Myasthenia gravis and Botox alternative other then fillers that are available?

The Miastenia gravis is a contra indication for the use of any Botulinum Toxin in a patient (Botox, Dysport, Xeomeen). But there are many options to treat facial fine lines or wrinkles, like fillers, chemical peels, lasers, skin care products, etc. Please consult with a Board Certified Plastic Surgeon or Dermatologist for more options.

Dear pajarita1,it is hard to tell without an examination. I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

In addition to a thin dermal filler, you may consider (from less to more invasiveness): topical hyaluronic acid, topical retinoid, microneedling alone, microneedline with platelet-rich plasma injection, and laser resurfacing. These can all address facial lines to varying degrees. Good luck. 

Thank you for your question.  I am sorry that Botox will no longer be recommended as a treatment of choice for you; however, there are many options that will help minimize facial lines.  SkinBetter Science offers a facial treatment to target lines. Additionally, I would also suggest a series of lasers from the Co2 to the Genesis Laser, depending on your skin type.  Best wishes

Botox, Xeomin, Dysport and Myobloc are all neuromodulators that would be contraindicated in patients with Myasthenia Gravis.  Your internal medicine doctor wants you to avoid all neuromodulators.  Fillers, lasers, radiofrequency devices and other rejuvenating procedures that do not affect muscle are your choices.  Fillers alone can do wonders for wrinkles.  Consider the new "line fillers" like Refyne and Defyne.  See an experienced medical provider.  All the best.  Alexis Parker MD

Hi pajarita1,There are many positive things you can do for your skin aside from Botox or Fillers. First, you can protect your skin by using sunblock. Do you know that unprotected sun exposure does more damage than chronological aging? You can also use the right skincare - try those with retinoic acid and/or glycolic acids.Best of all, you can still have microneedling, laser therapy or chemical peel. This can make fine wrinkles less visible.I respect your decision not to have fillers - but the best thing you can do is to have a professional assessment.All the best,Justin Harper, M.D. 

Depending what you like to accomplish
Laser can help with skin up to 1 mm depth of skin
Ultherapy can help with skin and muscle tightening 
But if you want to replace fat or collagen you need fillers.
Botox is good for prevention but does not do anything for damaged skin.