Mary Ruth Buchness, MD

If your doctor is skilled in the cosmetic use of Botox, he/she will know to use a minimal dose, like that used for upper lip "smoker's lines."  It may help your sweating, and if it doesn't, you won't repeat the treatment.  The only people I wouldn't try it on are those who play a reed instrument because it can affect the ability to pucker.

If Sculptra is injected by someone skilled in the technique, and the patient massages the injected area twice daily for at least 5 minutes for one week after injection, bumps will not form.  Sculptra is the longest lasting of the volumizing fillers, with results lasting 2-3 years.  That being said, it is possible to dissolve the hyaluronic acid fillers, such as Juvederm and Restylane, with an enzyme called hyaluronidase.  Many physicians prefer these fillers because they can make them go away if there is a bad result.  I decide which filler to use based on the individual patient and what effect they want.

If you have loose skin on the lower lids, Botox injections for crow's feet can make the skin under the eyes look baggy.  This is usually a problem in older people who could benefit from a lower lid lift, or blepharoplasty.  If you do get this side effect from Botox, it is temporary and will resolve as the effect of the Botox wears off.  Regarding not seeing an effect after 3 days, It can take up to a week for botulinum toxin to take full effect.