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Deep glabellar lines are something that have developed over many years of muscular activity. &nbsp;These lines, also known as "frown lines" or "11s", occur due to activity of the procerus and corrugator muscles. In most patients, the dynamic aspect of the lines (i.e., when they get the most noticeable during muscular contraction) can be dramatically improved with a neuromodulator such as&nbsp;Botox, Dysport or Xeomin. &nbsp;But in some patients with really deep static lines (when the face is at rest) even after the neuromodulator is in full effect, a deep line remains. &nbsp;Such patients often benefit from a little filler such as Juvederm Ultra or Restylane...but that area of injection is a bit risky (due to the tenuous blood supply) and should only be injected by an expert. &nbsp;Best of luck!

Glabella lines run in my family and I have had them noticeable from 22 years old, but now one side is a really deep, permanent line causing people to comment if I am upset or angry. Even when I have tried to hold and stretch the skin, the deep line is very noticeable. I am now 51 and really conscious about it. Can anything be done please? In the photo I am nice and relaxed but still it looks like I am frowning!

Can my inherited glabella lines be treated? I am tired of people saying I look permanently upset, even when I am happy? (Photo)

First of all, it would be helpful to see your before pictures to know what you looked like at baseline. But clearly the left eyelid does appear to be drooping (know as an eyelid ptosis). &nbsp;This occurs when some of the product affects one of the muscles that opens your eyelid. &nbsp;The appearance can be improved significantly with eyedrops such as iopidine (which is a prescription medicine). &nbsp;The ptosis is usually self limited and will eventually resolve on its own...in some cases this resolves within 4 weeks and in other cases as long as 3-4 months for complete resolution. &nbsp;The other thing that one can develop after Botox in the forehead is a brow ptosis, where the muscle&nbsp;in the forehead is so weakened by the product that your brow&nbsp;actually drops. &nbsp;This latter problem occurs when too much product is put too low on the forehead, more commonly in older patients. &nbsp;While your brows are a bit low-lying, it seems that this may be your baseline and it also sounds like your provider tried not to go too low on the forehead. &nbsp;In any event, notify your provider, get some eyedrops, and soon you'll be looking and feeling much better!

This is not the first time but I did get a little more this time because I wanted my wrinkles GONE. She was careful not to go too low because my eyebrows are a bit low. Today I woke up with my left eyelid a little droopy. It itches a little so I am not sure if this is botox-related 3 weeks out or something else.

I received botox in my forehead 20 days ago. Could it be affecting my eyelid almost 3 weeks later? (photo)

More than likely you had Botox injected in the area called the glabella (in the muscles known as the procerus and corrugators), which helps with frown lines - this is the 1st place most injectors put Botox. &nbsp;Treatment of this area alone is not enough to get rid of forehead lines...Botox in the forehead is needed for this. &nbsp;&nbsp;I would suggest finding a provider who takes good before and after pictures, who understands your concerns, and who has solid reviews on line. &nbsp;One other note - not everyone is a candidate for Botox in the forehead, so a thorough evaluation of your facial musculature is essential prior to treatment.

After 20 units my face unchanged. I don't have deep lines but my face looks like an accordion when I raise my eyebrows. I am 47 White male.

I had 20 units of Botox but it didn't work. How much more do I need? I'm thinking 30-40.

Ultrasound can be used to establish if a vein on your treated hands is open or clotted...however most often this can be determined with a physical exam. &nbsp;If a vein is hard and non-compressible, it's likely clotted. &nbsp;In any event, there are a number of ways to remove veins on the backs of the hands...or make them look less noticeable. &nbsp;Treatment options include microphlebectomies (taking the veins out through tiny incisions), sclerotherapy or laser ablation. &nbsp;Alternatively, you can mask the appearance of veins by injection of fillers. &nbsp;I'd suggest that you see a vein expert who also does fillers, in order that you have options available for consideration. &nbsp;Hope that helps!

I had sclerotherapy on my hands last year. The doctor in question didn't do a very good job. I realize I am a veiny man, and I can deal with my left hand, but my right hand is not looking so hot. Is there an experienced, compassionate doctor, that could use ultrasound to troubleshoot the problem and target some veins? The ones I want to remove are probably not recommended, and located on my wrist.

Can ultrasound be preformed on hand veins?

In your case fillers would be the best option. &nbsp;I prefer to use hyaluronic acid based fillers to correct this problem...such as Juvederm Ultra Plus or Restylane. &nbsp;Botox can be used adjunctively in some patients to relax a muscle known as depressor anguli oris, but based on your picture I don't believe it will do much...

