Anti-Wrinkle Injections vs Dermal Fillers: Which Treatment Is Right for You?
A Nurse Practitioner’s Guide to Choosing the Best Option for Your Concerns
With so many aesthetic treatments available today, it’s completely natural to feel unsure about which path is best for your skin goals. Two of the most widely known and frequently misunderstood procedures are anti-wrinkle injections and dermal fillers. Though both are injectable treatments used in facial aesthetics, they function very differently, target different concerns, and follow separate regulatory pathways in the UK.
This article offers a non-promotional, medically informed comparison—so you can better understand what’s involved, how these treatments work, and which one may be appropriate for your needs. Every recommendation made within DA Aesthetics is grounded in clinical knowledge, face-to-face evaluation, and ethical best practice.
What Are Anti-Wrinkle Injections?
Anti-wrinkle injections refer to the use of botulinum toxin type A, a prescription-only medicine used to temporarily relax specific facial muscles. By limiting the movement of these muscles, the treatment helps reduce and prevent dynamic wrinkles—the kind that form during facial expressions like frowning or squinting.
Common areas treated include:
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- Horizontal forehead lines
- Glabellar lines (between the brows)
- Crow’s feet (around the eyes)
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Mechanism of Action: When injected in small, targeted doses, botulinum toxin blocks the release of acetylcholine, a chemical messenger that tells muscles to contract. As the muscle relaxes, the overlying skin appears smoother.
Regulation in the UK: Botulinum toxin is classed as a prescription-only medicine in the UK. As of June 1, 2025, following updated guidance from the Nursing and Midwifery Council (NMC), it is now mandatory that all anti-wrinkle injections are prescribed only after a face-to-face consultation with a qualified prescriber. This includes both new and returning patients.
What Are Dermal Fillers?
Dermal fillers are injectable gels used to restore lost volume, enhance contour, or smooth out deep wrinkles. Most commonly, these products are made from hyaluronic acid (HA)—a naturally occurring sugar molecule that binds water and provides structural support to the skin.
Popular treatment areas include:
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- Cheeks and midface
- Lips
- Nasolabial folds and marionette lines
- Jawline and chin
- Tear troughs (under-eye hollows)
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Mechanism of Action: Unlike anti-wrinkle treatments, dermal fillers work by physically adding volume beneath the skin. This can lift sagging areas, improve contour, or soften the appearance of static wrinkles (lines visible even when the face is at rest).
Regulation in the UK: Hyaluronic acid-based fillers are not classed as prescription-only medicines, but they must be used responsibly within a clinical setting. At DA Aesthetics, all filler treatments are preceded by a full in-person consultation, even if not legally required. Patient safety and realistic expectations always take priority.
How Do These Treatments Compare?
Dissolving with Hyaluronidase
If the filler used is hyaluronic acid-based, I can dissolve it using hyaluronidase—a prescription-only enzyme that breaks down the filler safely and efficiently. This procedure is carried out only after a thorough face-to-face assessment to determine the extent and cause of the migration. At DA Aesthetics, I always review the clinical history, assess the risks and benefits of dissolving, and explain what to expect during and after the reversal. In many cases, a follow-up plan is required to restore facial balance once the filler has been fully broken down.
Observation
Not all cases of suspected filler migration require immediate intervention. In mild cases, particularly where the displacement is subtle or still within the early healing window, we may choose to observe the area. With client consent, I monitor the response over several weeks. If the irregularity persists or becomes more pronounced, we can proceed with dissolving or alternative correction methods.
Rebalancing (Case-by-Case)
In some instances, where the filler has shifted only slightly and no major asymmetry is present, it may be appropriate to rebalance the area using additional small volumes of filler in carefully selected zones. This is not a first-line approach and is only considered after thorough clinical judgment. My priority is always to preserve natural proportions and minimise further risk.
| Feature | Anti-Wrinkle Injections | Dermal Fillers |
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Primary Purpose |
Muscle relaxation |
Volume restoration and contouring |
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Substance |
Botulinum toxin A |
Hyaluronic acid (or similar) |
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Prescription Required? |
Yes – POM |
No – but clinical oversight advised |
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Consultation Type |
Face-to-face required |
In-person advised |
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Duration of Results |
3–4 months |
6–18 months |
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Reversible? |
Wears off naturally |
Can be dissolved (if HA-based) |
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Time to Effectiveness |
3–7 days |
Immediate |
Can I Have Both Treatments Together?
Yes—when clinically appropriate, anti-wrinkle injections and dermal fillers can be used together to address both muscle-related lines and volume loss. However, combination treatments should never be offered as a one-size-fits-all package. At DA Aesthetics, this kind of approach is always based on individual facial assessment and carried out over time to prioritise safety.
How Face-to-Face Consultation Protects You
Anti-wrinkle injections are regulated by law. A qualified prescriber must:
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- Assess your face and movement patterns in person
- Evaluate your medical history
- Discuss risks and benefits
- Create a treatment plan specifically for you
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Remote-only prescribing is not compliant with NMC regulations and places patients at unnecessary risk. Clinics that offer prescription treatments without in-person consultation may be operating outside professional standards.
Considerations for Safety and Risk
No injectable treatment is entirely without risk. The most common side effects include bruising, swelling, or temporary asymmetry. However, more serious complications—such as vascular occlusion with dermal fillers—require immediate recognition and intervention.
That’s why it is essential to choose:
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- A qualified healthcare professional
- A clinic with appropriate emergency protocols
- Practitioners who follow UK aesthetic regulations
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What Results Can You Expect?
Anti-wrinkle injections take several days to show results and are more subtle in their effect. They work best for preventing or softening lines.
Dermal fillers produce immediate changes—ideal for structural concerns like hollow cheeks, a weak chin, or thinning lips. However, results still depend on correct product choice and placement.
At DA Aesthetics, our approach is always to enhance—not transform—your features. Results are tailored to your facial anatomy and long-term goals.
Final Thoughts
The choice between anti-wrinkle injections and dermal fillers isn’t about which is “better”—it’s about which one addresses your concern most effectively.
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- For muscle-related lines: anti-wrinkle treatments are appropriate.
- For loss of volume or facial structure: dermal fillers offer more targeted support.
- In some cases, a combination may work best—but only if done in stages and under proper clinical judgement.
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Frequently Asked Questions (FAQs)
Yes. Under UK law, botulinum toxin is a prescription-only medicine. A face-to-face consultation with a qualified prescriber is legally and ethically required.
Both involve small injections. Most clients tolerate both well, especially with numbing options available for filler procedures.
Yes—if the filler is made from hyaluronic acid, an enzyme called hyaluronidase can dissolve it. This is not possible with anti-wrinkle injections.
No. Both treatments are temporary and require maintenance. Anti-wrinkle effects typically last 3–4 months; fillers may last 6 to 18 months depending on the area and product used.
Yes. Anti-wrinkle treatments target muscle movement, while fillers restore volume and structure. When performed together by a qualified practitioner, they can complement each other beautifully for a refreshed yet subtle appearance.