Had 2 vials of sculptra 5 weeks apart with the last one about 2 months ago. Is this expected affect of Sculptra/botox? (photo)

Question

I also had Botox to forehead and crows feet two weeks ago. I'm seeing a deep indentation at the side of my eyes when I smile and am wondering if this is normal (I didn't have it before). I'd rather not have a filler that close to my eyes, and I haven't had great experiences with them, but do you think it's the sculptra or the Botox or both that is contributing to this?

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs. It appears that the Botox has likely caused the indentation along the side of the eyes due to paralysis of the muscle in that area.  The overlying skin is no longer folding upon itself to give the wrinkled look but this has had the secondary effect seen in your pictures.  I would advocate for some hyaluronic acid dermal filler placement towards the outer portion of your eyes to help.

Michael I. Echavez, MD · Answer

It is a bit difficult to give you the best advice without examining you but I would say the Botox, rather than the Sculptra, is probably the cause of the changes you are seeing on the sides of your eyes.  Because the muscle is relaxed there, the skin is not bunching up.  This improves the lines but may cause secondary effects that you are seeing.  I would just let the Botox wear off and see if the issue resolves.  The dosage or placement of your Botox injections for the crow's feet may be able to be adjusted to prevent this from occurring again.

Cynthia Stolovitz, MD · Answer

Hi ,
 Where was your Sculptra injected? Sculptra is typically injected in the temples and lateral face .They address deep tissue collagen rebuilding.
Typically Sculptra is not injected in the forehead. It is like a result of the Botox. 
Go back to your injector and discuss.

Richard E. Moore, MD · Answer

Thank you for your question and posting your pictures. The indentation you are noticing is most likely due to the Botox caused by relaxation of the muscles that create the crow's feet but continued movement of the cheeks when smiling. There may be some contribution from the Sculptra if your cheeks are fuller in the plain just below the area of relaxation. That is difficult to assess from the pictures due to the differences in facial expression.I hope this was helpful - Dr. Moore.

Had 2 vials of sculptra 5 weeks apart with the last one about 2 months ago. Is this expected affect of Sculptra/botox? (photo)

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