperpigmentation, for example those that have skin darkening from an injury or certain skin disorders.

The way the chemical peels help improve the skin tone is by penetrating the skin's layers and breaking up the bonds in the skin, which causes the damaged layers to peel and flake off of the skin. Typically, those loosened layers are home to the pigment producing cells (melanocytes) that cause discoloration of the skin.

Once the peeling process begins, moisturizing the skin and applying adequate sunscreen is the key to promote healing of the skin. Many times the results of the peel can be seen within 7-10 days after doing the peel.

Mild Wrinkles:

A high strength VIPeel has a combination of acids including Phenol, Trichloracetic, Salicylic, Retinoic and Vitamin C), which will tighten the skin and improve mild photo damage and melasma.

Got Acne:

The Vitalize Peel, which is a mild medical grade peel that includes (Salicylic, Resorcinol and Retinoic Acid).

Got Dark Spots (acne scars) or Melasma:

Either the ViPeel or Vitalize Peel is a great option for addressing pigmentation issues on the skin in conjunction with a skin brightener or lightener product such as vitamin c or hydroquinone.

Dull Skin:

Glycolic Acids are great to give the skin a nice glow and fresh appearance in conjunction with Peptides and creams that contain growth factors. A Glycolic Acid peel is also great for those individuals that cannot afford any downtime.