Botulinum toxin and hyaluronic acid are the two most requested injectable treatments in aesthetic medicine worldwide. Many patients confuse them, but they serve entirely different purposes. Understanding when to use each — or when to combine them — is the key to achieving natural, harmonious results.
How Each Treatment Works
Botulinum toxin works by temporarily relaxing the muscles that cause expression lines. It is ideal for dynamic wrinkles — the lines that appear when you frown, smile, or raise your eyebrows. Results begin to appear 3 to 7 days after injection and typically last 4 to 6 months.
Hyaluronic acid, by contrast, is a dermal filler. It is injected to restore lost volume, define facial contours, hydrate from within, or fill in creases and folds. Results are immediate and can last 8 to 18 months depending on the area and product used.
When to Use Each Treatment
- Botulinum toxin: frown lines, crow's feet, forehead lines, subtle brow lift, excessive sweating
- Hyaluronic acid: nasolabial folds, lip enhancement, chin and jawline definition, under-eye hollows, cheek volume restoration
Can They Be Combined?
Not only can they be combined — in many cases it is the most effective strategy. Combining both treatments addresses dynamic wrinkles and volume loss simultaneously, delivering a comprehensive facial rejuvenation that looks natural and balanced. A common protocol is to apply botulinum toxin first and complement with hyaluronic acid two weeks later in the areas that need volume.
Why Physician Expertise Matters
Both botulinum toxin and hyaluronic acid require deep knowledge of facial anatomy. A natural result depends directly on the physician's experience, product selection, and injection technique. At Elyzea in Miraflores, Lima, Dr. Geldres — a board-certified plastic surgeon with extensive experience in facial harmonization — evaluates each case comprehensively to design a personalized plan that respects the natural expressiveness of the face. For international patients, both treatments are available at a fraction of US prices, with the added confidence of physician-only administration.
Book a Free Consultation
Hyaluronic acid in aesthetic medicine — what to expect
Hyaluronic acid (HA) is the most widely used filler material in modern aesthetic medicine. The reasons: it's a naturally occurring substance in human tissue, it produces predictable volume restoration, it can be reversed with hyaluronidase if needed, and modern HA products come in calibrated densities for specific anatomical zones. Lip-specific HA fillers are softer and more flexible; deep-cheek HA fillers are denser and more structural; tear-trough HA fillers are formulated to minimize Tyndall effect (bluish discoloration). Duration varies by product and placement zone — typically 9–18 months for most facial placements. The right HA in the right zone, placed with proper technique, produces natural-looking results that move with the face rather than creating a "filled" appearance.
Neuromodulators (botulinum toxin) at Elyzea
Botulinum toxin type A — including the brand-name product widely searched as "Botox," and equivalent products Dysport, Xeomin, and Jeuveau — is the most-performed aesthetic procedure globally for good reason: it produces predictable, reversible muscle relaxation that softens dynamic lines (forehead, glabellar 11s, crow's feet) and rebalances facial expression. At Elyzea, neuromodulator dosing is calibrated to your specific muscle activity and facial proportions, not to a one-size dose chart. The unit count is transparent at consultation, the brand of toxin used is named (not generic "neurotoxin"), and follow-up at 2 weeks ensures the dosing achieved the intended effect. Lasts 3–4 months; quarterly maintenance is standard.
Why Elyzea is different in Lima
Three things separate Elyzea from most aesthetic-medicine providers operating in Lima and across Latin America. First, we use real, manufacturer-genuine equipment — not the Chinese imitations sold under similar-sounding brand names that flood the regional market. Whether the procedure involves a HIFU platform, a CO₂ laser, a Morpheus8 unit, a picosecond laser, or any other technology, the device is the genuine FDA-cleared (or equivalent) product, with manufacturer service contracts and original consumables. Second, an MD anesthesiologist is on-site for procedures that require it. Topical numbing alone is inadequate for many protocols at the depth or energy that actually delivers results; on-site anesthesia means we can run the protocol as designed without forcing patients to grit through pain or quietly reducing energy mid-procedure. Third, a full clinical setup includes a treatment room, an anesthesia bay with proper emergency equipment, a private recovery room where patients can decompress 30–60 minutes before leaving, and a dispensary that stocks post-procedure care products. Not a single-bed spa room.
For patients flying to Lima from the US, Canada, Europe, or other Latin American countries, this clinical infrastructure is the prerequisite — not a marketing add-on. When you're a medical tourist, you don't have a local primary-care doctor and you don't have family in the same time zone. The clinic itself has to be capable of handling whatever happens during and after the procedure, in real time.
What the free virtual consultation covers
The 45-minute free virtual consultation with Dra. Geldres is the starting point for any treatment plan. We review your goals in detail, your medical history including current medications and skincare routine, photos of the area or concern (taken with consistent lighting), and any prior aesthetic treatments and their outcomes. We then discuss realistic options for your specific case, what each delivers, what each does not, and what a sensible sequence looks like if multiple modalities are appropriate.
For medical-tourism patients, the consultation also covers travel logistics: trip length, hotel recommendations in Miraflores, what to bring, when to arrive relative to the procedure, and what to plan for the recovery window. The goal is that you arrive in Lima with a clear plan and no surprises — and the freedom to redirect or decline anything that isn't right for you. The consultation is genuinely free and does not commit you to anything.
Transparent pricing — no surprises
Every treatment Elyzea offers is published on our public price list (prices.md in the website repository, mirrored on the price pages). The free virtual consultation determines protocol, sessions, and any combination plan; the per-session prices on the public list are what you pay. There are no opaque "personalized quotes" that scale to perceived ability to pay, no pressure-package upsells, and no surprise invoice items at checkout.
Anesthesia tier (topical, nerve block, oral sedation, or conscious IV sedation) is matched to the protocol depth and discussed transparently at consultation. When a treatment is part of a multi-modality plan (HIFU + Morpheus8, fillers + CO₂, etc.), the full cost is mapped out before any commitment. Lima pricing reflects local cost structure — significantly below US clinics for the same FDA-cleared technology — and the public price list ensures the savings actually reach the patient.