Published 2 June 2026 · Updated 30 September 2026
Reviewed by the MED YU MED medical team, DHA-licensed physicians practising at Med Yu Med, Bluewaters Island, Dubai. Facility DHA License 6589480. Last reviewed 4 August 2026.
Disclosure: Med Yu Med performs both treatments described here. That is a commercial interest, and the safety sections below should be read with that in mind.
The two treatments get discussed as if they were competing brands of the same thing. They are not. One temporarily reduces how hard a muscle pulls. The other adds volume where tissue has thinned. A line caused by muscle movement will not respond to volume, and a hollow cheek will not respond to muscle relaxation, which is why the honest answer to “which one do I need” starts with looking at your face at rest.
This page sets out what each treatment does, how long the published data says the effect lasts, what can go wrong with each, and how the two are decided between. The safety sections are not symmetrical, because the risks are not symmetrical either.
The one-minute version
| Botulinum toxin | Dermal fillers | |
|---|---|---|
| What it does | Reduces the contraction of the muscle that creates the line | Adds volume to tissue that has thinned or descended |
| Which lines it suits | Lines that appear or deepen when you move, such as frown and forehead lines | Lines and hollows visible when the face is completely at rest |
| Published duration | For frown lines, median 120 days at maximum frown and 131 days at rest, PMID 23106853 | Falls off through the year, with patient-rated improvement dropping to roughly a third by 12 months, PMID 37095274 |
| Most common problems | Eyelid ptosis 2.5 per cent, brow ptosis 3.1 per cent, all resolving on their own, PMID 24575858 | Bruising and swelling are routine; the serious risk is vascular occlusion |
| Worst realistic outcome | A drooping eyelid or brow, which the reviews report as resolving spontaneously | Permanent vision loss, rare and counted in published case reports worldwide rather than in percentages, PMID 30805636 |
How to tell which one your face is asking for
There is a test you can do in front of a mirror before any consultation, and it decides most cases.
Relax your face completely and look at the line that bothers you. If it disappears when you stop moving, it is a dynamic line, produced by muscle contraction, and that is the territory of botulinum toxin. If it is still there when nothing is moving, it is a static line or a volume deficit, and relaxing the muscle will not fill it.
Most faces past forty have both, which is why plans often combine the two. It is also worth asking why one treatment is being proposed for your face rather than the other.
What botulinum toxin does, and for how long
Botulinum toxin type A blocks the signal from nerve to muscle at the treated site, so the muscle contracts less forcefully and the skin above it creases less. The effect is temporary by design, and it wears off as nerve terminals recover.
The duration question has a pooled answer. A 2012 meta-analysis in Dermatologic Surgery, PMID 23106853, pooled four phase III trials covering 621 patients treated in the glabellar muscles. Of those, 523, or 84.2 per cent, were responders at day 30. Median duration of effect was 120 days measured at maximum contraction and 131 days measured at rest. The authors summarise it as sustained clinical benefit for four months in more than half of responders.
Four months is the number worth carrying into a consultation. A 2022 study in Aesthetic Surgery Journal, PMID 35704394, restates the same baseline, describing the standard glabellar dose as reducing line severity for approximately three to four months, and reports that by week 24 the responder rate for that dose had fallen to 16 per cent.
Two consequences follow. This is a recurring commitment rather than a one-off, and the price that matters is the annual one. And anyone promising six months or a year from a standard treatment is describing something the pooled data does not show.
What fillers do, and how they fade
Dermal fillers add volume. Hyaluronic acid fillers, the type used for lips and most facial contouring, are gels that occupy space in the tissue and draw water, and they are gradually broken down by the body.
Duration depends on the product, the area and how much movement it sits in, so a single figure is misleading. The trajectory, though, is consistent. A 2023 pilot study in Scientific Reports, PMID 37095274, randomised 60 women treated for nasolabial folds, and in the hyaluronic acid arm patient-rated improvement was 54.67 per cent at three months, 46 per cent at six months and 31.33 per cent at twelve. It is a small study reporting what patients said rather than what blinded assessors measured, so read the curve as a shape rather than as a number. The improvement does not stop abruptly. It thins out.
Filler type changes that curve. A 2015 randomised split-face study in the Journal of Cosmetic Dermatology, PMID 25564797, treated 40 subjects with a polycaprolactone-based filler on one nasolabial fold and a hyaluronic acid filler on the other, and found the polycaprolactone side showed statistically significant improvements at 6, 9 and 12 months, with both products equally safe and well tolerated in that study.
One practical difference that rarely gets mentioned in the sales conversation: hyaluronic acid can be dissolved with hyaluronidase if the result is wrong or if there is a vascular emergency, and in the published emergency cases below that is exactly what was given first. Materials other than hyaluronic acid are not reversible in the same way, which is standard clinical practice rather than a finding from the studies cited here. That reversibility matters clinically, and it is worth asking about before treatment.
