Botox or hyaluronic acid: what are the differences?

What are the differences between Botox and hyaluronic acid?

	Botox (botulinum toxin)	Hyaluronic acid
Nature of the product	Purified protein, derived from a bacterium	Gel made of a molecule naturally present in the skin
Action	Relaxes the muscle that creates the wrinkle	Fills the wrinkle or restores volume
Wrinkles treated	Expression lines (forehead, frown lines, crow’s feet)	Established or gravity-related wrinkles, volume
Result	From day 3, optimal between day 10 and day 15	Immediate, final within 3 to 4 days
Duration of effect	2 to 6 months	8 to 24 months
Length of session	10 to 15 min	15 to 45 min
Anaesthesia	None, or cream	Cream or local
Social downtime	None	None
If the result is not right	The effect wears off on its own	The gel can be dissolved with hyaluronidase
Price	From €250	From €350 per syringe

What is Botox?

“Botox” is the best-known brand name of botulinum toxin type A, a purified protein that has been used in medicine for more than forty years, particularly in neurology and ophthalmology. Injected in a very small dose into a facial muscle, it temporarily blocks the nerve signal that makes the muscle contract. The muscle relaxes and the wrinkle it creates with each expression fades. The effect is local and reversible: Botox does not fill the wrinkle, it acts on its cause.

It treats:

• forehead lines, frown lines (between the eyebrows) and crow’s feet;
• the tail of the eyebrow, discreetly lifted (“chemical brow lift”);
• neck bands;
• a jaw widened by large masseter muscles, to slim the lower face, and bruxism (clenching or grinding of the teeth);
• excessive sweating of the armpits, hands or feet.

What is hyaluronic acid?

Hyaluronic acid is a molecule naturally present in the skin, which attracts and retains water. Its production decreases with age, as does that of collagen. Injected as an absorbable gel, it fills wrinkles and folds, restores or creates volume and hydrates the skin.

It treats:

• established wrinkles: nasolabial folds, marionette lines, deep frown lines;
• the lips, tear troughs, cheeks and temples;
• the jawline, the chin and the nose;
• the hands.

Which product for which wrinkle?

It all depends on how the wrinkle looks at rest and in movement:

• a wrinkle that only appears with expression (frowning, smiling, raising the forehead) calls for Botox, which relaxes the muscle before the wrinkle becomes permanently etched;
• a wrinkle visible at rest, a fold or a hollow calls for hyaluronic acid, on which Botox would have no effect;
• an expression line that is already marked at rest, such as a long-standing frown line or a deep forehead line, often calls for both: Botox relaxes the muscle, and hyaluronic acid fills the remaining wrinkle.

The choice is made in consultation, after examining the face at rest and in movement.

Can Botox and hyaluronic acid be combined?

Yes, and it is common: Botox acts on muscle contraction, hyaluronic acid on loss of volume. Both can be injected during the same session. Combined over the whole face, they make up the non-surgical mini facelift, an option for anyone not ready for a facelift.

How are the injections carried out?

Both are carried out at the practice, 101 rue d’Antibes in Cannes, after a consultation to examine the face.

• Botox: 10 to 15 minutes, with micro-needles, without anaesthesia or after an anaesthetic cream. Immediate return to social activities; do not massage the injected areas or lie down for 5 hours. A check-up at around day 15 if needed.
• Hyaluronic acid: 15 to 45 minutes, after an anaesthetic cream or local anaesthesia, with a needle or a cannula, using CE-marked products. The consultation before injection is free of charge. Slight swelling may last 2 to 4 days; bruising, which does not always occur, a few days.

In both cases, a touch-up is free of charge if there is an imperfection.

How long does the result last?

• Botox: first effects from day 3, optimal result between day 10 and day 15, effect lasting 2 to 6 months. A session every 4 months in the first year, then every 6 months, maintains the result.
• Hyaluronic acid: immediate result, final within 3 to 4 days, effect lasting 8 to 24 months depending on the product, the area, the skin, age and lifestyle. Injections are repeated on average once a year.

Without repeat treatment, the effect gradually wears off and the face returns to how it looked before, with no “rebound effect”.

What are the side effects and risks?

• Botox: rare, temporary effects — a moderate headache for a few days, slight redness or a small bruise at the injection site, slight asymmetry or temporary drooping of the eyebrow or eyelid, which resolves within a few weeks.
• Hyaluronic acid: temporary bruising and swelling; more rarely, small irregularities or nodules, an inflammatory reaction or infection. In exceptional cases, the product can block a blood vessel: this is an emergency, treated with hyaluronidase, an enzyme that dissolves hyaluronic acid.
• Contraindications: pregnancy and breastfeeding for both; certain neuromuscular diseases for Botox; a skin infection in the area and certain autoimmune diseases for hyaluronic acid.

Choosing a qualified, experienced and reputable surgeon reduces these risks, and may even eliminate some of them.

How much do Botox and hyaluronic acid cost in Cannes?

Injection	Price
Botox, one area (for example frown lines)	€250
Botox, upper third of the face (forehead, frown lines, crow’s feet)	€420
Botox, upper third + neck	€600
Hyaluronic acid, one syringe	from €350
Lips, nose or chin	€350
Tear troughs	€350 to €550
Jawline	€550 to €1,100
Non-surgical mini facelift (Botox + hyaluronic acid)	€1,500 to €2,500

Cosmetic injections are not reimbursed by French national health insurance (Assurance Maladie). Only certain medical indications for botulinum toxin may be, outside the cosmetic setting.

Frequently asked questions