This is the most common question in my practice – and a fair one, since both treatments are injected and both are known as „wrinkle treatments“. They work in completely different ways, however.
The essential difference
Botulinum toxin relaxes muscles. It is used where lines are caused by movement – when frowning, smiling or squinting. The muscle works less strongly and the skin above it smooths out.
Hyaluronic acid fills. It replaces volume lost over the years and cushions folds that remain visible even when the face is at rest. It can also shape contours – at the chin, cheek or lips.
How do you know which one you need?
A simple test: stand in front of the mirror and relax your face completely. Lines that then disappear are caused by movement – botulinum toxin helps here. Lines that remain visible at rest are static – hyaluronic acid is the more suitable choice.
Typically movement-related: frown lines, forehead lines, crow's feet. Typically static: the nasolabial fold, marionette lines, hollow cheeks.
Longevity and procedure compared
| Botulinum toxin | Hyaluronic acid | |
|---|---|---|
| How it works | relaxes the muscle | replaces volume |
| Result visible | after 3–5 days | immediately |
| Longevity | 3–4 months | 9–18 months |
| Reversible | no, wears off on its own | yes, with hyaluronidase |
| Duration | 15–20 minutes | 30–45 minutes |
Can the two be combined?
Yes, and in practice this often makes sense. A typical example: botulinum toxin for the frown line, hyaluronic acid for the nasolabial fold. The two treatments do not interfere with each other and can be carried out in the same session.
What makes sense in your case is something we decide after analysing your face during the consultation – and sometimes the answer is that neither is needed for now.
