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A procedure to augment and/or medialize the paralyzed vocal fold would be indicated to improve the 81 year old man's speech. Botox has no role in treating vocal fold paralysis. A board-certified laryngologist would be best equipped to address your concerns.
A paralyzed vocal cord is best treated with an implant to move the vocal cord more medially or with a long term filler like Radiesse. Injecting Botox into the vocal cord would make the voice worse, not better, for someone with paralysis. One of the original indications for Radiesse was placement in the vocal cord for someone with paralysis. Spasmodic dysphonia is when the vocal cords are too tense from spasm and Botox relaxes the muscles so they can speak near normal. This was one of the first indications for Botox as well.
Botox will work beautifully to smooth out the wrinkles between your eyebrows. My patients refer to them as the "11 lines" because they look like the number 11. Botox will primarily correct the lines caused when you contract your muscles (dynamic wrinkles). If the lines are present at rest,...
You can smile right away after Botox. Massaging and rubbing the treated areas should be avoided, but smiling will not cause any untoward effects.
You can continue to use your skin care products before and even immediately after your Botox treatment. Botox will not interfere will your skin care routine.
