Injections: An overview of Botox, hyaluronic acid and fillers
Injectable treatments refer to minimally invasive procedures using Botox, hyaluronic acid and fillers, which smooth out wrinkles, restore volume and define contours.
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Important note
This article is for information purposes only and is not a substitute for a medical diagnosis or advice. If you are unsure, or if you require a personalised treatment plan, it is essential that you consult a qualified specialist.
The term ‘dermal fillers’ has become an integral part of modern aesthetic medicine. It refers to a whole range of minimally invasive treatments designed to smooth out wrinkles, restore volume and define facial contours – all without the need for surgery. However, the wide variety of substances and brand names used can quickly become confusing.
This article provides you with a clear and reliable overview of the world of dermal fillers. It explains the two fundamentally different mechanisms of action and helps you understand which method is right for which purpose.
What is a dermal filler treatment? Definition
In aesthetic medicine, the term ‘injection treatment’ refers to the injection of medicinal substances or fillers into or under the skin in order to alter one’s appearance.
The aim is usually to treat wrinkles, restore volume or contour the face. A distinction is made between two main categories of substances, which have completely different mechanisms of action.
The two main categories of dermal fillers
In aesthetic medicine, two main classes of substances are used for dermal fillers; these are based on entirely different mechanisms of action and serve different purposes:
- Muscle relaxants (e.g. Botox®): For the treatment of Cause caused by expression lines. These active ingredients specifically relax the muscles whose excessive activity is responsible for the formation of dynamic wrinkles.
- Dermal fillers (e.g. hyaluronic acid): For correcting volume loss and static wrinkles. These fillers replace lost tissue, lift deep-set wrinkles and reshape the contours of the face.
Category 1: Muscle relaxants (botulinum toxin)
This category has just one, but world-famous, representative: Botulinum toxin Type A (colloquially usually Botox® (as mentioned).
- Mechanism of action: Botulinum toxin is not a filler, but an active ingredient that specifically relaxes muscle activity. It temporarily blocks the nerve signals that cause a muscle to tense.
- Treatment objective: The smoothing of dynamic wrinkles (expression lines), which are caused by repeated muscle movements. When the muscle relaxes, the skin above it smooths out.
- Typical areas of application:
- The frown line between the eyebrows
- Horizontal forehead wrinkles („thinker’s forehead“)
- Crow’s feet at the corners of the eyes
Category 2: Dermal fillers (filling materials)
This category includes various substances used to restore lost volume or to sculpt contours. By far the most common and important filler is the Hyaluronic acid.
- Mechanism of action: Hyaluronic acid is a gel-like substance that occurs naturally in the body. It can bind enormous amounts of water. When injected as a filler, it plumps up the tissue from within, lifts wrinkles and shapes contours.
- Treatment objective: Topping up static wrinkles (wrinkles that are visible even when the face is relaxed) and the targeted Volume build-up.
- Typical areas of application:
- Filling in the nasolabial fold (the crease running from the nose to the corner of the mouth)
- Lip augmentation and contouring
- Cheek augmentation to accentuate the cheekbones
- Correction of the tear trough under the eyes
The big comparison: muscle relaxants vs. fillers
| Criterion | Muscle relaxant (Botox®) | Fillers (hyaluronic acid) |
|---|---|---|
| Mechanism of action | Relaxes the muscle | Adds volume |
| Objective | Smoothing out expression lines | Filling in wrinkles & defining contours |
| Covers… | The cause of the crease (muscle) | The symptom of a wrinkle (loss of volume) |
| Places of use | Upper half of the face (forehead, eyes) | Lower/middle half of the face (cheeks, lips, mouth) |
| Shelf life | Approx. 3–6 months | Approx. 6–18 months (depending on the product, injection technique and treatment area) |
The crucial role of qualifications: Who is allowed to administer injections?
Even though a dermal filler treatment may seem quick and straightforward, it is a medical procedure that requires in-depth knowledge of facial anatomy, the substances used and the injection techniques.
- The first choice: Specialists in plastic and aesthetic surgery, dermatology or oral and maxillofacial surgery have the most comprehensive training and experience.
- Other users: In Germany, other doctors and alternative practitioners are also legally permitted to administer injections.
However, the level of qualification can vary considerably, so expertise in a specific medical specialism is recommended.
Choosing a highly qualified, experienced practitioner is the most important factor in achieving a safe and aesthetically pleasing result.
Risks and the importance of insurance cover
Possible side effects of injections include swelling, bruising or redness. More serious, but rare, complications can include asymmetry, the formation of nodules or, in extremely rare cases with dermal fillers, vascular occlusion.
As these are cosmetic procedures, it is not automatically the case that health insurance will cover the costs of treating any complications.
One Consequential Costs Insurance protects you from the financial consequences should a medically necessary correction be required following your treatment.
Frequently Asked Questions (FAQ) about dermal fillers
In short: Botox relaxes muscles to smooth out expression lines. Fillers plump up wrinkles and restore lost volume. They treat different problems.
Most patients describe the injections as a slight prick. Modern fillers often contain a local anaesthetic. In addition, the skin can be numbed beforehand using an anaesthetic cream.
The aim of any professional dermal filler treatment should always be a natural-looking result. An experienced doctor will choose the dosage and injection sites in such a way that your natural facial expressions are preserved and you simply look fresher and more rested.
Usually not at all, as the injection is a minimally invasive It is a straightforward procedure. You can resume your normal activities straight after the treatment. You may experience slight redness or swelling, but this can usually be easily concealed with make-up.