Anti-wrinkle injections and dermal fillers are the two most common injectable treatments in the UK. They look similar — both involve a needle, both are quick, both work without surgery — but they do completely different things. Choosing the wrong one for your concern is the single most common reason patients are disappointed with injectable results.
This guide explains what each treatment actually does, when one is better than the other, and when the right answer is a combination.
Different mechanisms, different jobs
Anti-wrinkle injections relax a muscle. They use small doses of botulinum toxin to temporarily block the nerve signal that tells the muscle to contract. When the muscle can’t contract, it can’t fold the overlying skin into a wrinkle. The treatment works on lines caused by movement — dynamic lines.
Dermal fillers add volume. They are gel substances — most commonly hyaluronic acid — placed under the skin to fill a depression, plump a deflated area, or contour a feature. They work on lines and contours caused by lost volume or set static wrinkles.
The clinical implication is straightforward: if your concern is movement-based, you need anti-wrinkle injections. If your concern is volume-based, you need filler. If it’s both — which is common after the mid-30s — you need both.
Which areas each one works on
Anti-wrinkle injections work best on:
- Forehead lines (horizontal lines from the frontalis muscle)
- Glabellar lines (“the elevens” between the brows from the corrugator and procerus)
- Crow’s feet (lines radiating from the outer corner of the eye)
- Bunny lines (diagonal lines on the sides of the nose)
- Jaw slimming (relaxing an overactive masseter muscle)
- Gummy smile (relaxing the elevator of the upper lip)
- Platysmal bands in the neck
- Non-surgical brow lift — see our guide on how this works
Dermal fillers work best on:
- Cheek volume loss and mid-face flattening
- Temples that have hollowed with age
- Nasolabial folds (the lines from the side of the nose to the corner of the mouth)
- Marionette lines (lines from the corners of the mouth downward) — see our marionette lines guide
- Lip enhancement with lip fillers
- Chin and jaw contouring
- Tear troughs (the hollow below the eye) — see our guide on whether tear trough filler is worth it
- Non-surgical nose reshaping with non-surgical rhinoplasty
The grey zone
A few areas can be approached either way depending on the underlying cause:
Deep glabellar lines (“set elevens”) often need both: anti-wrinkle injections to stop the muscle deepening them further, plus a small amount of filler placed into the line itself to physically fill the depression. The glabella is a high-risk area for filler due to vascular anatomy — this should only be done by an experienced injector.
Lower-face wrinkles around the mouth. Fine vertical “smoker’s lines” sometimes respond to a tiny amount of anti-wrinkle injection to relax the orbicularis oris muscle, but the dose must be very small to avoid affecting speech and oral function. Filler placed into the lines themselves is often safer and more effective.
How long does each one last?
Anti-wrinkle injections: three to four months on average. The effect wears off as the body produces new nerve endings to replace those blocked by the toxin.
Dermal fillers: six to eighteen months, depending on the area treated, the product used, and the patient’s metabolism. Filler in highly mobile areas like the lips tends to break down faster than filler placed in less mobile areas like the cheek. Younger, leaner, more athletically active patients metabolise filler faster.
For both treatments, results last longer with regular maintenance than starting from scratch each time.
What does each procedure involve?
Anti-wrinkle injections
A typical upper-face session takes 10 to 15 minutes. Small doses are delivered through a fine needle into precise muscle points. No numbing cream is needed. Small bumps appear at each injection site and settle within 15 minutes. You can return to normal activities immediately, with the usual aftercare restrictions for 24 hours (no lying flat, no strenuous exercise, no facials).
The effect starts to appear at days three to five, with the full result at two weeks.
Dermal fillers
A typical filler session takes 30 to 45 minutes depending on the area. Topical numbing cream is applied for 15 to 20 minutes before treatment, and the filler itself contains lidocaine. Either a fine needle or a blunt cannula is used depending on the area — cannulas are generally preferred for higher-risk areas like the under-eye or non-surgical rhinoplasty.
Results are visible immediately, though swelling can persist for up to a week, so the “final” result is what you see at 14 days. Bruising is possible, particularly in well-vascularised areas like the lips and tear trough.
