Thinking About Getting Botox or Fillers? Read This First

Updated 09/12/22. As an esthetician, not a week goes by without someone asking me, “Renée, I’m thinking about getting Botox or fillers. Should I do it?” I’ve been working with skin for over 30 years, so I’m a trusted resource for my clients and friends. I have no motives other than to share my honest thoughts and to help you look your very best.

In this post, I’ll share a few things you might want to consider before getting Botox and fillers. I’ll also share some insight from Dr. Sam Lam, a board-certified facial plastic surgeon at Lam Facial Plastics. Hopefully, by the end, you’ll have what you need to make the right decision.

What Is Botox, and How Long Does It Last?

Botox injections use a toxin called onobotulinumtoxinA (a purified form of the botulinum toxin, which is produced by a certain type of bacteria). According to the Mayo Clinic, “Botox injections block certain chemical signals from nerves, mostly signals that cause muscles to contract.” This relaxes the muscles and essentially ‘freezes’ them to minimize repetitive facial movements that can lead to the formation of lines and wrinkles.

A Botox injection will typically last three to six months, depending on how quickly your body metabolizes it. You should start to see results one to three days after receiving the injection.

Is Botox Safe?

According to Dr. Lam, the Botox brand has been around since the early ’90s, although botulinum toxin has been around since the ’70s. The FDA cleared it for cosmetic purposes in 2002, but prior to that, it was used clinically and off-label for almost a decade. “The reason people get scared about side effects is that they hear the word toxin,” Dr. Lam says, “but it’s a very purified protein that’s injected.”

It’s not just used for cosmetic purposes, either. It’s also used for certain medical problems, including esophageal issues and cerebral palsy. “If you go to the right injector and you’re doing the right things afterward, it’s very safe and relatively risk-free from side effects,” he says.

Read five surprising ways Botox can improve your appearance and quality of life.

What Are Fillers and How Long Do They Last?

Dermal fillers are most commonly made of hyaluronic acid gel, although there are other options such as collagen and various synthetics. As we age, we start to lose volume in our faces due to a natural decrease in hyaluronic acid and collagen. Fillers can restore some of this volume and can be used to ‘fill out’ wrinkles. They last anywhere from a few months at a time to a full year depending on the type of filler that’s used.

5 Things to Consider Before Getting Botox or Fillers

Even though injections are considered noninvasive, you should think carefully before pulling the trigger. Here are a few things to consider if you’re still on the fence!

1. Make Sure Botox or Fillers Will Give You the Specific Results You’re Looking For

“What about your face is bothering you, and what are you wanting to improve?” This is the first question I ask someone who is considering Botox or fillers. A lot of people point to concerns such as dull skin, bumpy skin, large or clogged pores, or brown spots. While these are understandably bothersome, they aren’t best addressed through Botox or fillers. (Did you know, in some cases, Botox can backfire and cause your face to lose fullness?)

The other answer I’ll hear is, “I’m looking older, and I feel like I should do something about it,” or, “I’ve started noticing X lately, and it’s really bothering me.” I’m more inclined to steer someone toward injectables when they give this type of answer, especially if they’re 35 or older.

If something specific is really bothering you as you start to age, there’s nothing wrong with doing something about it. At this point, I’ll grab a mirror and have the client actually show me what’s bothering them about their face. This process might help us discover that some of these things can, in fact, be improved with Botox or fillers. This includes deep wrinkles, a thin upper lip, under-eye wrinkles, and sunken eyes that lead to dark circles.

2. Consider Alternatives to Botox and Fillers

Depending on your goals, there are plenty of other treatments that will make the skin look brighter, smoother, clearer, and tighter. Consulting an experienced doctor or esthetician is the best way to determine if one of these alternatives can give you the right results.

• Retinol or retinoids should be the first step for ANYONE who wants to turn back the clock on their skin. Read this beginner’s guide to retinol and retinoids.
• Professional or at-home chemical peels can significantly improve the texture of the skin and overall brightness.
• Laser treatments can help with many things, including resurfacing the skin and building collagen.
• Radiofrequency and Ultrasound are great options for noninvasive skin tightening.
• LED therapy can also help build collagen at certain wavelengths.

3. Find a Reputable Doctor Who Is Looking Out for Your Best Interest

If you decide to go for it, the best way to ensure you get the results you’re looking for is to consult a reputable, experienced doctor.

I have mixed feelings when I hear someone say, “My doctor thinks I would benefit from getting a little filler put in.” For starters, we can be easily influenced by others when insecurities are involved, and doctors know this all too well. Some doctors are aggressively looking to incorporate more cosmetic procedures into their practices because they can be quite profitable. This means they might be pushing these procedures onto patients for the wrong reasons. I truly wish this weren’t the case, but sadly it can be.

