In today’s world, you’d be hard pressed to find someone that hasn’t at the very least considered cosmetic injections. However, if you’re new to undergoing the needle (and even if you’re not), it’s completely normal to be a little confused by your options, especially if you aren’t sure about the difference between filler and botox.
To help simplify the process, we asked four top doctors in their field to break it down. “There are so many new fillers added to the market in the US alone every year that it’s difficult to keep up with all of them,” says Beverly Hills Cosmetic Dermatologist Dr. Simon Ourian.
What to know first is that there are two categories of injectables: Neurotoxins and dermal fillers.“They’re both injectable aesthetic treatment products, but the similarities between the category of dermal fillers and neuromodulators stop there,” explains Dr. Ava Shamban, Board Certified Aesthetic Dermatologist. Botox “freezes” an area (think forehead and the 11 lines between your eyebrows) and fillers, on the other hand, add volume or structure—almost like a nonsurgical facelift.
Injectables are big business and there are five major companies that manufacture both products—and they all call them something different. Allergan Aesthetics and Galderma have the biggest monopoly in the industry, boasting the largest portfolios of products. But other players like Merz Aesthetics and Revance Aesthetics are not far behind. And while there’s only one (technically two as of September) types of Botulinum toxin, there are currently seven different types of filler (hyaluronic acid-based formulas being the most popular).
Ready to dive in? Here’s what you need to know about all the cosmetic injections on the market as of January 2023.
Nuerotoxins
Even though most of us say “Botox,” Botox is actually the brand name of a specific botulinum neurotoxin manufactured by Allergan Aesthetics. There are currently five FDA-approved neurotoxins available in the US: Botox, Dysport (from Galderma), Xeomin (from Merz Aesthetics), Jeuveau (from Evolus) and the newest, longer lasting peptide-powered Daxxify (from Revance Aesthetics).
“Botulinum toxin type A acts on nerve endings in muscles to prevent muscle fibers from contracting,” says Dermatologist Dr. Sheila Farhang, MD. “Neurotoxins are used to treat dynamic wrinkles that are caused by muscles that are hyper mobile such as crow’s feet or frown lines, and forehead lines above the brows,” adds Ourian. They only last about 10 or 12 weeks, with the exception of the new Daxxify which can be six to 12 months.
Daxxify was just FDA-approved in September 2022. It’s the latest toxin innovation in 30 years and is unique from the four listed above. “It is the first neuromodulator powered by a different protein—a peptide exchange free of human serum albumin or animal-based components,” says Shamban. The best part: “It has the ability to deliver up to year-long results with as few as one to two treatments are needed annually,” she confirms.
Fillers
While botox is pretty easy to understand, fillers are a bit more complex. As a category, fillers are composed of products that are used to add volume or structure to the lines or contours of the face. “They help in lifting sagging skin and smoothing out fine lines,” says Ourian. “They last 12 to 18 months (and in some cases 24 months) before absorption fully dissipates and next treatment is required,” says Shamban. They are also reversible and can be dissolved with hyaluronidase.
HA Fillers
Hyaluronic acid (HA) fillers are one of the most popular thanks to their ability to replicate a soft, natural texture and youthful results. HA is found naturally in your body, so it dissolves naturally and gradually over time. “HA binds to water, making it an ideal product for correcting wrinkles and folds, as it binds with the skin’s own water,” explains Farhang. It generally lasts between 6 to 12 months depending on the individual and the product used.
