treatment selection

Botox or filler, which one do I actually need?

Short answer

They solve different problems. Neuromodulators soften lines caused by muscle movement. Filler replaces volume and changes shape or structure. A quick test at home: if the line only appears when you move, that is usually a neuromodulator question. If it is there when your face is completely still, filler or another approach is more likely relevant.

Sally's take

This is the single most common question I get, and the honest answer is that plenty of people who ask it need neither yet, or need a smaller amount of one rather than a lot of the other.

The mirror test gets you most of the way. Relax your face completely and look. Whatever is still there when nothing is moving will not be fixed by relaxing a muscle. Whatever appears only when you frown or raise your brows is movement.

The complication is that many concerns are a mix, and the order matters. Sometimes softening the movement first lets a line settle on its own over a few months, and you end up needing less of everything. That is the kind of decision that is worth a consultation rather than a price list.

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What neuromodulators do

Soften lines created by repeated muscle movement
Commonly used between the brows, across the forehead, and around the eyes
Take about two weeks to reach full effect
Typically last around three to four months
Do not add volume or change facial structure

What filler does

Replaces volume that has been lost, or adds structure that was not there
Commonly used in cheeks, temples, chin, jawline, and lips
Effect is visible immediately, though swelling obscures it for two weeks
Typically lasts from several months to over a year depending on product and area
Does not stop a muscle from creating a line

Where people go wrong

The most common mistake is treating a static line with more and more neuromodulator, hoping it will eventually go. If the line is etched into the skin, relaxing the muscle helps it soften slowly over time, but it will not erase it in one round.

The second most common is adding filler to an area that looks hollow because of shadowing rather than volume loss. More product does not fix a lighting problem, and it is how faces start to look heavy.

Questions worth asking

Looking at my face, which of my concerns are movement and which are volume?
If we could only do one thing this year, what would it be?
Is there an order that would let me use less overall?
Is there anything here that neither treatment will fix?

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