What goes wrong with botulinum toxin
The side effect profile is well characterised because the trials are large.
A 2016 systematic review and meta-analysis in Aesthetic Plastic Surgery, PMID 27495260, pooled 16 randomised, double-blind, placebo-controlled trials covering 42,405 participants. Across facial rejuvenation studies, the treated group had significantly more adverse events than placebo, with a relative risk of 1.24. For frown line injection specifically, the increases were in headache, relative risk 1.53, eyelid ptosis, relative risk 5.56 on an interval running from 1.68 to 18.38, and heavy eyelids, relative risk 6.94 on an interval from 1.27 to 37.93. Those intervals are wide, which makes the estimates imprecise rather than precisely alarming. For crow’s feet, the only significant increase was injection site haematoma.
Absolute numbers matter as much as relative ones. A 2014 systematic review in Dermatologic Surgery, PMID 24575858, covering 35 studies and 8,787 subjects, reported blepharoptosis in 2.5 per cent, brow ptosis in 3.1 per cent and eye sensory disorders in 3 per cent for upper face treatment, and lip asymmetry or imbalance in 6.9 per cent for the lower face. All of these events resolved spontaneously.
That last clause is the reassuring part and the honest one. A dropped eyelid is distressing and visible, and it resolved without intervention in these studies because the drug wears off. That evidence covers short-term aesthetic use, and it does not describe every possible outcome.
One rare effect belongs here rather than in a footnote, because it is the reason for the emergency instruction at the end of this page. The effect of the toxin can spread beyond the site injected. Difficulty swallowing, difficulty breathing, slurred speech or generalised weakness after any botulinum toxin treatment is not something to monitor at home.
The clinic’s own service page rules the treatment out in pregnancy and breastfeeding, under the age of 18, with an active infection or herpes in the treatment area, during an acute illness or a flare of a chronic condition, with known hypersensitivity to the product, with neuromuscular disorders including myasthenia gravis and Lambert-Eaton syndrome, with active cancer or ongoing cancer treatment, and with a bleeding disorder.
What goes wrong with fillers, and why this section is longer
Bruising, swelling, tenderness, lumps and asymmetry are the common problems, and they are usually manageable. The reason fillers demand a different level of caution is a rare complication with a permanent outcome.
If filler enters an artery, it can travel and block the blood supply to tissue or to the eye. A 2025 report in Aesthetic Plastic Surgery, PMID 40346341, describes two patients who lost vision after hyaluronic acid injection into the ear, one bilaterally and one in the left eye, with central retinal artery occlusion confirmed on ophthalmological evaluation. Hyaluronidase was given promptly and thrombolysis followed within hours, and neither patient regained normal sight. Angiography found anatomical variations in the ophthalmic arteries of both, which the authors propose as the cause. Both injections were into the ear, a site those authors say should not be a routine substitute for surgery, so this is the risk at its most extreme rather than the usual picture for lips or nasolabial folds.
The pattern is not limited to one material. A 2026 systematic review in the same journal, PMID 41263987, counted published cases of visual loss from biostimulator injectables: at least 11 for calcium hydroxylapatite, most involving the nasal dorsum, two confirmed for poly-L-lactic acid, two for one polylactic acid formulation, one for another, and for polycaprolactone no published blindness but one case of facial artery embolism.
Three things follow, and they are worth insisting on.
- Anatomy is not uniform. Both blinded patients above had ophthalmic arteries arising unusually. An injector cannot see that in advance, which is why technique and caution carry the safety rather than confidence.
- Some areas carry more risk than others. A 2019 review of the world literature in Aesthetic Surgery Journal, PMID 30805636, identified 48 published cases of vision loss between January 2015 and September 2018, and found the highest-risk sites were the nasal region at 56.3 per cent, the glabella at 27.1 per cent, the forehead at 18.8 per cent and the nasolabial fold at 14.6 per cent, with hyaluronic acid the material involved in 81.3 per cent of cases.
- Hyaluronidase and a written protocol on the premises are a minimum standard of preparedness rather than a guarantee of reversal. In the same 2019 review, complete recovery of vision occurred in 20.8 per cent of cases and partial recovery in 16.7 per cent, and no treatment was shown to be consistently successful.
None of this makes fillers unreasonable. It makes an unhurried consultation, a physician who knows the vascular anatomy of the area, and a documented emergency protocol the things worth checking before treatment.
Combining the two
Most treatment plans for an ageing face involve both, because dynamic lines and volume loss occur together. There is no rule that they must be done in one appointment, and spacing them has a practical advantage: when something looks different, you know which treatment did it.
Sequencing is also a matter of physiology rather than convenience. Relaxing a muscle changes how the tissue above it sits, so the volume a face appears to need can look different two weeks after a toxin treatment than it did before. Assessing filler needs after that settles avoids paying for volume you did not need.
Questions worth asking before either treatment
Five questions, and the answers tell you more than any before-and-after gallery.
