Botox, Fillers, and Facial Balancing: What You Need to Know

I can’t tell you how many times I’ve seen patients in consultation for Botox, thinking it’s the panacea of cosmetic beauty. In fact, it is a very useful product. But most individuals over 40 require more than just Botox to restore youthful beauty. Setting aside, for the moment, treatments that are done primarily for the health of the skin, we generally have two injection treatments commonly performed for the sake of cosmetic beauty: neurotoxins like Botox and dermal fillers. 

Neurotoxins: Smoothing Wrinkles 

Strictly speaking, Botox is a brand name for onobotulinum toxin type A, in the class of chemical agents called neurotoxins. In North America, we have other similar neurotoxins: Xeomin, Dysport, Jeuveau, and the latest addition, Daxxify. All of these products act to relax the muscles found just under the skin, resulting in a smoother surface.

These neurotoxins do an excellent job of reducing vertical creases between the eyebrows, horizontal creases across the forehead, and crow’s feet beside the eyes. Once the product is placed under the skin, it takes about two weeks for the full effects to settle in. By then, lines and wrinkles either soften or disappear. 

The Role of Fillers: Beyond Volume 

Neurotoxins, however, cannot treat a sagging face caused by volume loss. As we age, we lose the deep facial fat found above the brow, in the temples, under the eyes, mid-face, and around the mouth and chin. Without that deep fat, the skin simply drapes over the remaining facial structure, resulting in a tired or aged appearance. The solution for restoring youth and beauty lies in the strategic placement of dermal fillers. 

In the U.S., we have several categories of fillers with unique characteristics. They range from products that last several weeks to those that last years. And while fillers are effective, it’s important to understand that no filler provides a permanent solution—we all continue to age. 

Today, the approach to using fillers has evolved. It’s less about adding dramatic volume or creating unnatural features and more about achieving “facial balancing.” This modern technique focuses on bringing all the facial features into harmony, enhancing natural beauty by ensuring each facial part complements the others. 

Combining Treatments for Best Results 

Even with a surgical facelift, achieving a natural look includes replacing deep fat volume. In the operating room, surgeons often use fat or fat mixed with platelet-rich plasma. While fat is a beautiful filler, it too only lasts so long. This is why combining treatments—neurotoxins for wrinkle reduction and fillers for volume restoration and facial balancing—is often the best approach. 

Which Treatment is Right for You? 

So… Botox or fillers? Generally speaking, most people in their mid-20s can get away with just Botox. But as your face begins to show signs of aging and sagging, you’re likely going to need some form of dermal filler to restore the youthful appearance you remember. With the addition of options like Daxxify and Jeuveau to the market, there are more choices than ever to customize treatments for your unique needs. 

In the end, the goal is not just to erase wrinkles or restore volume—it’s to create a natural, harmonious look that lets your best features shine. 

Ready to take the next step? Schedule a consultation today and let us help you look restored and the best “you” that you can be.