You’ve seen the glossy magazine headlines promising “ageless skin” and heard the buzz around NYC’s latest med spa trends. But when you step into a clinical setting, the Botox vs. Dermal Fillers debate shifts from trends to science. At Skincare Sommelier, we know that a single wrinkle isn’t just a line — it’s a signal of how your facial anatomy is changing over time. Understanding the root cause of these changes is the difference between a “worked-on” look and a truly refreshed, natural appearance.
This guide is designed to help you navigate the technical aspects of injectables, ensuring your next aesthetic choice is backed by expert insight rather than hype.
Are Your Wrinkles Dynamic or Static?
To choose the proper treatment, you first need to identify the “personality” of your wrinkles. In our Forest Hills lab, we help clients categorize their concerns into two distinct groups to determine the most effective path forward:
Dynamic Wrinkles (The Lines of Expression): These are the lines that appear only when you use your facial muscles — when you laugh, frown, or concentrate.
- Where they live: “Crow’s feet” around the eyes when you smile, horizontal forehead lines when you’re surprised, and the “11 lines” between your brows.
- The Solution: Botox is the gold standard here. It addresses muscle movement, allowing the skin above to remain smooth and uncreased.
Static Wrinkles (The Lines of Time): These are lines that remain visible even when your face is entirely at rest. They are often caused by gravity, environmental damage, and a natural loss of structural volume.
- Where they live: Nasolabial folds (smile lines), marionette lines around the mouth, and deep tear troughs under the eyes.
- The Solution: Dermal Fillers are required to physically “lift” the skin and restore the lost structural foundation.
Interested in preventative care? Learn more about the ideal timing for your first treatment: What Age Should You Get Botox? Preventative Botox, Benefits & Expert Tips
Is Botox a Filler? Understanding Composition and Function
It is a common misconception, but the difference between Botox and Dermal Fillers starts with their biological makeup.
Botox is a neurotoxin — a purified protein that simplifies the conversation between your nerves and your muscles. It doesn’t “fill” anything; instead, it creates a window of rest for your skin to smooth itself out. Dermal Fillers, on the other hand, are gel-like substances (usually Hyaluronic Acid) that add physical mass under the skin.
Thinking of Botox as a “relaxer” and fillers as a “restorer” is the most accurate way to understand their unique roles in your treatment plan.
Deciding Between Botox and Fillers for the Forehead
When clients search for Botox or Fillers for forehead treatments, the answer depends entirely on the depth of the lines.
If the wrinkles appear only when you raise your eyebrows, Botox will prevent those temporary creases from becoming permanent. However, if those lines have become deep “trenches” that stay visible while your face is relaxed, Botox alone may not achieve the smoothness you desire. In these more advanced cases, we use Botox to stop muscle movement and an excellent dermal filler to subtly smooth the remaining surface indentation. This dual-action approach ensures the forehead looks smooth in every light.
The Skincare Sommelier Approach: What We Choose for Wrinkles?
In our Forest Hills practice, we move away from “one-size-fits-all” injections. Our philosophy is rooted in two main principles:
- Preserving Natural Movement: Instead of “freezing” the face, we focus on precision dosing. This ensures that, as wrinkles fade, your ability to express emotion remains intact. The goal is for you to look like yourself — only more rested and vibrant.
- Strategic Volume Restoration: We don’t believe in over-filling or creating artificial contours. Our approach focuses on placing filler only where bone and fat have naturally been lost over time. This restores the “scaffolding” of your face, preventing the heavy, artificial look often seen with poorly planned treatments.
“Facial rejuvenation isn’t about chasing every line; it’s about restoring harmony. We look at your face in motion to ensure the result is as beautiful when you’re talking and laughing as it is in a still photo.” — The Skincare Sommelier Team.
The Under-Eye Area: Botox vs. Fillers?
The skin under the eyes is among the thinnest on the body, making Botox vs. Filler for under eyes one of the most critical decisions for our NYC clients.
- Choose Botox if: Your concern is “crow’s feet” — the fine lines that fan out from the corners of your eyes during facial expressions. Botox relaxes the muscle that pulls the skin into these folds.
- Choose Fillers if: You have a “hollow” look or a visible tear trough that creates a dark shadow. Botox cannot restore volume. A dermal filler is the only way to physically bridge the gap between the lower eyelid and the cheek, eliminating that “perpetually tired” look that sleep alone cannot fix.
Explore our detailed guide: Botox under eyes: Cost, Benefits, Before & After Results
Can I Get Both in One Visit?
One of the most efficient ways to achieve a total refresh is through synergy. Can you get Botox and fillers at the same time? Absolutely. Most of our clients prefer to address multiple concerns in a single appointment to ensure overall facial harmony and save time.
However, because these treatments target different layers of the face, combining them requires a strategic plan. During your individual aesthetic consultation, we analyze your face both in motion and at rest. This allows us to determine the exact sequence of injections needed to “erase” wrinkles while maintaining your unique facial structure — all in one visit.
