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?

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6 answers to “Why doesn't Botox work on my crows...”

A: Botox works on dynamic wrinkles

David Shafer, MD

This is a great question. Botox works by paralyzing the underlying muscles, which prevents the formation of wrinkles by preventing the muscle from bunching up the overlying skin. For mild wrinkles at rest and wrinkles that are only visible when you contract your forehead or orbicularis (the muscle causing... more

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

John E. Gross, MD

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... more

A: You need combination treatment

George J. Beraka, MD

Botox relaxes the muscles, but your lines and folds are probably etched in your skin. In addition to Botox, you probably need to smooth these folds with fillers like Juvederm. If fillers don't help enough, the next thing to try is laser resufacing. This can be either superficial or deep resurfacing and I use... more

A: Botox Can Be Combined With Other Cosmetic Procedures to Achieve Aesthetic Goals

Mark Berkowitz, MD

I agree with Dr. Shafer.  I would add that if you are not ready for surgery speak with your cosmetic surgeon about other less invasive procedures to help diminish these lines.  Besides wrinkle fillers, thermage and  fractional laser skin resurfacing  can help to further diminish these... more

A: Botox relaxes smaller wrinkles

Jordana S. Gilman, MD

Every time we make a movement with the upper face, a crease is made in the skin.  When we are young the crease goes away when we relax the muscle.  Over time that creases get deep, and are visible even when the muscle is relaxed. Your creases may be so deep that simply relaxing the muscle isn't... more

A: Botox by itself may not be the answer for you

Sirish Maddali, MD

It is important to understand (as Dr. Gross said) the difference between wrinkles at rest and while moving. If you still have wrinkles that bother you AFTER Botox, you are not alone. Many patients need combination therapy. The actual combination depends on many factors and a discussion with your treating... more

Comments

Sergey Kalitenko, MD
30 posts
28 Oct 2008

Could be 2 reasons why you are not satisfied: 1. Not enough Botox: some people require up to twice as much as the majority of the patients. 2. Wrinkles may be too deep to be corrected by Botox. Possible solutions: 1. Experiment with number of units of Botox injected to get the optimal response. 2. Use filler to correct the deep wrinkles. 3. Consider wrinkle release procedure. 4. Continue to inject Botox as soon as the effect of the previous injection is gone, because repeated Botox treatments tend to make existing wrinkles less visible. Good luck!

aboutface
14 posts
10 Apr 2009

I've had two treatments that I am not satisfied with. Each provider has given me such huge shots in my frownlines to try and eliminate them, I look like a freak. Hate not being able to lift my brows in the center and would rather have the wrinkles. I think something can be said for getting Botox earlier, before the wrinkles get too deep. If I could do it over again, I would have started 5-6 years earlier.

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