1. What is the difference between Botox® and dermal filler?

What we mostly use at Cavendish Clinic is Botox, which is the brand name for our anti-wrinkle treatment. It contains the neurotoxin, botulinum toxin, produced by a bacterium called Clostridium botulinum. Botox relaxes the muscles in your face to smooth out lines and wrinkles, such as crow’s feet and frown lines.

The dermal fillers we use are hyaluronic acid fillers. In my opinion this is the safest dermal filler on the market apart from one’s own fat used as a filler in fat grafting.

Dermal fillers don’t only do what the word promises, namely “fill”. They can also promote collagen production by stimulating your fibroblasts which are cells present in your connective tissue.

We use these fillers to plump, restore, define, contour and rejuvenate.

  1. How quickly do you see result?

Botox: does not give a result immediately. Most people start seeing and feeling a result between 2-5 days. Some are rapid responders, some take longer. I like the cautious approach meaning that I’ll treat people with a dose I know is safe for their face and if after 2 weeks (time it takes to see full result) the result is not “strong” enough some people need a top-up.

Dermal filler: Dermal filler results are immediately.

The additional collagen stimulation takes 6 weeks. There is a product called Hyaluronidase that can dissolve hyaluronic acid fillers, so the effects of dermal fillers are not only temporary, but they can be reversed if necessary.
  1. How long do results last?

Botox: depending on age and expressiveness it lasts 3-6 months. On average the younger patients (i.e. late twenties, thirties) have Botox twice a year. Older patients three to sometimes even 4 times a year.

Dermal filler: depending on the treated area (e.g. very mobile area like lips versus static areas such as nose). The mobile areas filler has less longevity and can last 6 months to a year, sometimes even longer. It’s also up to individual’s rate of hyaluronic acid breakdown.

Less mobile areas can last longer up to 18 months to two years even. All depending on individual’s speed of hyaluronic acid breakdown. Plus you get the additional benefit of long-lasting collagen build up.

  1. What happens when the results wear off?

The results do not wear off overnight. You will very gradually see that you can move your forehead again, more and more. Your frown is coming back and crow’s feet appear again. When treating masseters or hyperhidrosis it’s the same. Areas treated with dermal filler will slowly go back to normal. It’s untrue that these areas will look ‘worse’ than its original state.

  1. What if I don’t like it?

It’s unlikely when having had an informative consultation and when managed expectations properly. Botox will wear off gradually. Dermal filler can be dissolved in the worst case scenario.

But this is very unlikely and yet again a reason to take baby steps when treating someone for the first time.

  1. Will I age more rapidly when using it? Will my face look older once I come off it?

No. On the contrary. But you must not forget that in the background the natural ageing process does continue. With the judicious use of toxin and dermal filler we’ll make you mature more nicely. The collagen stimulation from hyaluronic acid filler will give your skin better support.

  1. What can’t I do after treatment?

Some things to watch out for:

-Do not touch the area treated for the first 2 days following treatment. No facials, waxing or massages for the first 2 weeks

-Do not take aspirin, ibuprofen or other anti-inflammatory medication for 24 hours after treatment as -this may increase bruising. You may take paracetamol or codeine if you are uncomfortable

-No strenuous exercise or gardening for at least 24 hours but light exercise such as walking is ok

-Do not have a sauna, hot tub or go in a tanning booth for 2 weeks after treatment. Always wear a broad spectrum, high factor sun protection (SPF 30-50) on the face, neck, décolletage and hands

  1. How much does it cost?

The Cavendish doctors treat each patient individually and different treatment options may be available. A guide price can be provided upon an injectables consultation.

  1. What are the risks with Botox?

Some common injection-related reactions are mild swelling, redness, pain, itching, discolouration, bruising and tenderness. Other complications, which are very rare and usually temporary, include allergic reaction to Botox, local numbness, upper eye lid ptosis, or asymmetry, temporary headache.

  1. What are the risks with dermal filler?

Inflammatory skin reactions (for example redness, swelling, rash) which may be accompanied by itching, pain on application of pressure. Bruising, lumps or nodules can occur the first few days after treatment. Other very rare risks include discolouration or lightening of the injection area, necrosis (cell death,) abscesses (collection of pus,) granulomas (foreign body reactions,) and immediate or delayed hypersensitivity reactions along with poor or weak filling. It’s super important you see a well-trained medical aesthetic practitioner to minimize these risks. Do your research!


By Dr. Veerle Rotsaert


65 Margaret Street
T: 020 7935 4410


185 New Kings Road
Parsons green
T: 020 7731 4764


13 Kensington Church Street
W8 4LF
T: 020 7630 4535


24 – 26 Wilson Street
G1 1SS
T: 0141 473 0590