What is the difference between anti-wrinkle injections and fillers?
What do anti-wrinkle injections do?
Anti-wrinkle injections contain botulinum toxin type A, a prescription medicine that acts as a muscle relaxant. After injection it locally blocks the signal from the nerve to the muscle. The treated muscle then contracts less strongly, and the skin above it creases less. Lines caused by repeated movement, such as frowning or raising the eyebrows, become softer.
The effect usually starts after 3 to 5 days, is complete after about two weeks and lasts 3 to 4 months on average. With careful dosing you can still make your normal facial expressions; the aim is a more relaxed face, not a frozen one. Besides wrinkles, a muscle relaxant is also used for teeth grinding and excessive sweating.
What do fillers do?
A filler is a gel injected under the skin to add volume or provide structure. Most fillers are made of hyaluronic acid, a substance that occurs naturally in the skin. Well-known brands include Juvéderm, Stylage, Restylane and Revolax. Fillers are medical devices and must carry a CE mark.
The result is visible immediately, although there is often some swelling for the first few days. After about two weeks you see the final result. Hyaluronic acid filler can be dissolved with the enzyme hyaluronidase if needed. There are also biostimulators such as Radiesse and Sculptra, which stimulate your own collagen production; these cannot be dissolved in the same way.
Anti-wrinkle injections and fillers side by side
The table below lists the main differences. The values are averages and can vary from person to person.
| Anti-wrinkle injections | Filler (hyaluronic acid) | |
|---|---|---|
| How it works | Muscle contracts less for a while | Adds volume and supports the skin |
| Suitable for | Expression (dynamic) lines | Volume loss and some static lines |
| Typical areas | Forehead, frown, crow’s feet | Lips, cheeks, tear trough, chin, jawline |
| Result visible | After 3–5 days, full after ±2 weeks | Immediately, final result after ±2 weeks |
| Duration | 3–4 months on average | Usually 6–18 months, depending on the area |
| Reversible | No, the effect wears off by itself | Yes, can be dissolved with hyaluronidase |
| Status | Prescription medicine | CE-marked medical device |
| Prescribing/administering | Only on a doctor’s prescription | Injecting is a reserved medical procedure |
| Common side effects | Small bruise, mild headache | Swelling, bruising, tenderness |
How can you tell whether your lines are dynamic or static?
A simple test: look in the mirror with a relaxed face, then while frowning or raising your eyebrows. Lines that only appear during movement are dynamic. For these, anti-wrinkle injections are usually the first choice.
Lines that are also visible when your face is fully relaxed are static. They develop from years of movement combined with loss of collagen and volume. Anti-wrinkle injections can soften them, but usually do not make them disappear completely. Depending on the location, a filler or a skin-quality treatment such as a skin booster may then be a useful addition.
What is each treatment not suitable for?
A common misconception is that both treatments are meant for the same problems. A few examples of what does not fit well:
- Anti-wrinkle injections do not add volume. For thin lips, hollow cheeks or a deep tear trough they are not the right choice.
- A lip flip with a muscle relaxant makes the upper lip roll slightly outwards, but adds no volume; for more volume a filler is needed.
- Filler in the forehead is usually not the first choice for expression lines, because the cause there is muscle movement.
- With marked skin laxity, neither is a substitute for surgery; a doctor should tell you so honestly.
Can you combine anti-wrinkle injections and fillers?
Yes, the two are often combined because they address different causes of ageing. A well-known example is a deep frown line: first a muscle relaxant relaxes the muscle, and after about two weeks the doctor assesses whether a small amount of filler is still needed. Sometimes it no longer is. A step-by-step approach avoids using more product than necessary.
How is the choice made at Zalat Clinics?
At Zalat Clinics in Rotterdam-Zuid, a BIG-registered doctor assesses during a free consultation which treatment suits your skin and face, or whether treatment is not needed at this point. A free check-up follows after two weeks. The price is agreed in advance during the consultation.
Frequently asked questions
Which is safer, anti-wrinkle injections or fillers?
Both are safe and well studied when performed correctly by a qualified doctor. The risks do differ: with a muscle relaxant an eyelid or eyebrow may droop slightly for a while, with filler there is a small chance of a blocked blood vessel. An experienced doctor knows the anatomy and how to act if a complication occurs.
Can I have both treatments in one appointment?
In many cases, yes. Often, however, a doctor prefers to give the muscle relaxant first and place the filler after two weeks, so it is easier to see what is still needed.
Will the result look unnatural?
That mainly depends on the dose and technique. With a conservative approach your face stays expressive and the result usually looks like a well-rested version of yourself.
Is a lip flip a muscle relaxant or a filler?
A lip flip is a treatment with a small amount of muscle relaxant in the ring muscle around the mouth. The upper lip rolls slightly outwards, but no volume is added.