Quick Answer
Botox and filler solve different problems. Anti-wrinkle injections, sold in New Zealand as Botox, Dysport and Relfydess, relax the muscle that creases the skin, so they treat lines caused by movement: frown lines, forehead lines and crow's feet. Dermal filler is a hyaluronic acid gel that adds volume back where it has been lost, so it treats hollows and slackness: flat cheeks, a soft jawline, an undefined chin, thin lips. The quickest test is to hold your face completely still in a mirror. Lines that disappear when you stop moving are usually an anti-wrinkle problem. Lines and shadows that stay put are usually a volume problem. At Silk Clinical, anti-wrinkle treatment starts at $160 and lasts three to four months; filler starts at $350 and lasts six to eighteen months. Many faces need a little of both.
This is the question I am asked most often, usually phrased as "I don't know what I need, I just don't look like myself." It is a fair place to start, and the answer is more straightforward than the internet makes it sound.
I am Shontelle, the registered nurse who runs Silk Clinical Aesthetics at 66 Victoria Street in Christchurch. Here is how the two treatments actually differ, how I work out which one a face needs, and when the honest answer is neither.
The Fundamental Difference
Anti-wrinkle injections and dermal filler are both injectables, both take about half an hour, and both are performed by a registered nurse. That is where the similarity ends.
Anti-wrinkle injections switch a muscle down. They contain botulinum toxin type A, which temporarily blocks the nerve signal that tells a muscle to contract. Less contraction means less creasing of the skin above it. The three products available in New Zealand are Botox (onabotulinumtoxinA), Dysport (abobotulinumtoxinA) and Relfydess (relabotulinumtoxinA). All three are prescription medicines, all three are Medsafe-approved, and all three work through the same mechanism.
Dermal filler puts volume back. It is a hyaluronic acid gel, the same molecule your skin already makes, cross-linked so it holds its shape once placed. It sits beneath the skin and physically occupies space, restoring projection to a cheek, definition to a jaw, or fullness to a lip.
One is subtractive: it removes a movement. The other is additive: it adds structure. Almost every confusion about which treatment to book comes from not knowing which of those two things your face is missing.
The Mirror Test
Stand in front of a mirror in decent light. Make your usual expressions: frown, raise your brows, smile hard. Watch the lines appear. Then stop, let your face go completely still, and look again.
Lines that vanish when you stop moving are dynamic lines. They are made by muscle. Anti-wrinkle injections are the treatment for those.
Lines and shadows that are still there when your face is at rest are static. They are made by lost volume, lost collagen, or years of the same dynamic line etching itself into the skin. Filler, or a collagen-stimulating treatment, is the conversation for those.
Most faces over about 35 have both, which is why the answer is often a bit of each rather than one or the other.
There is a third category worth naming. If the skin itself has lost quality, crepey texture, sun damage, laxity across the whole lower face, then neither injectable is the right first move. That is a skin and collagen problem, and it is better answered with skin boosters or a tightening device than with volume.
What Anti-Wrinkle Injections Treat
The reliable areas are the ones driven by muscle:
- Frown lines between the brows, made by the corrugator and procerus muscles.
- Forehead lines, made by the frontalis.
- Crow's feet around the eyes, made by the orbicularis oculi.
- Brow lift, achieved by relaxing the muscles that pull the brow down.
- Bunny lines across the nose.
- Gummy smile, by softening the muscle that lifts the upper lip too far.
- Puckered chin, where the mentalis muscle dimples the skin.
- Marionette lines, partly, by relaxing the DAO muscle that pulls the corner of the mouth down.
- Masseter treatment, for jaw clenching, grinding, or slimming a heavy jaw angle.
- Hyperhidrosis, excessive sweating, which is a genuinely medical use.
Results appear over three to five days, reach full effect at ten to fourteen days, and last three to four months. Relfydess can show earlier and last longer, up to six months in clinical studies. The differences between products are covered properly in Botox vs Dysport and what Relfydess is.
What Dermal Filler Treats
Filler answers loss of structure:
- Cheek and midface volume, the flattening that makes a face look tired before it looks lined.
- Chin projection, which changes the profile more than most people expect.
- Jawline definition, sharpening a border that has softened.
- Tear trough hollows, in the specific cases where the anatomy suits it.
- Nasolabial folds, often better treated by supporting the cheek above them.
- Lips, from hydration and border definition through to considered volume.
Results are immediate, settle over one to two weeks, and last six to eighteen months depending on the area and the product. Lips are at the short end because the lip moves constantly. Structural cheek and jaw work is at the long end.
Detail on the areas and the products sits on our dermal fillers page and lip filler page, and how long dermal fillers last covers longevity honestly.
Where People Get It Wrong
Three patterns come up again and again in consultations.
Deep frown lines treated with filler alone. If a static frown line has etched itself into the skin, filler can soften the remaining crease, but injecting it while the muscle keeps folding the skin over the top is like plastering a wall that is still moving. The muscle has to be relaxed first. That is an anti-wrinkle treatment, then filler later if the line is still visible at rest.
Tired-looking eyes treated with anti-wrinkle injections alone. Relaxing crow's feet does nothing for a hollow under the eye. Sometimes it makes the hollow more obvious, because the softened skin no longer distracts from the shadow.
A soft lower face treated with lip filler. When the midface deflates, the lower face slackens and the mouth area looks heavier. Adding lips to that is treating the part of the face that is asking loudest rather than the part that is actually the cause. Supporting the cheek is usually the better first millilitre.
