West Orange Dermatologists

Botox and Potential Dangers of Platysmal Band Injections?

I'm a 45 year old woman considering botox for platysmal bands but very concerned about swallowing/breathing difficulties reported. However unlikely. I have googled any number of key words, but not been able to find what kind of dosage level the people had who had trouble? And would it be a sensible strategy to have the dosage in two batches - say 20 units one week with another20 the next? To establish that placement of the 1st ok and neither dosage of itself big enough to paralyse esophagus?

Botox injections of platysmal bands can greatly reduce the appearance of vertical neck lines. To decrease the risk of side effects from platysmal band injection with Botox, very small amounts of Botox should be injected per site - approximately 1-2 units every 2 cm of the band.

I would not suggest repeating the injections in a week as full action of Botox may not fully manifest until 2 weeks after injection.

The most important point is that you have the injections performed by a board certified dermatologist or plastic surgeon with training and experience in Botox injections.

Emily Altman, MD

Short Hills Dermatologic Surgeon

Will a Filler Like Radiesse Work to Fill Smile Lines on Cheeks? (photo)

I am in my late 20's and have had Radiesse for treatment of fat loss in my face before (tear troughs/naso labial area), namely as a result of weight loss. I have lines/folds in my cheeks that are prominent when I smile, and have only gotten worse as I've gotten older and lost weight. I have provided pictures. Are these folds/lines in my cheeks something that I could treat with Radiesse, to achieve a smooth cheek when I smile - WITHOUT having chipmunk cheeps when not smiling? Thank you!

Smile lines on the cheeks are usually a result of volume loss in the upper and midface, particularly the temples and the lateral and central upper cheeks.  This volume loss can happen in the bony structures, fat, or soft tissues of the face.  When volume is lost, the skin does not have the support it needs and it descends, forming wrinkles and folds.

The best approach to correcting that is to replenish the volume in the upper and midface.  The increased volume in the upper face will improve the smile lines without giving a chipmunk appearance.  If filler is needed in the lines themselves, it should be significantly less if the upper portions are filled first.

Radiesse or Sculptra would be my revolumizers of choice in this case.

Emily Altman, MD

Short Hills Dermatologic Surgeon

Risks of Fixing Lower Lip with Botox?

Hi there, what are the risks of correcting a crooked lower lip with botox or other procedures. It is not neurological, just a weak muscle on left side, very lax and inherited, 2 relatives have the same thing. most obvious when I speak and smile.

If I understand your question correctly, you are asking if Botox can be injected into the stronger part of the lips to weaken it so that it matches the weaker side.  I would advise great care with this decision because weakness around the mouth/lip muscles and cheek muscles that control the movement of the lips can result in slurred speech, dripping of liquids from the mouth and difficulty smiling on both sides.

And unfortunately Botox cannot be reversed until the body circumvents the blockade of the nerve-muscle communication by the medication, but that may take up to 3-4 months.

Emily Altman, MD

Short Hills Dermatologic Surgeon