As a next step, I would give Xeomin a try. If Xeomin works, you'll know that you have developed resistance to Botox and Dysport. If not, then as others have noted, you may want to try a different injector. It is critical to find an experienced injector who is board-certified in one of the core aesthetic specialties (i.e. dermatology, plastic surgery, facial plastics, oculoplastics).
You should always feel comfortable contacting your physician to ask them a question about any treatment that you have received. That being said, I re-evaluate my patients two weeks after Dysport injections to assess their response and satisfaction with treatment. By that time, we will know for sure that the neuromodulator has taken full effect. 70U, however, is a reasonable starting dose for the glabella and forehead in a first-time patient, but everyone is different and you may need more or less depending on your individual anatomy. Best of luck, and follow up with your injecting physician!
Great question! Neuromodulator (i.e. Botox, Dysport, etc.) into the DAO muscle is a relatively inexpensive, non-surgical, and temporary alternative to improve marionette lines. You might consult with a board-certified expert injector to see if this would be sufficient for you prior to trying a surgical alternative. Best of luck!
This is a fantastic question and one about which there is sometimes not even complete agreement by expert dermatologists. I obviously cannot comment about your specific case without more specific information, but I can give you some more general information which may help. 1) Clark's nevus is the old term for dysplastic nevus, which indicates that there were some concerning features noted on biopsy but that the pathologist did not feel that the nevus was a cancer. However, even for non-cancerous moles, sometimes the biopsy is concerning enough that complete removal is warranted. 2) Some dermatopathologists grade dysplastic nevi into mild, moderate, and severe categories, whereas other divide them in a binary fashion (two groups) according to whether or not they feel excision is needed or not. 3) Assessment of nevi is largely based on their overall architecture, which is facilitated by complete removal. Partial evaluation of a mole under the microscope can sometimes be misleading in terms of diagnosis because the complete architecture cannot be evaluated. All that being said, discuss this further with your board-certified dermatologist, and review the full pathology report together with her or him. If you are still conflicted, get a second opinion with another board-certified dermatologist to confirm that you are making the right decision. Best of luck!
Although Botox is not reversible, injections into the lateral brow (often in combination with treatment of the crow's feet, or lateral small lines), can elevate the brow to some degree. This is something to consider. Please seek re-evaluation with your treating physician to discuss your concerns and seek correction, if possible. Best of luck!
