Botox and fillers are often mentioned together, and the words get mixed up. They are different treatments. One is a drug that relaxes muscles. The other is a gel that adds fullness or smooths lines. This page explains the difference using what the FDA and medical societies say.
The short answer, from the FDA
The FDA says botulinum toxin products such as Botox, Dysport, Xeomin and Jeuveau are not dermal fillers. It describes them as injectable drugs that keep muscles from tightening, so wrinkles do not show as much. It describes dermal fillers as gel-like substances injected under the skin to create a smoother or fuller appearance, and it regulates them as medical devices.
The American Society of Plastic Surgeons (ASPS), a society of plastic surgeons, says botulinum toxin blocks the nerve signals to the muscle it is injected into, so the muscle cannot contract. It says fillers help diminish facial lines and restore volume and fullness.
Side by side
The table below draws on the FDA, the Botox Cosmetic label and ASPS. It is general, and individual products vary. Two figures are worth stating in words: the FDA says hyaluronic acid fillers last approximately 6 to 12 months, and that approved filler uses are for adults 22 and older.
Botox and fillers, from the sources
| Topic | Botox (botulinum toxin) | Dermal filler |
|---|---|---|
| What it is | Botox (botulinum toxin): An injectable prescription drug (FDA) | Dermal filler: A gel-like implant, a medical device (FDA) |
| What it does | Botox (botulinum toxin): Keeps muscles from tightening (FDA) | Dermal filler: Adds smoothness or fullness (FDA) |
| Where it is approved to be used | Botox (botulinum toxin): Frown lines, crow's feet, forehead lines, neck bands (Botox Cosmetic label) | Dermal filler: Wrinkles and folds, lips, cheeks, chin, back of hand (FDA) |
| How long the sources say it lasts | Botox (botulinum toxin): About 3 to 4 months for frown lines (Botox Cosmetic label) | Dermal filler: Approximately 6 to 12 months for hyaluronic acid (FDA) |
| Who it is approved for | Botox (botulinum toxin): Adults (Botox Cosmetic label) | Dermal filler: Adults 22 and older (FDA) |
When people use both
The FDA says that using dermal fillers together with Botox or other treatments has not been evaluated in a controlled clinical study. That does not mean the two are never used in the same visit. It means the FDA is telling you that a combined approach has not been studied that way. Ask your provider about the plan and the order.
ASPS has a patient video about planning a larger procedure around Botox and fillers. We did not watch or quote it.
What this means for choosing
A provider who has met you and looked at the area is the one who can tell you whether a drug that relaxes muscles, a filler, both or neither fits what you want. Questions to take with you:
Questions to bring
About the options
About safety and cost
For each on its own, see Botox and lip filler.
Where to go next
Sources
- FDA, Dermal Filler Do's and Don'ts for Wrinkles, Lips and More · US Food and Drug Administration (content current as of 07/07/2023 per the page) · read 22 Oct 2026
- FDA, Dermal Fillers (Soft Tissue Fillers) · US Food and Drug Administration (content current as of 07/06/2023 per the page) · read 22 Oct 2026
- FDA, FDA-Approved Dermal Fillers · US Food and Drug Administration (content current as of 11/09/2020 per the page) · read 22 Oct 2026
- BOTOX Cosmetic prescribing information and Medication Guide, revised 10/2024 (DailyMed) · AbbVie (Allergan). FDA-approved labeling on DailyMed, set id 485d9b71-6881-42c5-a620-a4360c7192ab · read 22 Oct 2026
- ASPS, Botulinum Toxin · American Society of Plastic Surgeons (ASPS), a professional society of plastic surgeons · read 22 Oct 2026
- ASPS, Dermal Fillers: introduction, types and recovery · American Society of Plastic Surgeons (ASPS), a professional society of plastic surgeons (sub-pages /types and /recovery also read) · read 22 Oct 2026