Paul Munsanje, MD

Consider a combination of 4 treatments for this area.

Keep using Botox underneath the eyes and make sure that you are not using too much at the side of the eyes and causing rebound increase in traction by the muscles under the eyes.

A skin booster like Sunekos can improve texture and color underneath the eyes.

Your picture doesn’t show a lot of volume loss but it’s not the best picture so I can’t be sure that you wouldn’t benefit from a small bit of a thin filler under eye filler like for example, Juvéderm, Volbella.

Finally, most medical skin care ranges include an under eye cream with a small amount of retinol.

I used disport for many years and switched to Botox about 10 years ago.

I did not notice any difference whatsoever apart from the packaging, the amount of water it’s mixed with under the units.

One other thing I noticed is people have been more trusting of the Botox brand and because it’s made in Ireland where I practice I’m a little biased so chose it despite the higher cost to my practice.

All fillers attract water and cause swelling. I’m not familiar with the filler that you are describing, but I understand that it’s more difficult to make short chain fillers, like Vycross from juvederm.

Filler does last longer than one year, particularly in areas that don’t move very much. Swelling happens regularly with normal life activities, for example, if you sleep on your front or side, you will typically experience swelling of the face in the morning because of gravity, pulling the fluid downward. Many of my patients have reported fillers being particularly swollen in the mornings during pregnancy, another time of increased swelling.

Hope this helps.

This line looks like something that would be improved by some strong lifting techniques. If placing both fingers on the corners of your jaw and pulling back gets rid of this line, then this is the case. The ways to do this would be with a surgical lift or a non-surgical option like thread lifting or facial filler lift.

There are some great techniques using Vycross Juvéderm fillers that are not as good as surgery but can give enough lift to get rid of a line like this. I think you would be talking about 4 to 6 mls with a good injector.

To know if Botox would be helpful stick out your bottom lip like a sad baby and notice if the corners of your mouth pull down more on that side. If they do, then Botox might help.

Hi Clemie,

Yes Nasolabial folds can be helped with Hyaluronic Acid fillers. I use Juvederm fillers which blend seamlessly with the skin and also contain an anaesthetic.  This is best discussed with a consultation first but treatment can of course be given on the same appointment.

Kind Regards,

Dr Paul