Many people also think that, because injections are non-invasive, there aren’t any risks involved. While side effects at the hands of a licensed injector are rare, they’re possible. For this reason, it’s so important that you go to a licensed, medical professional who is trained to deal with any potential side effects.

It’s all about trust, so the key is finding someone who puts you at ease, listens carefully to your goals and concerns, and doesn’t pressure you. Make sure whoever you go to really understands your aesthetic goals.

4. After Age 45, You Might Want to Consider Other Cosmetic Options

I often hear men and women who are over 40 say, “I’m losing tone but I want to avoid cutting my skin with a facelift.”

Many doctors are promoting Botox and fillers as a less invasive way to re-sculpt, plump, and tighten the skin in lieu of traditional facelifts. In my experience, injectables and technologies like radiofrequency or lasers can certainly hold things together up to a certain point in someone’s life. However, there comes a time when a traditional face or neck lift is the most effective way to get the results that people are looking for. It can be very challenging to make loose skin look tight again with fillers and lasers—all while maintaining a natural look. You can hit a wall with noninvasive treatments, so it’s important to consider all options and get several opinions from experienced doctors.

5. Be Sure You’re Getting Botox and Fillers for the Right Reasons

When I ask someone why they want Botox or fillers, I pay close attention to what gave them the idea in the first place. All of these answers are red flags:

• “My friend had X done and it looks so good!”
• “My doctor/nurse suggested I have X done.”
• “I heard about a celebrity who got this done and looks amazing for their age.”

These answers are especially common for people in their 20s and 30s. Many will see a friend or celebrity who had something done, and this will plant the idea in their head. These responses are red flags because I want to know how they feel about their own appearance— not about what a friend or celebrity does to their face. What I often discover is many young people don’t have an issue with their faces at all; they are simply experiencing FOMO and want to participate in the latest trend. I can’t tell you how many times I’ve gotten people to really think through the reasons they’re considering these types of procedures, only for them to discover that they are creating a problem when there was never one to begin with.

If I get one of these red-flag answers, my follow-up question will always be, “When you look in the mirror, are you frustrated with what you see?” Sometimes, an esthetician needs to act as a counselor to help a client understand the root of their issues. If a client realizes that they are unhappy in another aspect of their life, they often decide that a cosmetic procedure isn’t the answer. I’ve certainly had clients who came to the conclusion that what they needed most was to get back into therapy in order to work on self-acceptance.

In the end, the best advice I can offer is to make sure to do it for YOU. Don’t do something because you feel like it’s what society expects of you.

What I’ve Had Done

Many people want to know what I get done, and I’m never afraid to share (I’m 53, by the way.) I get Botox around my eyes, in between my brows, and a touch on my forehead. And I really like the result. I live in Austin but I fly up to see my friend, Dr. Sam Lam, in Dallas every three to four months because he is so good and I trust him so much.

About a year ago, he convinced me to get some filler, which I had never done before. (I was so nervous because we’ve all seen people with puffy-looking faces from filler!) He injected it near the sides of my face. It was so subtle, but it made a really nice improvement. It made my face look less long and slightly more round. A few months ago, he also put a tiny bit of filler in my lips. Again, I was so nervous, but I really liked that, too. So, all in all, Botox and fillers are what I’m dabbling in these days with a doctor who I trust to keep me looking like me!

Aside from all of that, I’m obviously mainly focused on good skincare. I focus on doing everything I can to create a smooth, even-toned texture with tight-looking pores. I’m not trying to erase every line or wrinkle that shows up. After all, it’s a battle that I won’t ever win (even with fillers and Botox.) I’m not willing to go to extremes to have the skin of a 25-year-old. I’ve been using sunscreen as a moisturizer every day since I was 28, and I’ve been using a retinol serum since I turned 41. These both have been game-changers for me. (I also feel lucky that I have at least one of the three facial features that will make you look younger.)

The Bottom Line

You are not missing out if you don’t get Botox and fillers. But, if you think they will make you feel happier and more confident, then go for it! Just be sure to find a trusted, reputable doctor who can help you achieve exactly what you want.

Next, can’t get your Botox right now? Try this temporary alternative!

Renée Rouleau

Celebrity Esthetician & Skincare Expert
As an esthetician trained in cosmetic chemistry, Renée Rouleau has spent 30 years researching skin, educating her audience, and building an award-winning line of products. Her hands-on experience as an esthetician and trusted skin care expert has created a real-world solution — products that are formulated for nine different types of skin so your face will get exactly what it needs to look and feel its best. Trusted by celebrities, editors, bloggers, and skincare obsessives around the globe, her vast real-world knowledge and constant research are why Marie Claire calls her “the most passionate skin practitioner we know.”