Botox vs Dermal Fillers

Not sure which is right for you? Here’s a side-by-side comparison.

Botox

Dermal Fillers

What it is

Botox is an injectable treatment using a highly purified form of botulinum toxin type A. It works by temporarily blocking the nerve signals that cause specific muscles to contract, which relaxes the muscles responsible for dynamic wrinkles — lines caused by repeated facial expressions such as frowning, squinting, raising the eyebrows, or smiling. The most common treatment areas are forehead lines, frown lines between the brows (glabellar lines), and crow’s feet around the eyes. Results typically appear within 3–7 days and last 3–6 months. Botox is also used medically for migraines, excessive sweating (hyperhidrosis), jaw clenching (bruxism), and neck spasms.

What it is

Dermal fillers are injectable gels used to restore volume, smooth static wrinkles (lines present even when the face is at rest), and enhance or reshape facial contours. The most widely used fillers are made from hyaluronic acid (HA) — a substance naturally found in the body — which attracts and retains moisture to plump and hydrate the skin. Common treatment areas include the lips, cheeks, nasolabial folds (smile lines), marionette lines, under-eye hollows (tear troughs), jawline, and chin. Other filler types include calcium hydroxylapatite (Radiesse), poly-L-lactic acid (Sculptra), and permanent fillers (generally not recommended). Results are immediate and typically last 6–18 months depending on the product and area treated.

Evidence

Strong. Botox is one of the most extensively studied cosmetic treatments in the world. It has been approved by the Australian TGA and New Zealand Medsafe for both cosmetic and medical uses. Decades of clinical research support its safety and efficacy for wrinkle reduction when administered correctly by a qualified practitioner.

Evidence

Strong for hyaluronic acid fillers. HA fillers are the gold standard in dermal filler treatment, with a well-established safety profile and the significant advantage of being reversible — they can be dissolved quickly using an enzyme called hyaluronidase in the event of a complication or unwanted result. Evidence for other filler types varies; poly-L-lactic acid has good evidence for volume restoration in facial lipoatrophy.

Who it suits

Botox is best suited to adults with dynamic (movement-related) wrinkles who are looking for a non-surgical, low-downtime cosmetic treatment. It is also used as a preventative anti-ageing treatment by people in their late 20s to 30s who want to slow the formation of deep lines. It is not effective for static wrinkles (lines present at rest) or for restoring lost facial volume — that is where fillers come in.

Who it suits

Dermal fillers are best suited to adults experiencing volume loss, deep static wrinkles, or hollowing due to ageing or weight loss. They are popular for lip enhancement and facial contouring. Fillers are a good option for people wanting longer-lasting results than Botox, or for treating areas where muscle relaxation alone would not achieve the desired outcome.

Typical cost (AUD / NZD)

$200–$600 per treatment area. A full upper-face treatment (forehead + frown lines + crow’s feet) typically costs $500–$900. Results last 3–6 months, after which repeat treatment is needed to maintain the effect.

Typical cost (AUD / NZD)

$400–$1,200+ per syringe, depending on the product, area treated, and the injector’s experience. Most areas require 1–2 syringes. Results last 6–18 months, with some products (e.g., Sculptra) lasting up to 2 years.

Risks & contraindications

Common side effects include temporary bruising, swelling, redness, or a mild headache at the injection site. A rare but well-known risk is drooping of the eyelid or brow (ptosis) if the toxin migrates — this is why choosing a qualified, experienced injector is essential. Botox is not suitable during pregnancy or breastfeeding, or for people with certain neuromuscular conditions (e.g., myasthenia gravis, Lambert-Eaton syndrome). Results are temporary and fully reversible.

Risks & contraindications

Common side effects include bruising, swelling, tenderness, and temporary asymmetry. The most serious risk is vascular occlusion — accidental injection into or compression of a blood vessel — which can cause tissue damage or, in rare cases, blindness if it occurs near the eye. This underscores the critical importance of only using a qualified, experienced medical injector. Fillers are not suitable during pregnancy or breastfeeding. Avoid blood-thinning medications and supplements (e.g., aspirin, fish oil, vitamin E) for at least a week before treatment to reduce bruising risk.