I have never seen a case in which Botox didn't inhibit the muscular motion in the treated area, but I have seen times where the creases in the skin remained the same. Mimetic lines, or wrinkles related to repetitive motion, usually improve with Botox inhibition of muscle movement, but as the lines were created by years of activity, it may take many months to a year of inactivity for the skin creases to improve. This especially occurs when the lines are deep folds. During the time that we are waiting for the skin folds to flatten during successive Botox sessions, a filler can be injected to help lift the crease. The Botox's affect on minimizing muscular action, may increase the longevity of the filler in the area. Usually the filler is Juvederm Ultra (not Ultraplus) or Restylane.
Botox and Dysport are wonder drugs when itr comes to improving DYNAMIC wrinkles. How does it work? The doctor injects small quantities of these drugs and they work as "blockers of muscular receptors" so when the nerve attempts to make the muscle move - it can't. When it can't move - no dynamic wrinkle. If you have a scar, or a very deep fold/wrinkle that is not caused by active muscle function - it will not go away completely or maybe at all. These are called static wrinkles. Most wrinkles of the forehead are dynamic and do resolve with botox.
