Thank you for the question. You’re 38-years-old and you are asking if you can make a significant
improvement in the static lines between your eyes which are by using Botox™ alone. And
you state in your question that is it possible to make a significant difference over years
without using fillers which you are aware are beneficial for static lines.
Well, I can certainly give you my perspective on this question. I’m a Board-certified
cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve
been practicing in Manhattan and Long Island for over 20 years and I was one of the first
groups of doctors who used Botox™ back in the mid 90’s. And so this question is very
relevant and it has a place in terms of what kind of effect it will have in relevance to
your question. So in the absence of your photo, it will be a little bit difficult to answer
your question and in the absence of a physical exam but I will give you some idea about what
the effect of Botox™ is on these lines.
So to begin with, let’s be clear on definitions. Dynamic lines are lines that occur when you
activate muscle. So when you frown, which you are describing, you are describing frown
lines that, with repetitive actions on the muscle caused an etching of the skin and those
lines are referred to as static lines. Now static lines are there at rest which means
even when you are relaxed and you are not frowning, those lines are present.
So from my perspective, when someone like you comes, yes when I look at someone, I always
think of a global approach to help them see an improvement because the challenge is, when
it comes to these frown lines often referred to as number 11 lines, people have an objection
to them and want to do something about them is because they always appear to be angry.
And so, if you think about it, if the Botox™ is used and you relaxed the muscles and the
static lines are still present, you may still give the perception or create the impression
that you are angry.
Now the fact that you are willing to be patient and wait over years is definitely meaningful.
There is no question that with continuous use of a neurotoxin, Botox™, Dysport, Xeomin,
anything that relaxes the muscle then the skin is no longer being creased and those
lines can soften. So to answer your question, it’s likely that you will benefit from just
using Botox™ alone but there is some exception to that. As you get older, genetically, you
are going to lose collagen, you are going to lose fat volume, you are going to lose
soft tissue volume and this area can still become deeper. So a lot of times, in my practice,
what I tell my patients is Botox™ will be your first step. Let’s see how you do with
Botox™ and do it consistently. Typically people come for Botox™ injections around
every 4 months. You do those injections and you stay consistently with it and see how
things look.
When you talk about these layers of skin, there is opportunity to do other things that
maybe you are concerned about that can be an alternative. For example, we use platelet-rich
plasma (PRP) in our practice to build up collagen in the dermis so this is technically not a
filler in a traditional sense of the word because this is derived from your own blood,
using your own blood and using the growth factors that are necessary for wound healing
that stimulates collagen is often an alternative that a lot of our patients really embrace
because they like the idea it is natural. In terms of other options for this area or
other areas of the face, you can consider non-ablative or ablative lasers. These are
things that are all part of the many solutions that are available to you that you can work
with your doctors to customize.
In the meantime, I think it is safe for you to at least move forward. A lot of times people
want to figure out everything they need before they go to the doctor and they do a lot of
research and the reality is that there are so many options and so many opinions and it’s
very hard for a person who is not a physician and who is in this field to really be able
to come up with the game plan that is likely to succeed for them. And in fact, you’ll
go to different doctors and you will get different opinions. So it is optimal for you to meet
with doctors and find the doctor that you are comfortable with because it really makes
a difference for a doctor who gets to know you, know your skin and know what works for
you and have records of your photography and show you how you’ve been progressing over
time. And so, this is something that, I think you are off to a good start because you’ve
learned a lot and thought this through but start by seeing how this works out for you.
If you feel that after a certain amount of time you want to do something more, there
are additional options for you.
So I hope that was helpful, I wish you the best of luck and thank you for your question!