See our injectables aftercare guide for the post-treatment dos and don’ts that apply to both treatments.
Which one is riskier?
Both treatments are very safe in experienced hands. The risk profiles differ:
Anti-wrinkle injections. The most concerning complication is product migration to nearby muscles — particularly the muscles of the eyelid, which can cause temporary eyelid droop lasting several weeks. Asymmetry is occasionally noted at two weeks and is easily corrected with a small top-up. Allergic reactions are extremely rare.
Dermal fillers. The most concerning complication is vascular occlusion — filler entering a blood vessel and blocking it, which can cause skin necrosis or, in extreme cases involving facial arteries that connect to the eye, blindness. The risk is very low with careful technique but cannot be reduced to zero. Filler can also migrate, lump, or — particularly with old, badly placed product — cause chronic puffiness. Unlike anti-wrinkle injections, hyaluronic acid fillers can be dissolved with hyalase if the result is unsatisfactory.
The highest-risk areas for filler — the under-eye, the glabella, and the nose — should only be treated by practitioners with detailed anatomical knowledge and immediate access to hyalase.
What does each one cost?
Anti-wrinkle injections typically cost less per session than filler because the product itself is cheaper and the volumes used are smaller. As a guide, single-area AWI starts around £200, while a syringe of filler typically costs £400 and up depending on product and area. Multi-area combinations work out more economical than treating each area separately.
Finance options through Chrysalis Finance, including 0% APR, are available across both treatment types.
When the answer is combination
Most patients in their late thirties onward benefit from some combination of both treatments. A typical example: a patient with forehead lines (dynamic), set glabellar lines (combined dynamic and static), tear trough hollowing (volume loss), and early marionette lines (volume loss) would receive:
- Anti-wrinkle injections to the forehead, glabella, and crow’s feet (single session)
- Small-volume filler to the tear trough at the same visit or shortly after
- Filler to the marionette lines or chin to support the lower face
Treating the dynamic lines first and assessing the result before adding filler often produces a more natural outcome — sometimes the volume loss looks less pronounced once muscle activity has settled.
For more comprehensive ageing, both treatments can be combined with biostimulators like Profhilo or polynucleotides for skin quality, and energy-based devices like Fotona 4D or Morpheus8 for tightening.
How to decide which to start with
A consultation with an experienced injector is the appropriate next step. As a rough guide:
Start with anti-wrinkle injections if your main concerns are dynamic upper-face lines, a heavy frown, or specific functional issues like jaw clenching or excessive sweating.
Start with filler if your main concerns are volume loss, deflated cheeks, lip enhancement, or correcting a contour irregularity.
Plan for both if you have a combination of dynamic lines and volume loss, which most patients develop by their late thirties to mid-forties.
The honest answer in some cases is that neither is right. Patients with significant skin laxity, hooded eyes, or deep facial descent often get better results from surgical treatments — see our guide on fine lines versus wrinkles and our specialist surgical consultations if you suspect this might apply to you.
Common questions
If I have anti-wrinkle injections will I look weird when they wear off?
No. The muscles return to their normal function over three to four months. You don’t end up looking worse than before treatment.
Can filler be reversed if I don’t like it?
Hyaluronic acid fillers can be dissolved with hyalase. The filler breaks down within 24 to 48 hours. Non-HA fillers (calcium hydroxyapatite, poly-L-lactic acid) cannot be dissolved and must wear off naturally over a year or more — which is why we use HA almost exclusively.
Will using both make me look overdone?
Not when both are used conservatively and with anatomical understanding. The overdone look usually comes from chasing perfection in any single area with too much product, not from combining treatments. A consultation with an experienced injector ensures you don’t drift in this direction.
Can I have one without the other?
Yes, absolutely. Many patients have only anti-wrinkle injections (typically in their early 30s) and add filler later as volume loss becomes more relevant. Others have filler only for specific concerns like lip enhancement.
RELATED: Anti-Wrinkle Injections FAQs | Dermal Fillers FAQs
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Medically reviewed by Dr Spyridon Vlachos, GMC 7522950.
