Botox vs dermal fillers: how they differ, what they cost and what to ask
Patients often arrive asking for one when the line they dislike needs the other. Whether Botox, filler or a combination is the right answer depends on whether the line moves, stays or sits in a hollow.
In The Ageless Blueprint, Dr Leah rates ten uses of Botox and seventeen filler areas out of 10, and explains what Dr Leah does when either one disappoints. This page gives the facts that apply before any consultation.Side by side
| Botox | Dermal fillers | |
|---|---|---|
| What it is | A prescription-only medicine, botulinum toxin type A, that temporarily relaxes the muscle it is injected into | A clear hyaluronic acid gel injected under the skin to restore volume, smooth a groove or give a feature more definition |
| Generally used for | Lines made by expression, an overactive muscle (jaw clenching, chin dimpling, neck bands) and excessive sweating | Hollows, folds and lines visible at rest, and features such as lips, chin or jawline that lack structure |
| Areas treated | Forehead, frown lines, crow’s feet, lip flip, gummy smile, mouth corners, chin, neck bands, masseters, underarms | Forehead, glabella, nose, temples, tear trough, cheeks, nasolabial folds, marionette lines, lips, chin and jawline |
| Results | Start within a few days, assessed at a review around two weeks; lines that move soften, lines fixed at rest may remain | Visible immediately, then settle over about two weeks as swelling goes down |
| Sessions | One appointment, repeated every three to four months to maintain the effect | One appointment, sometimes staged; repeated roughly once a year or when the result fades |
| Downtime | None for most people | Swelling and possible bruising for a few days; lips swell most |
| Discomfort | Several small injections, brief | Mild to moderate; most fillers contain a local anaesthetic |
| Typical UK price | Not advertised, because it is a prescription-only medicine priced after a face-to-face assessment; budget for three or four appointments a year | £200 to £450 per syringe for lips, £300 to £500 for cheeks, £350 to £650 for forehead or glabella; a 5 ml male jawline £1,500 to £2,500 |
| Main risks | Redness, swelling, bruising or headache; brow heaviness, a peaked brow, asymmetry or eyelid droop that wear off with the toxin; rarely, loss of response | Bruising, lumps, migration and puffiness; rarely, a blocked blood vessel causing skin damage or vision loss, highest risk in the forehead, glabella and nose |
The practical differences
Botox in brief
- Works on movement: it cannot add volume or fill a groove that is there at rest
- Short appointment, modest single cost, but the effect needs topping up three or four times a year
- Cannot be dissolved; a heavy brow or peaked eyebrow has to wear off
- Brand matters less than the injector: Botox, Bocouture, Azzalure and Relfydess are all UK-licensed
Dermal fillers in brief
- Works on structure: it restores volume and support but does nothing for a line caused by muscle movement
- Immediate result that usually lasts around a year, so the annual cost is often similar to Botox
- Can be dissolved with hyaluronidase if the result is lumpy, uneven or migrates
- The serious risk, vascular occlusion, is rare but area-dependent, so the injector’s emergency plan matters
Five things to ask before you book either
- Does my line show when my face is at rest, or only when I move? If it is there at rest, will Botox alone improve it?
- Are you a GMC, NMC or GDC registered prescriber, and will you see me face to face before prescribing Botox?
- If you are suggesting filler for my forehead, between my brows or on my nose, how do you manage the vascular risk in those areas?
- Do you keep hyaluronidase in clinic and have you used it for a blocked vessel before?
- How many syringes or units are you planning, what will the total cost be, and when will I need to come back?
Dr Leah’s verdict on both is in the guide
Chapter 1 of The Ageless Blueprint rates ten uses of Botox out of 10 and chapter 2 rates seventeen filler areas, from the forehead to the jawline, on results, cost, effort and risk. Together they set out which lines Dr Leah treats with Botox, which with filler and where Dr Leah uses both, what a good injector checks before planning either, and what Dr Leah does when a brow goes heavy, a filler migrates or a result stops lasting. Forty-two pages, with illustrations of each area.
This page gives general information and does not replace a consultation with a qualified practitioner who can assess your face, skin and medical history. Prices are typical UK ranges, accurate as of September 2026, and vary between clinics. For adults aged 18 and over.
Common questions
Yes, and the two are often planned together: Botox for the muscle movement and filler for a fixed groove or lost volume. Many practitioners treat them in one appointment or a few weeks apart. Dr Leah explains in the guide which combinations Dr Leah uses and in which order.
Filler. Botox typically wears off in three to four months. A hyaluronic acid filler usually lasts around a year, longer in some areas, and MRI studies have found traces of it in the tissue two years or more after treatment.
Hyaluronic acid filler can be dissolved with an enzyme called hyaluronidase, although dissolving carries its own risks and the area can look hollow afterwards. Botox cannot be reversed; it wears off with time.