When patients come to see me for facial rejuvenation, one question I’m often asked is:
“Should I have Botox or fillers?”
It’s a great question and the honest answer is that while each treatment can work beautifully on its own, the most natural, balanced results often come from using both together.
What is the Difference Between Botox and Fillers?
Although they are often mentioned in the same breath, Botox and dermal fillers work in completely different ways.
Botox relaxes overactive facial muscles. By softening movement, it smooths out lines caused by expressions - particularly across the forehead, frown lines, and around the eyes. It’s ideal for treating dynamic wrinkles that appear when we smile, laugh or frown.
Dermal fillers, on the other hand, are used to restore lost structure and volume. They contain hyaluronic acid, a naturally occurring substance that attracts moisture, keeping the skin plump and hydrated. Fillers can enhance features such as the cheeks, lips and jawline, or replace volume that has diminished with age.
So, in short:
- Botox relaxes the muscles that create lines.
- Fillers restore the shape and structure beneath the skin.
They do different jobs, but when combined thoughtfully, the results are far greater than what either can achieve alone.
Why Combination Treatments Look More Natural
When we age, changes happen in several layers of the face - the skin, fat pads, muscles and bone. Addressing only one layer rarely delivers a complete result. Botox smooths the surface, but without support underneath, the skin can still appear tired. Fillers add support, but without balancing muscle movement, expression lines remain.
By combining the two, we can create harmony, with:
• Botox to smooth dynamic lines;
• and Fillers to restore youthful contours and reduce static lines.
It’s a bit like painting and framing a picture one enhances the other. Together, they deliver a fresh, rested appearance that looks effortlessly natural rather than “done”.
I often tell patients: "The goal isn’t to change your face - it’s to bring balance back to it."
A Good Lip Flip Combines Botox and Fillers
One of my favourite examples of how Botox and fillers can complement each other is the lip flip.
This delicate treatment uses a tiny amount of Botox in the upper lip to relax the muscle and create a gentle upward curl. The result is a slightly more defined, softly lifted upper lip - without adding volume.
It’s a lovely option for anyone seeking a subtle enhancement. I call it the “fairy-tale kiss effect” - natural, balanced, and beautifully understated.
For those who want a little more shape or fullness, I often combine the lip flip with a small amount of dermal filler. My approach is always conservative, usually starting with just 0.5ml, because less is more. This gives definition and hydration while keeping lips soft and natural.
Masseter Botox and Jawline
Another area where Botox has proven transformative is in treating the masseter muscles, located at the back of the jaw.
When these muscles are overactive, they can cause teeth grinding (bruxism) and even tension headaches. Botox can relax the muscles, helping to reduce discomfort and as a bonus, it can also slim and refine the jawline, creating a softer, more feminine contour.
However, some patients, particularly males, prefer to keep a defined jawline and here the placement of filler can maintain a sharp edge.
Sad Mouth and Marionette Lines
Botox can be used carefully to relax the muscles that pull the corners of the mouth down, so the corners sit in a more neutral or slightly lifted position. This softens a “sad” or "RBF" expression without changing how you move your mouth to speak or smile.
To enhance this, we often combine Botox with dermal filler in the marionette lines – the grooves that run from the corners of the mouth towards the chin. Filler smooths the crease to reduce the dark shadows that collect at the corners of the mouth. Together, these treatments can make the lower face look more relaxed, upbeat and refreshed, while still keeping your expressions looking natural.
The Secret to Beautiful Results
Whether we’re treating the forehead, lips or jawline, the secret to great outcomes lies in personalisation. Every patient’s face is unique, so the treatment must be too.
That’s why consultations are so important. They give us the opportunity to discuss your goals, understand your facial anatomy, and design a plan that combines treatments safely and effectively for your best result.
For many of my patients, the perfect combination is Botox for movement, fillers for structure, and skincare for glow.
Choosing Your Clinician
A good clinician can follow a protocol, but a great one knows how to adapt it to each patient’s anatomy, personality and expectations.
Every face tells a different story, and my job is to enhance what’s already beautiful in the most natural, balanced way. That’s why my consultations are never rushed; I take time to listen carefully, so we can agree on what truly suits you.
Botox and fillers aren’t rivals - they’re partners. Used together in experienced hands, they can subtly lift, smooth and rejuvenate your face while keeping your natural expressions intact.
If you’d like to explore whether a combined approach could enhance your features, I’d love to meet you. Book a consultation and lets discuss your concerns.
Authors Experience
After completing her Master of Science in Aesthetic Medicine in 2020, Dr Joanna has continued to build her knowledge through advanced training courses and international conferences. But while technical skill is essential, She believes the real art of aesthetics lies in understanding the person behind the face.
Resources:
- Aesthetics Journal - 11 Aug 2025: Clinical Insights to the Lip Flip by Dr Harry James
- Aesthetics Journal - 19 May 2025: Assessing Candidacy for jaw-Slimming Injections by Dr Mariam Al-Ani
