Thank you for your question.
You submitted your question without a photo and you’re basically describing a situation
where you’re away from home, you’ve had a rhinoplasty where there was hump reduction
as well as some tip surgery for a bulbous tip.
And you are asking, is 6 days too early to get Botox® for crow’s feet lines and forehead
lines.And you are stating that you are now day 2 and that your eyes are fairly swollen.
Well, I can certainly share with you how I would advise any patient who comes to me with
a comparable situation and how I guide my patients who I operate on as to timing to
an injectable procedure like Botox®.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
I belong to the first group of doctors to use Botox®.
I’ve been using it for my patients since 1993.
And so, I have a lot of experience with helping people with Botox®.
So to answer your question, I would say that the better question to ask is this the optimal
situation to get Botox®.
Now the question of whether or not you can or cannot do something is dictated after a
surgical procedure like you’ve undergone.
And you state that you had significant swelling around your eyes.
Well, Botox® is really not a filler.
It’s a neurotoxin.
And what that means is that you need the toxin to be placed in a way that the nerves that
go to the muscle that is causing the wrinkles to occur is effectively delivered.
This is in contrast to a filler.
So for example, if we use a filler like a hyaluronic acid filler to treat under eye
hollows or tear trough, if a person is swollen, then that procedure becomes difficult because
you cannot really appreciate the contour improvement when there is swelling.
So I would typically wait until some swelling related to whatever it was, whether it’s
surgery or whether it’s allergies or anything else, to get the optimal orientation.
Now, when it comes to Botox®, what I would be concerned about, I’ll start first with
the crow’s feet areas since your eyes are swollen, I would be somewhat concerned about
the dilution of the Botox® in the area of swelling because the fluid and the dosage
could interact in any way that you might not get the full benefit.
It is important to see how swollen you are at day 6.
And more than likely, you would probably be safe enough to do as long as you don't have
significant swelling.
And in terms of the relative swelling, the doses for Botox® for the crow’s feet lines
is relatively low and therefore a problem also with migration which is another issue
of the Botox® to another area is relatively small.
But if the Botox® floats down to the muscles that are responsible for facial expression,
based on the dosages are not likely to be an issue but again, you have to ask yourself,
is it really worthwhile to have the possibility of either a diluted effect or a potential
migration away from the target?
When it comes to the forehead, I suspect again that if you don't have much forehead swelling,
then chances are, you should be probably okay to do that.
I think that it will be okay for your doctor to ultimately decide if they are comfortable
with doing the Botox® for you.
Most of the time, it’s really the clinical scenario that dictates when we do anything
in this field.
And understanding that there’s a lot of swelling or significant swelling then it’s
suboptimal for whether it’s a Botox® or whether it’s an injectable filler.
You want to work with maximal predictability.
I don't think that there’s really much of a loss of opportunity if you are doing this
at a place where you traveled for surgery, to then come back to where you live and get
the Botox® procedure done more locally.
So I hope that was helpful, I wish you the best of luck and thank you for your question.