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Mr Giovanni Ferrando is a vastly experienced consultant plastic and reconstructive surgeon with private clinics in London and Italy. He is known for his innovative and pioneering work in designing and developing new techniques to be used in cosmetic and aesthetic surgery, and has a very keen attention to detail, always striving to achieve natural-looking results. He specialises in all kinds of aesthetic surgery, with special interest in rhinoplasty, blepharoplasty, facelift, breast augmentation, Botox injections on other less invasive aesthetic medicine treatments. 

Botox and fillers are two very popular procedures for achieving a more youthful face but sometimes, the differences between the two aren’t so clear.

Mr Ferrando, clarifies when Botox and fillers are used, how effective they are, possible side effects and he also provides an insight into how they compare regarding price.


What are both Botox and dermal fillers used for?

Botox and dermal fillers are both used for the reduction of wrinkles, but the reasons for choosing them are completely different.


When to use Botox

Botox is the brand name of a toxin but there are similar products (e.g. Dysport, Azzalure, Xeomin, Bocoture and more) on the market. The correct area to treat with Botox is the upper portion of the face (on the horizontal forehead lines), the wrinkles around the eyes and frown lines between the eyebrows: the so-called “11s”.


When to use fillers

Fillers are used for the purpose of filling wrinkles and replacing the lost volume on the face, especially on the cheeks, the jawline and the temporal area. Soft fillers can be used superficially, either for the improvement of fine lines or creating a net under the skin for a better texture.


Is Botox effective?

Botox is very effective. It was used for the first time in the 1980s by a Canadian ophthalmologist and dermatologist, Alastair Carruthers, who accidentally discovered the toxin’s anti-ageing properties. Botox works because it temporarily blocks the signal from the nerve to muscles. This results in a small and reversible paralysis of those muscles and, consequently, a relaxation of the muscles, softening of the wrinkles and a more youthful appearance.


How effective are dermal fillers?

Dermal fillers are effective too but the areas we treat are different, as well as the scope. Wrinkles on the lower face are generally caused by gravity and sun damage so, in these areas, we use filler and not Botox. Since the wrinkles of the upper third of the face are due to excessive muscular action, Botox remains the best treatment for these particular areas.


What are the side effects of both?

Both Botox and fillers can have side effects if used incorrectly. We must be careful to make sure that sterilisation is effectively carried out to avoid infections. This can occur with any injectable such as fillers, vitamins, PRP etc. If fillers are not correctly injected, asymmetries or bumps can occur. As for Botox, in addition to asymmetries or bumps, we may have a temporary descent of the eyebrow or an asymmetry of the eyebrow or a temporary descent of the eyelid.


Practitioners who take only courses for a couple of days and who have no real knowledge of facial anatomy and cannot deal with any complications are not the right professionals to choose for this kind of medical procedures.


Which is more likely to produce long-term results?

Both filler and Botox can give excellent results if used correctly with the right timing and right frequency. They are a great solution for keeping patients looking young. By using them, we can postpone more aggressive interventions (e.g. plastic surgery) for a while.


How do Botox and fillers compare regarding price?

The price of Botox and normal fillers is generally the same. For different fillers, such as Radiesse, which need different injection techniques (often with microcannulas), the price is higher.

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