In the photo you will see that my mouth has a downward turn which makes me looks upset when I am not. I'm trying to determine if it's Botox I need or Juvederm to put the corners in a straighter or ever upward position like shown in the photo on the right. Any answers would be greatly appreciated!

Which do you use to correct a downward turn to the corners of the mouth, Botox or Juvederm? (Photo)

We have veins on both sides of the neck. It is very common to notice veins on one side of the neck more than the other and this is usually not indicative of any sort of problem. &nbsp;The veins that you typically feel or see with the naked eye are the external jugular veins...these become fuller when you're lying on the side of the vein you're trying to feel.

I notice when I lay down on my right side I can feel a vein in my neck,but when I lay on my left side I don't feel a vein on my left side of my neck.

Do we have veins on both sides of our neck,or just on one side?

Vein Treatment

In general, no!!!..unless you're treating totally different areas. &nbsp;After treatment, your skin needs time to recover and heal.&nbsp;&nbsp;ln our practice we space&nbsp;IPL treatments for the face about a month apart. &nbsp; Several treatments are usually needed to achieve desired results. &nbsp;If you were doing IPL treatments "every other day", I would hope you meant that you were treating totally different areas (say face, chest and hands). &nbsp;Even so, you'd run out of areas pretty fast!

Can I get IPL treatment for sun damaged spots every other day? Thank you!

Can I get IPL treatment for sun damaged spots every other day?

Temple veins are treatable. &nbsp;You practitioner must first&nbsp;always make sure it's a vein and not an artery. &nbsp;Assuming it's a vein, there are a number of ways that it can be treated, including sclerotherapy (injections), external laser, and microphlebectomies (taking the vein out through a tiny incision). &nbsp;If you treat this vein, other veins have to take over, so yes they'll be under a bit more "pressure", but veins are low pressure anyways. &nbsp;There are risks associated with each procedure. &nbsp;Sclerotherapy can cause hyperpigmentation in some patients...and there are extremely rare risks of blindness and loss of skin on the forehead&nbsp;&nbsp;(which I have never seen but have been reported)...so it must be done with extreme care by an expert.&nbsp;External laser can cause pigment changes as well. &nbsp;Microphlebectomies can leave tiny scars. &nbsp;Sometimes multiple treatments are needed...and there's always a chance that over time new veins will appear (but if so are usually smaller).

I am 38 years old and I have developed one very prominent dilated temple vein going down across my temple to the corner of my eye. Its about 3 mm in thickness and is prominent when I smile. 1) Can this be safely treated? 2) Would treating or removing this vein put other veins under greater pressure? 3) Will treatment leave any scares? 4) Would treatment cause any risk or concern to my eyesight? 5) Would treatment give permeant results? Thanks in Advance

Dilated Temple Vein. Can this be safely treated?

Prominent veins on the backs of the hands are a cosmetic concern, particularly for women as they get older. &nbsp;There's an expression that you may have heard: "You can tell a woman's age by the appearance of her hands". &nbsp;Well, that doesn't have to be the case - these veins can be either eliminated or masked in several different ways. If it's just the veins you're trying to get rid of (and not trying to also mask the underlying tendons and build volume on the backs of the hands), options include sclerotherapy (injection of the veins), microphlebectomies (taking out the veins through tiny incisions) and endovenous laser ablation (EVLT). &nbsp;On the other hand (no pun intended!), if you'd like to build volume on the backs of the hands to mask the veins and tendons, you should consider dermal fillers just as Radiesse, Juvederm Ultra Plus or Voluma. &nbsp;Keep in mind that if you treat the veins directly, they will no longer be available for IV access should you get sick one day...so hopefully you have good veins in the forearms or antecubital regions that they can access. &nbsp;The veins will still be available should you choose fillers. &nbsp;The downside to fillers is that they are not permanent and depending on the product you choose will last 1-2 years. &nbsp;Hope that helps!

I have horrible thick veins in my hands. Is there any treatment that can eliminate them?

Based not only upon your photos but also your age, I would definitely recommend fillers over a facelift. &nbsp; Facelifts are great but are generally best for older individuals who have considerably more sagging skin than you. &nbsp;The other part about facelifts is they are permanent. &nbsp;Injection of hyaluronic acid fillers, on the other hand, can be reversed with a little hyaluronidase if you're not happy with your results. &nbsp;When in doubt, have a couple of consults before you make any decisions. &nbsp;Best of luck!

I am 43. I want to know if I can hold off on a facelift by getting fillers or if I should go ahead with a facelift to correct sagging.

Facelift or Fillers? (photos)

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