Most patients do not arrive knowing which injectable they need. They describe what they notice: “I look tired,” “This line makes me look angry,” or “My face feels heavier than it used to.”
Those descriptions are useful starting points. My job is to understand what is creating the concern before recommending a treatment.
Botox and filler do different jobs. Sometimes one is appropriate, sometimes both can help, and sometimes neither addresses the main issue.
When muscle movement is the concern
Botox and similar wrinkle-relaxing injections temporarily reduce selected muscle activity. They can soften lines associated with frowning, squinting, or raising the eyebrows.
I assess your face at rest and in motion, including how your muscles support the position of your brows and influence expression.
A line that remains visible at rest does not automatically need filler. It may involve established skin folding, sun damage, or another factor that requires a different approach.
When volume or contour is the concern
Filler may help when an appropriate change in volume, projection, or contour would address the problem.
Examples can include selected concerns involving the cheeks, chin, lips, or other areas, depending on the product and your anatomy.
However, fullness is not the same as support in every situation. Adding filler to an area affected primarily by laxity or tissue descent may create bulk without producing the improvement you want.
When a combination makes sense
Some patients have separate concerns that respond to different treatments.
For example, wrinkle-relaxing injections may address frown lines while carefully selected filler improves an unrelated contour concern. The treatments should each have a clear purpose.
A combination is not inherently more natural or more effective than a single procedure. We can stage treatment and assess the first change before deciding whether another step is worthwhile.
When I recommend another approach
Texture, discoloration, dryness, and scarring may respond better to skincare or a procedure directed at skin quality.
Significant loose skin or a desired change beyond the limits of injectables may warrant a surgical consultation.
Sometimes the most useful recommendation is to maintain what is working or leave a feature alone.
Timing and existing treatments matter
Tell me about previous injectables, what was used, and where it was placed whenever possible.
We also discuss upcoming events, recovery time, medications, and medical history. A rushed timeline can change whether treatment is appropriate now, even when the procedure might otherwise suit you.
Understand the risks
Wrinkle-relaxing injections can cause bruising, headache, asymmetry, and eyelid or brow drooping, among other adverse effects.
Filler can cause swelling, bruising, infection, and uncommon but serious vascular complications involving tissue injury, vision loss, or stroke.
The consultation should make these risks understandable without implying that a careful technique eliminates them.
How we decide at Modern Aesthetics
At Modern Aesthetics in San Jose, I assess your anatomy, movement, skin, treatment history, and goals. I explain what I recommend, what improvement is realistic, and what I would not treat.
Schedule a consultation to discuss your concerns. You do not need to choose a procedure before we meet.
Updated October 23, 2026.