Which specific muscle or which specific tissue plane are you treating, and why that one? What is the product being used, and is it reversible? Is hyaluronidase available in this room today? What is the plan if there is a vascular event, and who makes the call? And what does the published data say about how long this will last, as opposed to what the clinic hopes?
The fourth question is the one that separates a prepared clinic from an unprepared one, and it is reasonable to ask it out loud.
What Med Yu Med performs
Both treatments are on the service list. Botulinum toxin runs as botulinum therapy, and is also used for excessive sweating. Hyaluronic acid filler treatments include lip augmentation, correction of nasolabial folds and face contouring of the cheekbones, chin and lower third. The clinic also performs filler dissolving, which matters more than it sounds, because it means the reversal agent is something the clinic works with in planned treatments as well as in emergencies.
Which treatment is proposed, if either, follows assessment. Prescription-only medicines are prescribed by a licensed physician at consultation, and nothing on this page is a recommendation to use one.
When something is wrong, and how fast to act
Two things after these treatments are emergencies rather than questions for the next working day. The clinic is open from 10:00 to 22:00, and neither of them is a reason to wait for opening hours.
Call 998 immediately for difficulty breathing, difficulty swallowing, slurred speech or generalised muscle weakness at any point after a botulinum toxin treatment, including weeks later, and for swelling of the lips, tongue or throat, chest pain, fainting or loss of consciousness.
After a filler treatment, go to the nearest emergency department with ophthalmology cover, and call the clinic on the way rather than instead of going, for any change in vision including blurring or double vision, pain around the eye, skin that turns white, dusky or mottled in or around the treated area, or sudden pain out of proportion to the procedure. These are the signs of vascular compromise. In the published cases of vision loss, hyaluronidase was given promptly and thrombolysis followed within hours, and sight was still not fully restored, PMID 40346341.
Seek medical attention the same day, without the emergency department, for spreading redness with heat and pain, fever, an open wound or blistering, or a lump that keeps growing weeks after treatment.
Related reading
Frequently Asked Questions
What is the actual difference between botulinum toxin and fillers?
Botulinum toxin reduces how forcefully a muscle contracts, so lines created by movement crease less. Fillers add volume to tissue that has thinned or descended. The practical test is to relax your face completely: a line that disappears at rest is muscle-driven and belongs to toxin, while a line or hollow still visible when nothing moves needs volume. Many faces have both, which is why plans often combine them.
How long does each one last?
For botulinum toxin there is a pooled figure. A meta-analysis of four trials with 621 patients, PMID 23106853, found a median duration of 120 days at maximum contraction and 131 days at rest, which the authors describe as four months of benefit in more than half of responders. Fillers fade gradually rather than stopping: in one study of nasolabial folds, PMID 37095274, patient-rated improvement went from 54.67 per cent at three months to 31.33 per cent at twelve.
Which one is safer?
They fail differently. Botulinum toxin’s common problems are temporary by nature: a 2014 review of 35 studies and 8,787 subjects, PMID 24575858, reported eyelid ptosis in 2.5 per cent and brow ptosis in 3.1 per cent, all resolving spontaneously. Fillers are usually uneventful but carry a rare complication with a permanent outcome, vascular occlusion, which has caused documented vision loss, PMID 40346341. That difference is why filler consultations should be slower.
Can filler be removed if I do not like it?
Hyaluronic acid filler can be dissolved with hyaluronidase, which is also the emergency treatment for vascular occlusion. Materials other than hyaluronic acid, including biostimulators, are not reversible in the same way, which is standard clinical practice rather than a finding from the studies cited here, and the 2026 review of visual loss from those materials, PMID 41263987, is a reminder of what that raises the stakes on. Ask which material is being used and whether it is reversible before agreeing.
Should I have both at the same appointment?
Not necessarily. Spacing them tells you which treatment produced which change, and relaxing a muscle alters how the tissue above it sits, so the volume a face appears to need can look different a couple of weeks after a toxin treatment. Assessing filler needs after that settles can mean using less.
What symptoms after filler need urgent attention?
Sudden or severe pain out of proportion to the procedure, skin turning white, dusky or mottled near the treated area, any change in vision including blurring, or pain around the eye. Contact the clinic within the hour rather than waiting, because in the published cases of vision loss, PMID 40346341, treatment was measured in hours. For difficulty breathing or swelling of the lips, tongue or throat, call 998 immediately.
Prices per unit and the zones we treat are on the page Botox in Dubai: zones, reference doses and prices per unit. Volume treatments for the lips are described on the page for lip fillers in Dubai.
Medical disclaimer: This page is for informational purposes only and does not replace a consultation with a licensed physician. It does not recommend or prescribe any prescription-only medicine.
License statement: MED YU MED operates under DHA License 6589480.
Individual results caveat: Results vary by diagnosis, anatomy, product used and individual response, and no outcome is guaranteed.
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