Botox in Upper Part and Fillers on Lower Part of Face?

I am 42 and have had Botox 4 years ago with a good result, but now I hate looking at my wrinkles. I need my brows, crows feet, smile lines, and my top lip is very liney. Do I need fillers in the lower part of my face and Botox in the top?

Doctor Answers 17

You need appropriate treatment...and it may include both botox and fillers

into both the upper and lower all depends on your specific needs...certainly when the materials came on the market, botox was only for the upper face and fillers were used mostly in the lower face at the nasolabial as we've gained more experience, there are no more hard and fast rules...botox is regularly injected into the lip area, the chin, the jawline and the lower lids...and fillers are often injected into the forehead, between the eyes and into the crow's feet talk with your doctor about the most appropriate way to achieve your wishes...should be an easy task...

Las Vegas Dermatologist
4.6 out of 5 stars 9 reviews

Botox vs Filler placement in specific parts of the face.

Typically one places Botox in the upper part of the face, and filler agents in the creases in the lower half.  Each patient is different.  Seek out an experienced injector.  They will be able to take you through the process.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Botox is best in the upper part of the face and filler in the lower

That combination of Botox in the upper part of your face, forehead, glabella, and crow's feet are ideal for fixing those wrinkles around your brows that you don't line.  Fillers are best for the lower part of the face to fill in depressions, lines, and wrinkles around the mouth.  The top lip can also benefit from the Fraxel laser to soften and resurface those fine lines around the mouth.  This is a good example that a combination of modalities can be used for the best results.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews

BOTOX vs Facial Fillers

BOTOX and fillers work very well together to achieve outstanding aesthetic results, although their indications are different. BOTOX will relax the muscles and soften the wrinkles created by movement. Fillers are used to fill where volume has diminished in the face. As far as your brows, forehead and crows feet, BOTOX would be recommended to diminish the lines. Smile lines in the nasolabial folds around the mouth would be best treated with facial fillers, such as JUVEDERM, with the goal to fill in the crevices where the volume has decreased. The lines above your upper lip can be treated with either BOTOX or filler, or a combination of both depending on the severity of the lines. I highly recommend a consult with a physician who is experienced and knowledgeable with the inticate facial anatomy to achieve the optimum cosmetic results.

William P. Mack, MD, PA
Tampa Oculoplastic Surgeon
5.0 out of 5 stars 38 reviews

Botox and fillers

Botox is used to stop dynamic movement and fillers are used to replace volume.  These treatments complement each other and both can be used in the upper and lower face by an experienced injector to give a youthful, natural result.  Please consult a board certified dermatologist or plastic surgeon who has experience in treating the face with Botox and fillers.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

Botox and fillers are indeed used in this manner

Exactly! I employ BOTOX to reduce the muscular function of the forehead and crows feet regions in order to give smoother skin contours. I employ fillers for creases and depressions in the lower part of the face as well as any other regions of the face where there are creases, wrinkles or depressions. I do not like to use BOTOX on the lower part of the face. Injecting BOTOX in the region around the mouth runs certain risks of disfigurement including a pouty “duck-like” look of the upper lips and possible weakness of the corners of the lower lips.

Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon

Traditionally Botox or Dysport are used in the upper face

Traditionally Botox or Dysport are used in the upper face, and fillers in the lower face. But now both are used throughout the face. Artfully administered by an experienced dermatologist or plastic surgeon, combining these approaches can give the best results

William P. Coleman III, MD
Metairie Dermatologic Surgeon
3.5 out of 5 stars 2 reviews

Botox is not only for the upper face and fillers can be used in the upper face

In the past, Botox was used in the forehead and crows' feet near the eyelids. Fillers were used in the smile folds and lips. During the last decade +, there has been great advance in the understanding of the aged face. Fat atrophy is responsible for the lack of support and drooping of the face.

Botox is used for wrinkles related to muscle movement and the skin that folds above this motion repeatedly. Once the muscle doesn't move, the skin doesn't act like an accordion and eventually the lines diminish if not disappear. Lower facial lines are treated better wtih fillers because inhibition of muscle movement would cause an inability to correctly smile, speak or eat.

Lately we have started to add fillers to the upper face. Temple wasting, lateral eyebrow support to recreate a youthful appearance and help elevate a droopy upper eyelid, and cautious filling superficially of the "eleven" in the glabellar region of the forehead (between the eyebrows) are a few of the upper facial filling areas.

Botox has been used to diminish the gummy smile, minimize nasal tip movement with speech in some people who have this trait, lessen a dimpled appearance of the chin, and help elevate the corners of the mouth, and even the jowls by treating the DAO and platysma muscles, respectively. These off-label uses should be done by an experienced physician.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Botox and fillers

Botox or dysport is a great way to treat facial lines of animation of the upper 1/3 of the face.  Fillers such as restylane, juvederm, or radiesse are great to fill lines of the lower face.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Botox, facial contouring, Dysport, lip lines, skin care, laser

Dear Caris, Thank you for your question. Botox and fillers are the first steps in restoring facial shape and reversing the signs of aging. They can be used in combination or separately with great resuts. How much of each and where they are placed is the key ingredient. The addition of other non-surgical techniques such as Thermage, IPL and General skin care will also help to freshen up your appearance!

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 118 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.