Quick answer: Anti-wrinkle injections relax the facial muscles that cause dynamic wrinkles (the ones formed by expression), while dermal fillers add volume beneath the skin to smooth static wrinkles and restore lost fullness. They treat different problems, last for different lengths of time, and are frequently used together rather than as alternatives to each other.
If you’re weighing these two up, the honest starting point is that they’re not competing options for the same problem. Here’s how they actually differ, and why combining them is often the better answer than choosing one.
The core difference: how each one actually works
Anti-wrinkle injections (commonly known by the brand name Botox, alongside alternatives like Dysport and Xeomin) use botulinum toxin type A to temporarily block the nerve signals that trigger specific facial muscles to contract. With the muscle relaxed, the overlying skin can’t crease the same way, softening the dynamic wrinkles caused by repeated expression, forehead lines, frown lines, and crow’s feet.
Dermal fillers work completely differently. They’re gel-like substances, most commonly made from hyaluronic acid, injected beneath the skin to physically add volume and fullness. Rather than relaxing a muscle, fillers plump hollow or sunken areas and smooth static wrinkles, the lines that remain visible even when your face is completely at rest.
Dynamic wrinkles vs static wrinkles: the distinction that matters most
This is really the whole basis for choosing between them. Dynamic wrinkles only appear when you move your face, frowning, squinting, raising your eyebrows, and anti-wrinkle injections are specifically designed to address these by relaxing the muscle causing them.
Static wrinkles are visible all the time, even with a relaxed, expressionless face, and they’re typically caused by lost volume, thinning skin, and reduced collagen and elastin production as part of natural ageing, rather than by muscle movement. Dermal fillers address these by restoring the volume underneath, since there’s no overactive muscle to relax in the first place.
Where each treatment is typically used
Anti-wrinkle injections work well for:
- Forehead lines
- Frown lines between the eyebrows
- Crow’s feet around the eyes
- Jaw clenching and tension (via masseter treatment)
Dermal fillers work well for:
- Hollow or sunken cheeks
- Nasolabial folds (the lines running from nose to mouth)
- Lip volume and shape
- Under-eye hollows (tear troughs)
- Restoring general facial volume lost with age
How long each treatment lasts
This is one of the clearest practical differences. Anti-wrinkle injections typically last 3 to 4 months before the muscle-relaxing effect gradually wears off. Dermal fillers generally last considerably longer, commonly up to 12 months, though this varies depending on the specific filler used and the area treated.
Can they be used together?
Yes, and this is genuinely common practice rather than an unusual combination. Because they address different types of ageing, dynamic movement versus lost volume, they complement each other well. A treatment plan might use anti-wrinkle injections to soften forehead and frown lines while using filler to restore volume in the cheeks or smooth deeper static lines elsewhere. Using both together can also help results look more natural and can extend the overall visible improvement, since each treatment is doing the specific job it’s best suited for rather than being stretched to cover a problem it wasn’t designed to address. We’ve explored how combining facial aesthetics with wider treatment planning works in more depth separately, if you’re thinking about your face and smile together as part of one overall plan.
Which one is right for you?
There’s no universal answer, it genuinely depends on what you’re seeing in the mirror. As a general guide: if lines only appear when you make an expression and disappear when your face is relaxed, anti-wrinkle injections are usually the better starting point. If you’re noticing volume loss, hollowing, or lines that are visible even at rest, filler is generally the more appropriate treatment. Many people, particularly as they get a little older, benefit from a combination of both rather than one alone.
The only reliable way to know which combination genuinely suits your face is a proper consultation, comparing yourself to generic before-and-afters online won’t account for your specific facial structure and how you age. Book a consultation and we’ll assess your face and talk through what would actually make the most difference for you.
Frequently asked questions
Are dermal fillers and Botox the same thing? No. Anti-wrinkle injections (Botox and similar) relax muscles to reduce dynamic wrinkles caused by expression. Dermal fillers add volume beneath the skin to smooth static wrinkles and restore lost fullness. They work in entirely different ways and treat different concerns.
Which lasts longer, dermal fillers or anti-wrinkle injections? Dermal fillers generally last longer, often up to 12 months, compared to anti-wrinkle injections, which typically last 3 to 4 months before needing a repeat treatment.
Can I have both treatments at the same time? Yes. It’s common and often beneficial to combine both, since they address different causes of facial ageing. A consultation can determine the right combination and areas for your specific face.
Which is better for smile lines around the mouth? This depends on the specific lines. Fine lines caused by lip movement can respond to small, carefully placed anti-wrinkle doses, while deeper, more established smile lines (nasolabial folds) are typically better addressed with dermal filler to restore lost volume.
Do both treatments hurt? Both are generally well-tolerated, with most people describing mild discomfort rather than significant pain. Fillers can involve slightly more sensation than anti-wrinkle injections since they add volume beneath the skin, though this varies by area and individual.
Not sure which treatment suits you?
A proper consultation is the only way to know for certain, based on your actual facial structure rather than a generic comparison.
Book your facial aesthetics consultation online or call 01604 604545 to speak to the team at our dentist in Northampton. We’re open Monday to Friday, 8:30am to 5:30pm, plus one Saturday a month.
Written by Dr Anesh Patel
Dentist, B.D.S. M.F.G.D.P. (UK)
Co-owner of Cliftonville Dental, Dr Anesh Patel qualified from Kings College London in 1999 and has practised in Northampton ever since, with a special interest in cosmetic and implant dentistry.
View full profile →
