We asked Mr Ferrando to explain how he uses Botox and Fillers to look at which is most effective.

What are both Botox and dermal fillers used for?

Botox and dermal fillers are both used for the reduction of wrinkles, but the indications and the actions are completely different. Botox is the brand name of a toxin but there are similar products like Dysport, Azzalure, Xeomin, Bocoture, and others on the market. The correct area to treat with Botox is the upper portion of the face on the horizontal forehead lines, the wrinkles around the eyes and between the eyebrow frown lines, the so called: “11s”. Fillers are used for the purpose of filling wrinkles and replacing the lost volume on the face, especially on the cheeks, the jawline and the temporal area. Soft fillers can be used superficially either for the improvement of fine lines or creating a net under the skin for a better texture.  

Is Botox effective?

Botox is very effective. It was used for the first time in the 1980s by a Canadian ophthalmologist and dermatologist, Alastair Carruthers, who accidentally discovered the toxin’s anti-aging properties. Botox works because it temporarily blocks the signal from nerve to muscles. That means a small and reversible paralysis of those muscles and consequently a relaxation of the muscles, softening of the wrinkles and youthful appearance.

How effective are dermal fillers?

Dermal fillers are effective too but the areas we treat are different and the scope is different. Wrinkles on the lower face are generally caused by gravity and sun damage so in these areas we use dermal fillers not Botox. Since the wrinkles of the upper third of the face are due to excessive muscular action, Botox remains the best treatment for these particular areas.

What are the side effects of both?

Both can have side effects if used incorrectly. We must be careful to make sure sterilisation is carried out effectively to avoid infections. This can occur with any injectable such as fillers, vitamins, PRP etc If fillers are not correctly injected asymmetries or bumps can occur.

As for Botox, in addition to the previous side effects we may have a temporary descent of the eyebrow or an asymmetry of the eyebrow, or a temporary descent of the eyelid. Practitioners who take only courses for a couple of days and who have no real knowledge of facial anatomy and cannot deal with any complications, are not the right professionals to choose for this kind of medical procedures.

Which is more likely to produce long-term results?

Both, (filler and Botox), if used correctly, with the right timing and right frequency, can give excellent results  and are a great solution for keeping patients  looking young. This way we can postpone more aggressive interventions such as plastic surgery for a while.

How do they compare in price?

The price of Botox and normal fillers is the same. For different fillers, such as RADIESSE, that need different injection techniques (often with microcannulas), the price is higher.