Will a deep laser peel make Botox and Juvederm less effective?

I like Dr. Sinclair's very frank answer. I was kept from getting a touch-up of Restylane around my lip and chin area before my Fraxel Re:Pair because it was just short of the eight week cut-off date my doctor requires before Fraxel procedures. I was told by an assistant in the doctor's office that the laser would go so deep that the filler would be removed if done too close to the procedure! It turned out that my procedure was delayed, and I could have gotten the touch-up anyway. I was annoyed because I feel that I would have started at a better place than I did had I been up to date on my line filler. I think that the doctor was just avoiding extra factors that might or might not affect the outcome of the Fraxel Re:pair. But I was apparently given misinformation as an explanation as to why he has that cut-off time!

In our experience, this is not a problem inasmuch as Botox is placed in the muscle, and fillers are placed below the level where a laser peel does not reach. However, we generally ask patients to wait 1 week  between injectables and laser peels. If we are using non-ablative lasers (unlike a laser peel) we do the laser treatment first, followed by the injectable treatment. 

Botox effects the muscles, not the skin. Shortly after a Botox injection, the Botox disappears entirely; only the effect of the Botox remains. Fillers are usually injected deeper than the depth of a laser peel so it is not likely that a laser peel will do anything to a derma filler. Having said that, talking about the depth of a laser peel in "layers" is nonsense. The depth of laser peel is measured in microns or millmeters, not layers. Not even experts all agree on what constitutes a layer when it comes to skin! In short, it goes like this: Skin is composed of an outer layer called the epidermis and a deeper layer called the dermis. But... there are two types of skin, thick and thin. Thick skin is present on the palm of the hand and the sole of the foot. The skin everywhere else is thin skin. The epidermis of thick skin is composed of five layers (from the outside in): stratum corneum stratum lucidum stratum granulosum stratum spinosum stratum basale Some people combine number 4 and 5 as a single entity, called the Malpighian layer, which would make the epidermis have 4 layers rather than 5. The epidermis of thin skin is composed of three layers (from the outside in): stratum corneum stratum spinosum stratum basale Some people combine number 2 and 3 into a single layer called the Malpighian layer, which would make epidermis have 2 layers rather than 3. The dermis itself also has two layers (from the outside in): the papillary layer the reticular layer Then again, some folks divide the layers into 4 layers such as Skin Fat Muscle Bone If you went down "3 layers" in this scenario, you would be down to bone! NOT GOOD!! Anyway, now you know more than most of the world about skin layers!