In aesthetic medicine, practitioners may perform injections of botulinum toxin (Botox) or hyaluronic acid. Many patients wonder about the difference between these two methods. In reality, the characteristics and applications of the two products are quite different. Botulinum toxin is used to “smooth out” wrinkles by reducing the activity of certain muscles, whereas hyaluronic acid is a dermal filler used to visibly reduce wrinkles and create volume for facial contouring. Often confused, these two products are distinct but can also be complementary.
Confusion between the two products used in aesthetic medicine is common. This misunderstanding stems from the similarity in application method—namely, injection. Botulinum toxin—commonly known as Botox—and hyaluronic acid are both used in aesthetic medicine for facial rejuvenation without surgery, also referred to as a medical facelift. Another common point: the effects of these injections are temporary. For Botox, achieving lasting results requires repeat injections approximately every 6 months. The effects of hyaluronic acid injections vary depending on the treated area (subject to more or less movement) and the type of hyaluronic acid used (highly cross-linked or not). These effects can last between 12 to 18 months.
The action of Botox on the skin is not the same as that of hyaluronic acid. Botulinum toxin has a myorelaxant effect and neutralizes the contraction of the nerves responsible for expression lines, such as the frown lines (glabellar lines), crow’s feet, and forehead wrinkles. Botox therefore induces a slight muscle-paralyzing effect, which can result in the often-criticized “frozen look” when injected in excessive amounts. Botox is also used to treat bruxism and excessive sweating. Hyaluronic acid reduces wrinkles through a filling action at the level of skin folds. It is also used to create or restore volume—for example, to sculpt and contour the cheekbones when there is a loss of malar fat. It is also used for facial contouring and enhancement.
Although the term “acid” may sound alarming to some, hyaluronic acid is in fact a completely biodegradable and biocompatible substance. Hyaluronic acid (HA) is naturally present in the body. This molecule is found in the dermis, the synovial fluid of the joints, and the vitreous humor of the eye. It plays a key role in wound healing and protection against ultraviolet rays emitted by the sun. Hyaluronic acid is known for its ability to capture and retain water in tissues, helping to deeply hydrate the skin. With age, the skin loses firmness and elasticity as the production of collagen and hyaluronic acid declines. Epidermal cell regeneration slows down, tissues sag, and wrinkles and fine lines appear.
In addition to its hydrating properties, hyaluronic acid is an excellent filler. When injected subcutaneously, it firms and plumps the skin, visibly reducing wrinkles that alter facial expression, such as nasolabial folds or marionette lines. A significant advantage: since it is a natural substance, hyaluronic acid is extremely well tolerated by patients, and side effects from injections are rare and minor. In recent years, hyaluronic acid has become the flagship product of aesthetic and anti-aging medicine. As it does not involve any surgical procedure, hyaluronic acid injections in Geneva or elsewhere are performed in a medical office.
Article written by Dr Romano Valeria
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