Joel Caschette MD

Molemarvel, Botox stops muscles of expression from moving. These muscles cause “lines in motion”, or dynamic lines. As a result, Botox stops the “lines in motion” from showing up. The static lines, or “lines at rest” that you are describing, do not improve with Botox. Treatment with Botox will not “completely eliminate” these lines. You wrote: “sure, when I smile, they look less”. This is Botox working as it should- to decrease lines in motion. You also wrote: “…my last stint it would either seem that the dr was very stingy with the product or I am building up an intolerance…” It’s impossible for me to know how much was injected by your practitioner. However, assuming the dosing was appropriate, there have been reports of development of antibodies to Botox, which can result in decreased or no effect. This is rare, and, as a Cosmetic Medicine specialist, I have never seen this happen. Remember- It’s Your Face! Make sure to talk with a trusted and experienced Medical Doctor about Botox injections. Nothing guarantees good results, but treatment by a knowledgeable Doctor maximizes chances of great results. Best Wishes, Joel G. Caschette, M.D. Medical Director Visage Medical Skin Care www.visagemedicalspa.com 14271 Metropolis Avenue Unit B Fort Myers, FL 33912 2311 Santa Barbara Boulevard Unit 114 The Shoppes at Santa Barbara Cape Coral, FL 33991

Intense Pulsed Light, also called IPL, BBL and Photo Facial, mainly helps to get rid of brown spots (age spots, liver spots) and red spots (small red spots, small veins). The “browns” get browner temporarily, then rise to the surface and fall off within about 10 days time. The reds may look a darker red or grey color after treatment. Often they are deeper down and are made of blood vessels, which are more complex structures than brown spots. They do not rise to the surface. Instead, they get reabsorbed by our bodies after IPL treatment over several weeks. I recommend applying sunblock (SPF 30 or higher) and moisturizer twice a day for the first week after treatment, and at least once a day the second week after treatment. This is even if you’re not out in the sun! Minimizing sun exposure after treatment is best- red and brown spots usually are caused by sun damage in the first place. If you have to be in the sun, use SPF 30+ sunblock, and reapply every 2 hours.