I usually explain to my patients that the worst thing about botox and dermal fillers such as restylane is that you become a junky. Many times people forget what they looked like before the treatment and when the product is gone and the effects wear off, we get a cruel reminder that it is time to go back for another treatment.
If anything, the effects of both botox and filler can build over time to provide a longer lasting and sometimes permanent improvement.
With subsequent use of botox, the muscles atrophy thereby changing the anatomy improving the wrinkles and bulges of the muscles involved. Additionally, neurological pathways from the brain to these muscles are disturbed, and this subconscious action of muscle flexion becomes "un learned," making it more difficult to produce the lines.
With filler, it has been shown that the act of injection creates a tunneling trauma which leads to scar tissue, thereby improving the "fold" or wrinkle permanently.
Dr. Malouf
