What's The Difference Between Botox and Fillers?

Botox changes targeted muscle activity; dermal fillers add volume. This episode explains the distinction using lines that appear with facial expression and lines that remain when the face is at rest. The products serve different purposes and are not interchangeable.

In this June 25, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD introduces the concepts of dynamic and static facial lines. He uses the creases in a book's spine as an analogy for how repeated movement can leave a lasting mark.

Key takeaways

🔎 Dynamic lines relate to expression.

Examples in the episode include forehead lines when raising the eyebrows, frown lines and crow's feet with smiling or squinting.

🔎 Static lines remain at rest.

Dr. Smith explains how repeated movement can contribute to lines that no longer disappear completely.

🔬 Botox reduces targeted muscle contraction.

The discussion connects that effect with expression-related wrinkles.

🔎 Fillers occupy space.

The episode describes their role in selected folds and areas where additional facial volume is desired, including the cheeks.

💬 Questions answered

Are Botox and fillers the same type of injectable?

No. The episode groups them as cosmetic injectables but distinguishes a treatment that changes muscle activity from one that adds volume.

Are fillers only used for wrinkles?

No. Dr. Smith also discusses adding volume and shaping facial contours, particularly in the cheeks. Choosing a product and injection site requires an individual assessment.

ℹ️ Current safety context

The recording offers a broad introduction, not a treatment map for every facial line. Filler suitability is product- and site-specific. Complications can occur; accidental injection into a blood vessel can cause serious tissue injury or vision loss. Review the FDA's current filler guidance with a qualified clinician.

🎧 Episode chapters

01:00 — Dynamic facial lines and expression

02:13 — Static lines and the book-spine analogy

04:20 — How Botox changes muscle activity

05:13 — How fillers add facial volume

🔗 Related information

Explore Botox treatment information, dermal filler information, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released June 25, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources