Botox & Fillers in Miami. Learn what is Best for You from an Expert. Top-Rated, Double Board Certified Plastic Surgeon


Both Botox and fillers have become staples of rejuvenation. Which one is right for you?

Truth is, each face ages slightly differently and has different needs. Therefore, some patients may benefit from one of them or both. Botox and Fillers work in VERY different ways, and the beneficial effects may be complementary. Both of them are injected, and only work locally (in the sites injected, not elsewhere in the body).

In very simplified terms, Botox is a muscle relaxant. Therefore, it smoothens out the skin in the treated areas, as the underlying muscle decreases (“freezes”) its function. The active Botox molecule is Botulinum toxin A. In contrast, fillers only “fill” the areas where they are injected, such as wrinkles (filling wrinkles) OR restoring volume (filling larger and deeper areas that have sunken with age). Fillers can be made of different materials, but the most used is Hyaluronic Acid by far. HA is a naturally occurring substance. Juvéderm and Restylane are both HA fillers, with a variety of formulations that are designed to target different types of wrinkles.

Are there any alternatives to Botox?

Yes, they are. Dysport, Xeomin, Revance, and Jeuveau are all Botox alternatives. They all work using the same principle, but have minor differences onset of action (time to start seeing the results) and duration.

Do Botox and fillers work right away?

Botox takes approximately 2 weeks to have a full effect. Fillers have immediate results. 

Is Juvéderm or Restylane the same as Botox?

No, as you can see above. They are very different and complimentary in most cases.

Are fillers (Juvéderm, Restylane) and Botox safe?

Yes, they are, and this is one of the reasons they are so popular. Both hyaluronic acid fillers and Botox are FDA-approved for reducing the appearance of wrinkles, fine lines, and folds on the face, and are very safe and effective when administered by experienced medical professionals.

Do celebrities look odd because of too much Botox?

No, this is largely a myth. It is almost impossible to make a face to look ‘odd’, even if applied by inexperienced injectors. On the other hand, fillers can be more problematic if placed incorrectly. In the wrong hands, fillers can make a face look odd, indeed. This is why it is very important to find an experience medical provider.

Can fillers (Juvéderm, Restylane) be reversed:

It depends on the type of filler. Hyaluronic Acid (HA) fillers dissolve with time, although this could be from months to about year and a half. If you are not bothered too much by the looks, you could potentially just wait. On the other hand, if the filler is HA, it can be reversed almost instantly using a medication named Hyaluronidase, which is injected into the area(s) that needs to be treated. This reversal is highly effective and oftentimes referred as filler “depletion” treatment. The reversibility of HA fillers is one of the reasons they are so popular, in addition to its safety profile. Other fillers not as commonly used, including collagen-based fillers, may be permanent and more difficult to remove; therefore, they are less used by practitioners. Based on the above, it is important to find an expert with good credentials to perform your filler treatments.

Can Botox be reversed:

No, it can’t, but fortunately the effects are temporary (about 3 months) and in only very rare cases create problems, which are typically minor.

Which is better, Fillers (Juvederm, Restylane) or Botox?

Both can be good and are, most of the time, complementary. However, people age slightly differently and may have different needs, preferences or priorities. In general, Botox is much better on the forehead and around the eyes to smoothen finer wrinkles, while fillers are typically preferable in the rest of the face, either effacing deeper wrinkles or volumizing areas, such as the lips (lip enhancement or augmentation).

How long do Botox and Fillers last?

Botox typically last 3 months. Hyaluronic acid filler duration vary greatly depending on the filler structure and location of the injection. More mobile areas of the face (e.g. lips) tend to have shorter-lasting effects than areas that have minimal movement (e.g. high cheeks); therefore, duration may last 3 months to sometimes 2 years. Other type of fillers less commonly used (e.g. collagen based, Sculptra), can have permanent or semi-permanent results.

What are Juvéderm Voluma and Juvéderm Ultra?

