Confused between Botox & Dermal Fillers?

OZ Cosmetic Clinic | 6 Mar 2013

Many people are confused with Fillers and Botox because both of them are used concomitantly to erase wrinkles and they are not permanent treatment. But do you know that they have different usages? Here’s the breakdown by Korean Doctor at OZ Cosmetic Clinic.

Various Dermal Filler Material

Human or Bovine collagen (CosmoDerm, CosmoPlast, Zyplast, Zyderm, Cymetra)
An allergy test is required 4 weeks prior for the Bovine collagen treatment. With an effectiveness that last lesser than 3 months, these fillers are not used anymore.

Hyaluronic acid (Restylane, Juvederm, Perlane)
It draws fluid to the treated area and its effectiveness lasts for about 3 to 6 months. The recommended areas and effectiveness differ with the size of the Hyaluronic Acid particles.

Small particles such as Hyaluronic Acid like Restylane and Juvederm are recommended for removing thin wrinkles under the eye with an effectiveness that lasts for about 3 to 6 months. Large Hyaluronic Acid particle like Perlane are highly recommended for deep wrinkles such as nasolabial fold and for lips and nose augmentations. Its effectiveness lasts about 6 to 9 months. Hyaluronic Acid can be resolved by Hyaluronidase.

Calcium hydroxylapatite (Radiesse)
Similar in composition with Large particles Hyaluronic Acid but with a longer effective period of about 6 to 12 months. It does not leave any remnants but it can’t be removed easily. It’s recommended for the removal of thick wrinkles like the nasolabial fold and for nose augmentation. As it calcifies, it is not recommended for lips augmentation and due to the risk of necrosis, it should not be used for forehead augmentation as well.

Biodegradable polymer (Bio-Alcamid, Interfall, Aquamid, Sculptra)
It is composed of 95% Water and 5% Polymer. The effect lasts for about 1 to 5 years. Over time, the water will be absorbed and there will be degradation of the polymer but not completely. Interfall and Aquamid which contains Monomer have been reported to have the ability to cause severe granuloma and prohibited in some countries so I do not use these products.

Bio-Alcamid, which does not contain Monomer and can be removed by aspiration, is softer than Arterfill or Artercoll. It is recommended for lips and nose augmentations to correct deep wrinkles like the nasolabial fold. It is not recommended for the removal of thick wrinkles such as the periorbital and perioral wrinkles.

Microscopic plastic beads and bovine collagen (Artefill & Artecol)

Made of Poly Methyl Methacrylate (PMMA), the collagen disappears over time but the plastic beads remain permanently under the skin.

It lasts for 5 years and though it is the choice filler for correction of congenital anomaly like hemifacial microsomia, it is not recommended for augmentations of soft areas like the cheeks and lips. It feels like a hard lump and once injected, the patient is unable to have it removed and because of that, I do not usually recommend this treatment.

Fat cells harvested from your body (Autologous fat)
After 6 months from the injection 60% remains but the surviving fat cells lasts forever. It is the filler of choice for the augmentations of the cheeks and forehead such as hollow cheeks and depressed forehead respectively. However, due to its hardness, it is not recommended for augmentation on pressure bearing areas such as the nasolabial fold and the nose.

It is also not recommended for lips and breasts augmentations as well as it can cause calcification after injection. It also requires repeated injections.

It can cause severe complications such as skin necrosis and granuloma. It has the tendency to move to other areas. It is soft and though it lasts forever, it cannot be removed. It is strongly prohibited to be used as a facial aesthetic filler even though the product is permitted for medical use in eyeballs.

Are there too many kinds of Dermal filler materials?

Is this confusing?

I have made a diagram to compare each material briefly.




Recommended usage


Human, Bovine collagen

2 to 4 months

 -  -

No longer used


Hyaluronic acid (small particle)

3 to 6 months

Complete degradation
Easily Removable

Short action

Thin wrinkle


Hyaluronic acid (large particle)

6 to 9 months

Complete degradation
Easily Removable

Relatively short action

Thick wrinkle

Thin wrinkle

Calcium hydoroxyapatite

9 to 18 months

No remnant
Relatively long effect


Thick wrinkle
Augmentation except lips

Thin wrinkle
Lips, Forehead

Biodegradable polymer

2 to 5

Long effect

Left polymer

Thick wrinkle

Thin wrinkle

Microscopic beads and collagen

5 years

Long effect

Hard and Irremovable

Congental defect

Thin wrinkle

Fat graft


Own body material

Repeated injection

Cheek and forehead augmentation

Are you still confused ?

Then, let’s choose the appropriate filler according to the effect you want next week.

Stay tuned.

OZ Cosmetic Clinic
KangNamKu NonHyunDong
49-17 Medifriend B/D 6F
Seoul, South Korea 135 010

Tel: +82 2 511 7373
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Website: OZ Cosmetic Clinic