Botox vs. Dermal Fillers Cost: Understanding Your Aesthetic Investment
When evaluating the cost of Fillers versus Botox, it’s essential to understand that these treatments are priced and billed according to different clinical models. This distinction is vital for planning your long-term maintenance:
- Botox is priced per “Unit”. You are paying for the precise amount of neurotoxin required to relax a specific muscle group. The number of units needed depends on the strength of your facial muscles and the area being treated. For example, horizontal forehead lines and “11 lines” require different dosages. Typically, Botox results last 3-4 months and require maintenance every 3–4 months.
- Dermal Fillers are priced per “Syringe”. Fillers are measured by volume. A syringe contains a set amount of gel used to lift the skin or restore volume in areas such as the cheeks or lips. While the initial cost per syringe is higher than a few units of Botox, the longevity is significantly greater. Depending on the product and your metabolism, fillers can last anywhere from 6 to 18 months.
Not sure how many units you might need for these areas? Find out here: How much Botox do I need?
At Skincare Sommelier, we view these not just as isolated procedures, but as a strategic, consistent plan to preserve your skin’s integrity and youthful architecture over time.
Comparison Table: Botox vs. Dermal Fillers
| Feature | Botox (Neurotoxins) | Dermal Fillers |
| Action | Relaxes muscles | Adds physical volume |
| Best For | Forehead, Crow’s feet, “11” lines | Cheeks, Lips, Smile lines, Hollows |
| Results Seen | 3–7 days | Immediately |
| Longevity | 3–4 months | 6–18 months |
| Ideal Candidate | Dynamic wrinkle correction | Static wrinkle & volume loss |
FAQ
Is Botox a filler?
No. This is the most common myth in aesthetics. Botox is a neurotoxin that relaxes muscles, smoothing out wrinkles. Dermal fillers are injectable gels that add physical volume to “fill in” hollows or deep folds. They are two distinct tools used for different purposes.
Which is better for smile lines (nasolabial folds)?
Dermal fillers are generally the preferred choice for smile lines (nasolabial folds), as these are typically caused by a loss of volume in the mid-face rather than muscle overactivity. Fillers replace that lost support, lifting the tissue and softening the crease in a way Botox cannot.
What are the potential side effects of Botox and fillers?
Both treatments are FDA-approved and safe when performed by experienced professionals. The most common temporary side effects are minor swelling or pinpoint bruising at the injection site, which usually resolve within a few days.
How many units/syringes will I need?
This is determined during your consultation. Every face is unique, and we tailor the amount to your specific anatomy to ensure a natural, never “overdone” result.
How long do the results of Botox or Dermal Fillers last?
Botox typically lasts 3-4 months. Dermal fillers are longer-lasting, with results lasting 6 to 18 months, depending on the specific product used (e.g., Juvederm vs. Restylane) and your body’s unique metabolism.
Do Botox or filler injections hurt?
At Skincare Sommelier, we prioritize your comfort. Botox injections use very fine needles and are often described as a quick “pinprick.” For fillers, we use topical numbing creams, and most modern fillers contain lidocaine (an anesthetic) within the gel to minimize discomfort during and after the procedure.
Can dermal fillers be dissolved if I don’t like the result?
Yes, this is one of the most significant safety advantages of Hyaluronic Acid (HA) fillers. If you are unhappy with the outcome or a complication occurs, we can safely use hyaluronidase to dissolve the filler within 24–48 hours. Botox, however, cannot be dissolved and must wear off naturally.
Will my wrinkles look worse if I stop getting treatments?
No. This is a common fear. If you stop getting Botox or fillers, your skin will return to its original state over time. In many cases, because Botox prevents you from etching deeper lines into your skin for several months, your wrinkles may actually look better than if you had never had the treatment at all.
Can I exercise after Botox?
We recommend avoiding strenuous exercise, saunas, and heavy lifting for at least 24 hours after your treatment. Increased blood flow and heat can increase the risk of bruising and, in the case of Botox, potentially cause the product to migrate to unintended muscles.
At what age should I start considering injectables?
There is no “perfect” age. Many clients in their late 20s and early 30s opt for “Preventative Botox” to stop deep lines from forming. Others wait until they notice visible static wrinkles in their 40s before starting fillers. The best time to start is when a specific concern begins to affect your confidence.
Can dermal fillers be dissolved?
Yes, this is one of the most significant safety advantages of Hyaluronic Acid (HA) fillers. If you are unhappy with the outcome or if a complication occurs, we can use an enzyme called hyaluronidase to safely dissolve the filler within 24–48 hours. Botox, however, cannot be dissolved and must wear off naturally.
Your Individual Aesthetic Consultation
Choosing between Botox vs. Dermal Fillers is a clinical decision that shouldn’t be made based solely on trends. At Skincare Sommelier, we invite you to an individual aesthetic consultation in our Forest Hills office. We will analyze your unique facial architecture to create a custom plan that restores facial harmony and brings back your natural, refreshed glow.
Ready to start your journey? Contact Skincare Sommelier Beauty Lab & Med Spa today to book your session.