Both are Hyaluronic Acid fillers manufactured by Allergan (AbbVie), with slightly different characteristics. Voluma is a little bit “thicker” and is placed slightly deeper in the tissues to restore lost facial volume.

Does Juvéderm hurt more than Botox?

Juvederm and Botox are both injectables, meaning that you may experience mild discomfort when the fine needle penetrates the skin. Some patients may experience more discomfort with filler injections as the injectable gel does have a slighlty more dense structure. However, this potential discomfort is prevented or minimized using a topical numbing cream, and the inclusion of lidocaine (anesthetic) in all Juvederm XC fillers. 

Can I use makeup after Botox and Juvederm/Restylane?

Just a few hours after treatment, you will be able to wear makeup as you normally would. We recommend avoiding significant heat exposure (saunas, hot tubs) and high-intensity exercise for approximately 12-72 hours, depending on the specific treatment 

What is the difference in dermal fillers?

Different dermal fillers have different composition and formulations. Juvederm, Restylane, Sculptra, Radiesse, and Belotero are all hyaluronic acid fillers that help stimulate collagen and elastin production in the body. Radiesse is a calcium filler that targets naturally occurring collagen growth at or near the injection site. Sculptra is a proprietary formulation of poly-L-lactic acid, which estimates your skin’s own natural collagen production. Each has their own different durability and treatment is recommended to targeted areas of the face.

What is the difference between Restylane and Juvéderm?

Restylane and Juvéderm are the brand names for two different hyaluronic acid filler families. Both work very efficiently, and have minor differences in profiles, making them work better in some areas than others. For instance, Restylane L’s preferred use is generally to correct the undereye areas. 

Why to choose Dr. Rivera-Serrano as your surgeon and aesthetic provider?

Dr. Rivera-Serrano is among the country’s most highly trained plastic surgeons, having completed two separate residencies (plastic surgery & head & neck surgery / ENT) and two clinical fellowships in some of the most prestigious institutions in North America, Asia & Europe. He is double board certified by accredited bodies recognized by the American Board of Medical Specialties and the Florida Board of Medicine, and has vast surgical experience, having performed thousands of successful surgical cases. Dr. Rivera-Serrano has been a University Professor of Surgery teaching residents on how to perform plastic surgery and knows the intricacies of the field. He is a respected member of the Miami plastic surgery community, an innovator, and author of numerous articles in leading peer-reviewed journals and textbooks. Always aiming for natural results, he knows how to combine artistry with safety. All the above sets him apart as a top surgeon with one of the most comprehensive plastic surgery offerings throughout Miami, South Florida, and Colombia.

"The face is the mirror of the mind, and eyes without speaking confess the secrets of the heart"

When to avoid plastic surgery

  • -You do not have time to recover. In general, for facial surgery, we recommend three months between surgery and a special or social (red carpet) event, as a safety net. However, most people look presentable in normal social situation in three weeks, and oftentimes earlier. For body procedures, recovery can be from a few days (e.g., liposuction) to two to three weeks (tummy tuck or BBL). For most procedures, heavy activity such as exercise should be avoided for 3 weeks.

  • Complications are uncommon. However, they do occasionally happen, and delayed healing cannot be 100% avoided. This timeline is necessary to allow most of the swelling to go away and the results and tissues to appear natural, especially if the surgery is in a visible area.

    – You want a perfect result because you will only be satisfied with perfection, and you know you will not be happy otherwise.

    – You want perfect symmetry.

    – You are taking blood thinners or immunosuppressants for medical conditions.

    -You are a current smoker, or a current passive smoker (or live with a partner that smokes close to you). -You are overweight or obese.  Typically, we recommend not having surgery if your Body Mass Index is above 32-34, with the exception of some liposuction procedures. Use this link to calculate your BMI.

    -You are doing it for someone else or fitting an ideal image.  Plastic surgery is a personal decision, and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

    -If you want to read more about expectations after plastic surgery and possible complications click here.

344 scaled