Crepey skin under eyebrows after azzalure for frown lines?

Question

I had azzalure injected for my "elevens" - lines between my eyes - 9'days ago and now the skin below my eyebrows (not eyelids) looks crepey - I'm due for a top up if I need it, what would you suggest? Thank you

Jason Emer, MD · Answer

Keep in mind it can take 1-2 weeks for final results. If at that time, you're unhappy with final results, a touch up of Azzalure and/or venus legacy or thermage treatments can help give improvement. Best, Dr. Emer

Nelson Castillo, MD · Answer

Thank you for sharing your question.  If the Azzalure was placed too high between the brows it may have also affected your frontalis muscle - the muscle that helps elevate your eyebrows.  This can cause the eyebrows to drop a small amount demonstrating some mild excess skin.  Talk to your injector as this may resolve once all of the medication has kicked in by two weeks.  Hope this helps.

Hardik Soni, MD · Answer

Thank you for your question. If the product was placed too high between the brows it could have affected the muscle that helps elevate your eyebrows (frontalis muscle). This can cause your eyebrow to drop a little bit resulting in some excess skin. I recommend having this evaluated by your injector to determine the best treatment plan for you. Best of Luck!

Mark Taylor, MD · Answer

Most individuals with crepey, lax upper eyelids use the frontalis muscles to hold up the loose crepey skin giving them forehead lines.  When Botox, Dysport or Azzalure is used, the frontalis muscles are relaxed and the loose crepey skin looks worse.  A blepharoplasty is usually the best solution unless the eyebrows have dropped naturally with aging and the onset of skin laxity in which case a brow lift may also be useful.

Prashant Murugkar, MD · Answer

Hi thanks for your query, I have had patients where this has happened after the frown lines injection both after botox and azzalure, my observation has been that there is an inherent laxity of the skin between the browns and the lids due to aging or fat loss and the loss of muscle tone after the injection will unmask this laxity. In patients with this potential laxity, I take great care to inject and limit the dosing. I would therefore argue that a top up would not essentially help. Please discuss with your PS. Do keep me posted, warm regards Dr Prashant Murugkar

Michael H. Gold, MD · Answer

Thanks for your question and photos would have been helpful here.  You live outside the US as Azzalure is the name of Dysport outside the US.  Most of the toxin effects with all of the toxins have taken hold at 2 weeks after the injection which is when we usually ask our patients to return for us to determine that everything is what we want or whether we need to do a touch-up or not.  I would go back to your injector at two weeks and see what they can at that time.

Melvin Elson, MD · Answer

The Azzalure may have weakened a lower part of the frontalis and this may be the reason for this, but at 9 days there may be some improvement of the area/ when you go back for the other injection check with your doctor to see what he can do

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