First I would like to emphasize that true allergy to Botox when used for aesthetic purposes (a process that would involve the development of antibodies against Botox) is exceedingly rare. I have been injecting Botox for cosmetic purposes since 1991 and have personally never seen a documented case. Lack of efficacy is more often due to lack of injector experience, improper placement of the material, or the use of too little material or too dilute a concentration for treating a particular problem.However, in the event that allergy to Botox is believed to play a role in its lack of effect, Xeomin, which is essentially a Botox molecule that has been stripped naked of the potentially allergy-producing proteins that surround it, would be a logical substitute. If, however, switching to another neuromodulator does not produce the desired results, The Nonsurgical 3D Vectoring Crow's Feet Lift offers a viable alternative. Although this approach is best reserved for static folds, it often provides sufficient cheek augmentation in this region to keep the area smoother even when smiling. For more on this ten minute, nonsurgical technique, check out the archives of Realself.com
