Thinking about botox or fillers? Dr Shilpi Bhadani explains how they work, how long they last, the risks, side effects, maintenance and why your choice of doctor matters.
Botox and fillers have become some of the most popular aesthetic treatments for people looking to refresh their appearance without going under the knife. While both are minimally invasive, require little downtime and can be performed on an outpatient basis, they work in very different ways.
In a conversation with Rishika Shah/Rediff, Dr Shilpi Bhadani, plastic and aesthetic surgeon and founder of SB Aesthetics, Gurgaon, explains how botox and fillers work, how long they last, their potential risks and why choosing the right practitioner matters.
What are the biggest benefits of botox and fillers?
The biggest benefit is that both are non-surgical procedures with minimal downtime.
Botox works by relaxing the muscles. This helps soften lines, reduce the appearance of tension on the face and create a more relaxed appearance.
Fillers, on the other hand, restore lost volume. Unlike fat grafting, where fat has to be taken from another part of the body and then injected into the face, fillers are readily available in pre-filled syringes and can be administered directly in the area that requires volume.
Both treatments can provide effective facial rejuvenation without surgery.
How long do botox and fillers last?
There is some variability depending on the individual, the product used and the area being treated.
Botox generally lasts around four to six months while fillers can last anywhere from around eight months to two years depending on the product used and the areas in which they are injected.
Since the results are eventually reversible, maintenance treatments are required if patients want to continue seeing the effects.
What are the risks and side effects?
With fillers, patients can experience swelling, bruising or asymmetry. Another known complication is filler migration, where the product can move from the area where it was injected, particularly if it is overfilled or not administered correctly.
A rare but serious complication is vascular occlusion, where the filler enters or compresses a blood vessel and affects the blood supply to the surrounding tissue. This can occur with fillers in different areas of the face, not just the lips.
With botox, one possible complication is the drooping of the eyelid, known as ptosis. This can happen if the product affects muscles that were not intended to be relaxed.
Why is choosing the right practitioner so important?
The doctor is extremely important. Assessment is key because we need to know where to inject, what to inject and how much to inject.
Botox is measured in units while fillers are measured in millilitres, so it is important to be cognisant of the amount being administered.
Patients should also have a clear treatment plan because these are procedures that may need to be repeated over time. The aim should not be to keep adding more product but to determine what is actually required at each stage.
Can botox and fillers make you look overfilled?
They can if they are not used appropriately.
The amount of product and where it is placed makes a significant difference to the final result. A good practitioner should assess the patient's face and understand what needs to be treated rather than simply injecting more product.
With regular maintenance, the amount of product required may also be less than what was used during the initial treatment.
How often do you need maintenance treatments?
Botox generally needs to be repeated every four to six months, while the frequency of filler treatments depends on the product and the area treated.
Regular touch-ups can be used to maintain the result but they don't necessarily require as much product as the first treatment.
For example, if botox is done twice a year, it can help keep the facial muscles relaxed and prevent dynamic lines and expressions from becoming as pronounced.
Are the results permanent?
No. Both botox and fillers are temporary treatments and need to be repeated to maintain their effects.
Botox gradually wears off as muscle activity returns while fillers are naturally broken down by the body over time. The duration varies depending on the product, treatment area and individual patient.
The advantage is that the effects are eventually reversible, giving patients the option to reassess their treatment as their face changes with age.
What should patients know before getting botox or fillers?
These may be non-surgical procedures but that doesn't mean they are risk-free or that they can be approached casually.
A proper assessment is essential to determine whether botox, fillers or another treatment is actually an appropriate solution for the patient's concern. The doctor needs to understand facial anatomy, choose the appropriate product and administer the correct amount.
The goal should always be facial rejuvenation that looks balanced and natural rather than simply adding volume or eliminating every line.
When used thoughtfully, botox and fillers can provide significant rejuvenation with minimal downtime but the expertise of the person administering them is just as important as the product itself.