None of this is intuitive from the outside, which is exactly what the consultation is for.
What They Cost
The pricing structures are completely different, which makes the two hard to compare at a glance.
Anti-wrinkle injections are priced per unit. At Silk, Dysport is $6 per unit, Relfydess $7, and Botox $14, with a $160 minimum charge per visit. Single areas start from $160, the frown and crow's feet from $260 each, a two-area package is $380 and three areas $600. The full breakdown, including how that compares with the rest of the city, is in the 2026 anti-wrinkle pricing guide.
Filler is priced per millilitre. At Silk, lips are $350 for 0.5ml or $500 for 1ml, soft and medium filler is $500 per millilitre, and structural work on cheeks, chin, jaw or tear trough is $640 per millilitre, or $1,000 for two millilitres. The 2026 filler pricing guide covers it area by area.
The number that actually matters is the annual one. Anti-wrinkle treatment is a smaller amount two to four times a year. Filler is a larger amount roughly once a year, sometimes less. Over twelve months, a three-area anti-wrinkle habit and a single millilitre of cheek filler land in a broadly similar place.
Combining Them
Most treatment plans past the mid-thirties use both, and they work better together than either does alone. The usual logic is that filler rebuilds the structure and anti-wrinkle injections stop the movement that is wearing the surface down.
A common sequence looks like this. Anti-wrinkle treatment first, because it is the smaller commitment, it takes effect in two weeks, and settling the muscle changes how the face sits at rest. Review at two weeks. Then, if there is still a hollow or a slackness that movement was not causing, filler at a separate appointment.
We generally do not place filler and anti-wrinkle product into the same area on the same day, for two reasons. Swelling from filler makes it harder to judge the anti-wrinkle result accurately, and if something reacts, separating the two makes it obvious which product was responsible. Different areas on the same day is fine and we do it often.
If you are thinking about a bigger plan, our approach to sequencing several treatments is described in combined treatment plans.
How I Decide in a Consultation
I look at four things, in this order.
What bothers you. Not what I would change. What you notice in photographs and in the mirror at the end of a long day. If we fix something clinically interesting that you never cared about, that is a failed treatment.
What your face does when it moves. I will ask you to frown, raise, smile and rest while I watch. Most of the decision is made here.
What your face does when it is still. Volume, projection, shadow, symmetry, skin quality. The structure underneath.
What is realistic in one appointment. Almost nothing good happens in a single long session. I would rather do one thing well, review it, and then decide the next thing with the first result in front of us.
Sometimes the outcome of all that is that neither treatment is the answer yet. We have a whole article on what we will not treat and why, and I mean it.
Which One Should You Start With?
If you are in your late twenties or thirties, your lines only show when you move, and your face still holds its shape at rest, start with anti-wrinkle injections. It is the smaller decision, it is temporary, and if you decide it is not for you, everything returns to baseline in three to four months. Botox at 30 covers the preventative argument and where it is oversold.
If you are in your forties or later, your face looks flatter than it used to, and the lines are visible in a still photograph, start with structure. A millilitre in the right place does more for how rested you look than any amount of muscle relaxation.
If you are somewhere in between and genuinely unsure, book the consultation and do not book a treatment on the same day. Come in, get assessed, take the plan away, and book when you have thought about it. Nobody at Silk will push you to decide on the spot, and what to expect at your first cosmetic appointment sets out exactly how that visit runs.
Frequently Asked Questions
Can I have Botox and filler on the same day?
In different areas, yes, and it is common. In the same area, we usually separate them by two weeks, so that swelling does not obscure the assessment and so that any reaction can be attributed to the right product. Your nurse will tell you which applies to your plan.
Which one looks more obvious?
Filler, generally, because it changes shape rather than movement, and because there is immediate swelling for a few days. Anti-wrinkle injections change nothing about your face at rest for the first three to five days, then soften gradually. If you have an event, plan filler at least two weeks ahead and anti-wrinkle treatment at least two weeks ahead as well.
Does filler stretch the skin over time?
Sensible volumes replacing lost volume do not stretch skin. Repeated overfilling, year after year, in an area that was never that full, is a different matter, and it is one of the main reasons we work conservatively and prefer to add at a review rather than overshoot on the day.
Will anti-wrinkle injections stop working if I use them for years?
For the vast majority of people, no. A small number of people develop antibodies that reduce the response over time, which is uncommon and more associated with high, frequent dosing. Most long-term patients find the opposite: the muscle weakens with reduced use and they need less product, less often, as the years go on.
Is one safer than the other?
Both have strong safety profiles in trained hands, with different risk profiles. Anti-wrinkle injections are prescription medicines and their unwanted effects, such as a heavy brow or an uneven result, are temporary and resolve as the product wears off. Filler carries a rare but serious risk of vascular occlusion, which is why the clinic must keep hyaluronidase on site and have a rehearsed protocol. Ask any clinic that question before you book filler. Treating filler complications explains what that response involves.
What if I want neither and just want better skin?
Then say so. Texture, tone, pigment and laxity are their own category and are better answered with skin treatments, collagen stimulation, or device work than with injectables. A good consultation should be perfectly comfortable ending with a plan that contains no needles at all.
Filed underBotox vs fillerdermal fillersanti-wrinkle injectionscosmetic injectables Christchurch
