Is Botox Only Good for Certain Face Wrinkles and Lines?

or does botox injection help with all facial lines and furrows?

Doctor Answers 89

Botox is used for crow's feet, frown lines, and frorehead wrinkles

Botox is used to treat "dynamic" wrinkles in the upper face.  These include the frown lines, forehead creases, and crow's feet.  The frown lines are created as the result of contraction of the corrugatoe and procerus muscles.  This wrinkle is noticed most when squinting.  The forehead creases are the result of contraction of the frontalis muscles and is noticed most by raising the eyebrows.  The crows feet (the area at the outside portion of the eyes) are caused by contracting the orbicularis oculi muscle.  this is noticed most when smiling.

While Botox may be used in expereinced hands in the lower portion of the face and neck, it is best to think of Botox as the primary treatment for use the facial lines and wrinkles in the upper part of the face.

Cincinnati Facial Plastic Surgeon
4.8 out of 5 stars 121 reviews

Botox is great for wrinkles on the forehead and around the eyes

Botox and Dysport work on those wrinkles which are the result of overactivity of certain facial muscles. Much like your favorite pair of pants will be wrinkled if you repeatedly fold them in the same place, the skin wrinkles in areas of repeated folding. I use these products primarily in 3 areas: the horizontal forehead lines, the vertical lines between the eyebrows (frown lines) and the crow's feet around the eyes. Both products work by temporarily relaxing these muscles, reducing or eliminating the presence of wrinkles for approximately 3-4 months. I have found that with repeated use, patients are able to stretch their need for retreatment to 6 months or longer, as you retrain yourself not to repeatedly draw your brows together, for example. 

Other lines, such as the nasolabial folds (parenthesis lines, between the nostrils and the corners of the mouth) are not effectively treated with Botox and Dysport. Fillers such as Restylane, Juvederm, and Radiesse are much more effective for these static wrinkles which are not the result of muscle activity but rather occur with changes in facial volume and skin laxity. 

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Botox reduces wrinkles form muscles

Botox relaxes muscles. Thus Botox reduces wrinkles, that are produced by muscles. The frown lines or "11" between the eyes are an example. After the muscles in this area have been relaxed the lines is the skin also decrease. 

Robert Kasten, MD
Mainz Dermatologic Surgeon

Botox works for most facial wrinkles and lines.

While Botox is most commonly used for glabellar areas (frown lines), forehead lines and crow's feet, it can be used widely for lower face and neck lines in experienced hands. For example, we can use it for bunny lines on the nose,  wrinkles around lip (smoker lines), chin,  lines under eyes, neck bands and neck lines. In addition, we can use Botox for nonsurgical brow-lift or elevation of mouth corners. However, to get the most natural results, addition of dermal fillers are necessary in some cases.

Sherry Li, MD, PhD
New York Dermatologist
5.0 out of 5 stars 1 review

Botox relaxes muscles, and fillers give volume

Thanks for your question. Botox relaxes muscles, so it is particularly good at smoothing out lines around the eyes, eyebrows, and forehead. Injectable fillers, however, give volume and create contours on the face, so they are great at treating lines around the mouth, for example. Botox and fillers should be injected by a certified plastic surgeon or dermatologist; ask for a consultation, and they'll be able to tell you what would give you the best results.

Cory Torgerson, MD, PhD, FRCSC
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 150 reviews

Botox is primarily for upper facial lines and wrinkles

Botox Cosmetic is approved by the FDA for treatment of lines and furrows between the brows. It can be injected in other areas for treating lines but is considered an 'off-label' use.  The most common areas treated are the brow furrows, the crow's feet area around the eyes and the forehead.  It can also be used to treat bunny lines on the bridge of the nose and lines around the lips. Extreme care must be taken when injecting Botox in the cheeks and lower face to avoid weakening the smile muscles.

James McMahan, MD
Columbus Plastic Surgeon
4.8 out of 5 stars 38 reviews

BOTOX® is a relaxer, so it is used to relax muscles which are causing lines

BOTOX® is a relaxer, so it is used to relax muscles which are causing lines; for example, frown lines between the eyebrows, and crow's feet around the eyes.

Fillers are used to fill areas of volume loss, for example permanent creases on the face, and also scars.

Sometimes, for example between the eyebrows, a person will have permanent creases which are made worse by over-activity of the muscles in that area. In this case the best results may come when BOTO® is used to relax the muscles, and a filler like Juvéderm is used to restore volume to the permanent creases in that area.

Kevin C. Smith, MD
Niagara Falls Dermatologic Surgeon
4.7 out of 5 stars 4 reviews

Botox works for wrinkles caused by muscle activity.

Botox is a neuromodilator for wrinkles cause by muscle activity and not to confused with a filler. Therefore, it is best indicated for the frown lines and off-label application for the crows feet, horizontal forehead creases (selective) and rarely for mouth wrinkles, elevation of the corners of the mouth, or treatment of permanent platysmal vertical banding in the neck. 

Peter Schmid, DO, FAACS
Longmont Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Consider how Botox works to determine where to use it.

Botox works by blocking neurotransmitters that cause facial muscles of expression to contract. In other words, Botox (and Dysport, another company's brand name for botulinum toxin) act as muscle paralyzers. If the treated muscle can't contract, it can't make (or worsen) an expression line or furrow. Sometimes the expression lines (like the frown lines between your brows) have been used so much and for so many years that even when the offending muscles are paralyzed, the line is still visible. Here is the time for fillers, like Juvederm or Restylane! (Fillers alone won't work for long, as the active muscles simply push the filler out of the correction site--not a fault of the filler, just the doctor that didn't fully inform the patient, or the patient that only wants to pay for half the proper procedure!)

Any facial muscle that contracts and causes a line can be potentially treated with Botox and paralyzed. Consider that you will probably want to smile, talk, kiss, open your mouth to eat, and animate your face with normal expressions. These areas should generally NOT be injected with muscle paralyzers (especially with ones that can last as long as several months--Botox and Dysport). In certain patients, in special circumstances, with careful and judicious application, and with minimal amounts, use of Botox in areas other than the frown line, around the eyes, or the central forehead is possible. Be careful!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Botox works best on the upper face.

While many areas of facial wrinkles can be treated with Botox, and now Dysport, the upper face tends to give the best results. The frown lines between the eyebrows are the only site specifically approved for use by the FDA, however, the forehead and perioccular areas are also frequently treated "off label".

Since Botox and Dysport stop muscle motion, the wrinkles that the upper facial muscle make are diminished. The lower face is best treated with fillers. Filler can reduce wrinkles, but do not interfere with motion, such as speaking and smiling. If we can't smile, it's not good; if we can't frown, there aren't too many complaints.

Us of Botox and Dysport for brow lifting, lip lines, neck bands and facial asymmetry is also done, but these are less frequently performed procedures, and take a but more skill and experience o do predictably. In other words, it is easier to make a mistake in these areas.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.