Botox relaxes the underlying muscle. Fixed wrinkles may not improve.

John E. Gross, MD answers: Why doesn't Botox work on my crows lines?

I have had five atempts at botox for the crows lines around my eyes, my brow and a very distinct lateral line above my nose (forehead area) but it does not seem to work. My crows feet were slightly lessened, by forehead wrinkles still wrinkled to a lesser amount but still noticable and the vertical line is still very prominent. I have been to two different doctors but the results are still very poor.

Why is this?


John E. Gross, MD
13 months ago

It is useful to think of dynamic (from movement or when the muscle functions) and static (at rest) wrinkles or lines. Botox will diminish the function of the underlying muscle and improve those lines or wrinkles that result from the muscle contracting. If thre is a fixed line when the muscle is at rest, then it may not be improved with Botox.

But there are other options that may help. In our youth when our facial muscles function, a line or wrinkle may is created, but it goes away when the muscle returned to rest. As we age, our skin thins, the amount of collagen and elastin in the dermis diminishes, and lines or wrinkles persist even when the underlying muscle is relaxed.

You can improve the quality of the skin and diminish fine lines in a number of ways.  An experienced aesthetic surgeon can make recommendations. They may suggest medical grade skin care, light or laser based treatments. There are a number of ways to encourage our skin to replenish what is lost with time and aging.

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