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The Difference Between Botox and Filler

Hi, I’m Dr. Tim Osborn, a facial plastic surgeon  here at Seaport Smiles in Boston, MA and today we’re going to talk a little bit today about Botox and filler and what the difference is between the two.

Treating Wrinkles in the Upper Face with Botox

Botox is an agent that helps to relax muscles. It’s designed to prevent the transmission from a nerve to a muscle, and ultimately, to alleviate wrinkles. Botox works in the upper face to deal with wrinkles in what we call the glabella, the central part of the forehead, the actual forehead, vertical lines in the forehead, and the wrinkles at the corners of the eye (crow’s feet).

A big part of how we live our lives is facial expression. Those facial expressions are what leads to wrinkles in the upper part of our face. Botox is there to alleviate some of the wrinkles that happen with normal use of our facial muscles. One of the things that I like about how we treat patients is that we don’t completely remove all of their facial expression. It’s a very, very common concern that people want the subtle look and that’s how we treat patients with Botox.

Treating Wrinkles in the Lower Face with Filler

Filler is for the lower part of the face, so anything from the cheeks, what are called the nasal labial folds, lip augmentation, and jawline augmentation. These are areas of the face that are best treated with a filler. There are all sorts of different fillers but what I use most commonly is called a hyaluronic acid filler. I use the Juvederm brand, which is produced from natural substances. It’s very well tolerated, so patients don’t typically have reactions to it. Most commonly it’s used to fill in and blend the junction from one part of the face to the other where there’s normally a wrinkle and so we’re trying to lift up and volumize that wrinkle so that it doesn’t catch as much of the light.

Common types of filler treatment we offer include cheek augmentation as well as under eye treatment to reduce the appearance of bags and dark circles under the eyes. The most common area that’s treated are the nasal labial folds. For a lot of patients they have deep wrinkles in that area and they catch a lot of light, making them look tired and older than their years. With the fillers we are able to remove some of that wrinkle and blend the junction from the cheek to the upper lip.

Another area that we often treat with fillers  is what’s called the “pre-jowl”. Patients will come in and they have a little bit of jowling going on. It may be far too early for a facelift or the patient may simply not want to have surgery, so we use filler to blend the junction from the jowl to the chin to soften it and help to accentuate the jawline.

If you want to learn more about our Botox or filler treatments, give us a call at (617) 752-2220 or schedule your complimentary in-office or virtual consultation online today.


Seaport Smiles is located in Boston, MA and is the only multi-disciplinary orthodontic and craniofacial surgery practice in New England. They offer a full range of facial plastic surgery,skin care, and orthodontic services.