botox and fillers

Should you get Botox before or after fillers? What a Cosmetic Dentist has to say

By MK Dental Excellence

As a cosmetic dentist, I often see patients interested in both Botox and dermal fillers to address the signs of aging. Both injectables are powerful tools in my aesthetic toolbox, but the question of  “Botox before fillers or fillers before Botox?”  is a common one.

The truth is, there’s no single “best” answer. The ideal sequence depends on your individual goals and facial features. Here’s a breakdown to help you decide:

Understanding the Difference

  • Botox: Relaxes overactive muscles that contribute to wrinkles and fine lines, particularly in the forehead, frown lines, and crow’s feet.
  • Dermal Fillers: Add volume and definition to areas that have lost fullness due to collagen depletion, like smile lines, nasolabial folds (lines from the nose to the corners of the mouth), and lips.

Botox First Approach

There are several reasons why a Botox-first approach might be recommended:

  • Muscle Relaxation: Botox temporarily relaxes muscles. This can sometimes create the illusion of added volume, particularly in areas like the lower face where wrinkles are caused by muscle contraction. Addressing these wrinkles first with Botox can give a clearer picture of where fillers might be most beneficial for adding definition and structure.
  • Dosage Optimization: When muscles are relaxed with Botox, it allows for a more precise assessment of volume loss. This can lead to a more natural-looking result with fillers, as less filler may be needed to achieve the desired outcome.
  • Facial Harmony: Addressing wrinkles caused by muscle movement with Botox can create a more balanced foundation before adding volume with fillers.

Fillers First Approach

In some cases, starting with fillers first might be a better strategy:

  • Volume Replacement: If volume loss is the primary concern, addressing it with fillers can create a lifting effect, which can sometimes minimize the appearance of wrinkles. This can then reduce the need for as much Botox.
  • Structural Support: Fillers can provide structural support to sagging skin, which can indirectly reduce the appearance of wrinkles caused by laxity, potentially minimizing the need for Botox.
  • Thin Skin Considerations: For patients with very thin skin, using fillers first can create a plumper base, making Botox injections safer and more effective.

If you’re searching for top-notch Botox therapy in Cincinnati, don’t hesitate to schedule an appointment with Dr. Manju Kejriwal.

The Combined Approach

Many patients achieve optimal results with a combined approach, receiving both Botox and fillers in the same session. This is especially effective when addressing concerns in multiple areas of the face. However, it’s important to note that Botox and fillers are typically not injected in the same location to avoid interference with each other’s effects.

Ultimately, the best course of action depends on a thorough consultation with a qualified cosmetic dentist or dermatologist. Here’s what to expect during your appointment:

  • We will discuss your specific concerns and desired outcomes, including your aesthetic preferences and budget.
  • An examination of the facial structure, skin quality, and movement patterns of your muscles will be conducted.
  • Based on the assessment, a personalized treatment plan will be created, outlining the recommended sequence (Botox first, fillers first, or combined), injection sites, and types of products best suited for your needs.


  • Choose a cosmetic dentist or dermatologist with extensive experience in injectable treatments to ensure safe and effective results.
  • Both Botox and fillers offer temporary improvements. Discuss realistic expectations for longevity and the need for maintenance treatments.
  • Open communication with your provider throughout the consultation and treatment process is crucial for achieving the best possible outcome.

By working together with your cosmetic dentist and understanding the interplay between Botox and fillers, you can achieve a rejuvenated and naturally beautiful appearance.