Board Certified in Dermatology
Recommended for: Board Certified in Dermatology +-1
Patient trust score
3 skill endorsements
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Botox is very effective when used for dynamic wrinkles. When it fails to work, it is usually because not enough was used or the botox was expired or stored incorrectly. Very rarely there are patients who develop resistance to botox if they have been using it for a very long time. In this case it is best to use an alternative such as Dysport.
If you have wrinkles present at rest and these lines are due to muscle movement (typically between the brows or horizontal forehead lines), these can be improved significantly by botox. They may not disappear completely if they are present at rest. In addition to botox, a small amount of filler can be used to minimize, even further, the presence of lines at rest. I have found many of my patients to be very satisified with botox alone since they still have a great result and appear more relaxed.
Botox does wonders for crows feet as well as for undereye wrinkles that are caused by excessive movement of the muscles. That being said, if someone has a lot of loose skin under the eyes and crepiness (loss of elasticity, etc), then I typically never treat infra-orbitally and very conservatively (low units) will treat the lateral lines. Sagging of the lower lids is an issue whenever there is skin laxity and needs to be addressed as a potential problem prior to injecting this area. I will often perform a clinical test to determine if there is a lot of lid lag (and therefore too much loss of elasticity) before injecting this area.
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