Botox, Filler, or Skin Treatment? How I Decide
“I just want to look refreshed.” It’s the most common goal patients bring in, and it can point to very different treatments. Some need Botox. Some need filler. Some need a skin treatment. Many need a combination.
Here is the process Candice Roberts, NP, uses at our Houma, LA office to decide between Botox, filler, or skin treatment, starting before you even walk in the door.
The tool comes from the assessment, not the request. Candice gathers your concerns ahead of time through a Future You plan, asks deeper questions at your visit, then does a full facial exam in the same order every time: fine lines and wrinkles first, then volume loss, then skin. That order decides whether Botox, filler, or a skin treatment comes first.
Candice Roberts, NP, on choosing the right tool.
Choosing the Right Tool
“How do we decide basically on what tool to use? That is where the art of the consultation and the assessment really comes in,” Candice says.
“We do a full facial exam, just like if you went to a traditional doctor’s office for a sore throat. They’re doing a full exam on you to assess.”
How the Decision Gets Made
Before your visit: the Future You plan
“Before you even come in, I ask you a bunch of questions, I customize a plan for you, and I send that to you ahead of time,” Candice says. You can request yours with a free Future You plan.
At your visit: going deeper
“We almost do it again to dive a little bit deeper.” These questions get to the root cause of what’s bothering you.
The mirror and the exam
“I always give you the mirror. I start at the top, I work my way down, and I tell you what I see in every area.”
A set order, every time
“First, we typically focus on the fine lines, wrinkles, then we switch more to the volume loss, and then I finalize with the skin. I do this on every patient almost every time.”
Lines, Volume, Skin
Each part of the exam points to a different tool:
| The exam looks at… | Signs Candice notes | Tool it points to |
|---|---|---|
| Fine lines and wrinkles | Lines that deepen with expression | Neurotoxins like Botox |
| Volume loss | Hollowing, flattening, lost support | Dermal filler |
| Skin | Texture, tone, sun damage, breakouts | Skincare, peels, or laser |
Often the answer is more than one. For example, muscle pulling may be treated first with Botox before filler, or skin may come first, as in why skin quality comes before Botox and filler.
“I always give you the mirror. I start at the top, I work my way down, and I tell you what I see in every area.”Candice Roberts, NP
Same Process, Every Patient
Following the same order on every face means nothing gets skipped. A patient focused on a deep fold still gets her skin assessed. A patient focused on dark spots still gets her muscle movement checked. That’s how the plan catches the real cause, not just the obvious one.
It’s also why two patients with the same goal can leave with different plans. More on that in Why Even Twins Get Different Treatment Plans.
Not sure whether you need Botox, filler, or a skin treatment?
Schedule a ConsultationWho May Not Be Ready
This process works for nearly everyone. You may want to wait if:
You’ve already decided on one treatment
We’ll still assess the whole face, and we’ll tell you honestly if a different tool fits better.
You want to skip the exam
The exam is what makes the recommendation accurate. Without it, it’s a guess.
You’re short on time
A thorough consultation takes a little time. It’s worth scheduling when you can be present for it.
You’re pregnant or breastfeeding
Injectables are typically postponed. Skincare guidance is often still available.
Your Questions, Answered
How do you decide between Botox, filler, or skin treatment?
Through a full facial assessment done in the same order every time: fine lines and wrinkles, then volume loss, then skin. Lines from movement point to Botox, lost volume points to filler, and texture or tone point to skin treatments. Many plans combine them.
What is a Future You plan?
It’s a custom plan Candice prepares from your answers to a set of questions before your first visit. You receive it ahead of time, so you arrive already understanding the options and the reasoning.
Why does Candice hand me a mirror?
So you can see exactly what she sees. She walks through each area from the top of your face down and explains what she notices, which makes the plan easier to understand.
Can I get Botox and filler at the same visit?
Sometimes. When the plan clearly calls for both, they may be done together. When it’s unclear how much is muscle and how much is volume, neurotoxin often comes first.
What if I only want one treatment?
That’s okay. Your plan can start with one treatment. We’ll still assess everything so you know what else might help later.
Why would you suggest skincare when I asked about injectables?
Because injectables can’t improve texture, tone, or breakouts. If skin is a big part of what makes you look tired, treating it first can make injectables look better and require less product.
The Right Tool for Your Face.
Start with a free Future You plan, then come see us in Houma. We’ll walk through your face together, mirror in hand.
Prefer to talk first? Call or text 985-247-0115