Botulinum toxin : treatment of expression lines
Botulinum toxin is a medicine injected in very small amounts into certain facial muscles. It temporarily relaxes muscles responsible for expression lines. It does not fill wrinkles but reduces the force of muscular contraction causing them.
This treatment is indicated for dynamic wrinkles, those appearing during facial movements. It smooths the forehead, reduces frown lines between the eyebrows and diminishes crow's feet around the eyes. In certain indications, botulinum toxin can also limit primary excessive underarm sweating.
Its effect appears gradually : beginning between the third and fifth day, fully developing around the tenth day and lasting an average of four to six months. The aim is not to freeze features but subtly relax overused areas to soften expressions and prevent deep wrinkles.
Hyaluronic acid : filling wrinkles and restoring volume
Hyaluronic acid is a molecule naturally present in our skin whose main function is retaining water and maintaining hydration and firmness. In aesthetic medicine, it is injected as a gel of varying density according to the treated area and desired effect.
Its role is entirely different from botulinum toxin's. It fills hollows, corrects established wrinkles, restores lost volume (cheekbones, temples, chin), enhances areas such as the lips or jawline and allows facial lifting techniques.
In a lightly cross-linked form, it can also deeply rehydrate the skin within revitalisation treatments such as Skinboosters.
Hyaluronic acid's effect is visible immediately after injection. It lasts between six and fifteen months according to product type, injected area, patient metabolism and technique used.
Botulinum toxin or hyaluronic acid ?
Botulinum toxin is indicated to regulate muscular activity. It is particularly suited to reducing expression lines, preventing their appearance in younger patients or softening a face marked by tension, severity or fatigue.
Hyaluronic acid is indicated for wrinkles already visible at rest, loss of volume or skin density and imbalances in facial harmony. Its action concerns facial structure and contours more than mobility.
Thus, botulinum toxin acts on the muscular cause of expression lines, while hyaluronic acid corrects their visible consequences — hollows, laxity, loss of contours — while helping restore facial softness and balance.
Can botulinum toxin and hyaluronic acid be combined ?
Combining botulinum toxin and hyaluronic acid is now considered the reference method for overall facial rejuvenation. These treatments act on different mechanisms and complement each other perfectly. Botulinum toxin relaxes muscles responsible for expression lines, smoothing mobile facial areas, while hyaluronic acid restores volume, fills hollows and reshapes contours. Together, they act on both facial dynamics and structure, offering a more complete, natural and harmonious result. This synergy achieves subtle rejuvenation without rigidity or excess while respecting expressions and each face's individual balance.
Are there different contraindications or side effects ?
Both treatments have excellent tolerance when performed by an experienced doctor. Botulinum toxin is contraindicated during pregnancy, breastfeeding, neuromuscular disease or known allergy to any component. Hyaluronic acid must not be injected with an active skin infection in the target area, in patients with autoimmune diseases or during pregnancy and breastfeeding.
Botulinum toxin side effects are rare and most often minor : slight tension, transient discomfort or, exceptionally, small temporary asymmetry. Hyaluronic acid effects are generally limited to local redness or swelling that quickly subsides.
A prior medical assessment and attentive follow-up are essential to ensure treatment safety and result quality.
Conclusion : botulinum toxin or hyaluronic acid ?
Botulinum toxin and hyaluronic acid are the most frequently performed aesthetic medicine treatments, but neither is superior to the other. Each addresses distinct, often complementary objectives according to the face's nature, structure, history and patient expectations. The truly “best” treatment is therefore the one precisely suited to the patient's morphology and expression.
A medical consultation is essential before injection. It analyses the areas concerned, assesses muscular dynamics and designs a tailored care protocol planned for the long term and adjusted at each stage.
In Geneva, this combination of medical rigour and aesthetic judgement produces highly appropriate results — subtle, natural and balanced — far from standardisation or excess.
