What should I have done first: Botox/filler?

Question

I'm 33 and have never had any cosmetic procedures. However I would like to get Botox to dynamic forehead lines (faint lines visible when I raise my eyebrows) and fillers to naso labial folds. As I haven't had anything before I would prefer to get one area treated at a time. Which area should be given priority and what else can be done to appear more youthful? I have quit smoking, and began a skincare regime using a cleaner, toner, BHA exfoliant, serum and moisturiser. What else should I do? Thanks

Mitchel Goldman, MD · Answer

Botox is a great first-line treatment for the early signs of aging. By smoothing out the forehead, you attain a younger look overall. That said, if the nasolabial folds bother you more, then do them first, especially since you can’t see the forehead lines unless you raise your brows. It all comes down to your preference, not someone else’s judgment of you.
The new skincare routine you have plus sun avoidance will keep you looking young for quite some time. I’d suggest adding in a laser treatment to help your skin stay thick and healthy. Please consult a board-certified dermatologist who is an expert in anti-aging techniques.

Kory Kitagawa, MD · Answer

After a healthy lifestyle, great skin care products and sun avoidance, Botox is the first thing I’d recommend for looking younger. Just smoothing out your forehead rejuvenates you by a few years. You might want to start laser therapy every two years or so to encourage your skin to look and act younger. A board-certified dermatologist will help you pick and schedule the best treatments for you.

Julie Forero, DO · Answer

Dear Tannyleics,
Congratulations on quitting smoking!  That is the most important thing you could do for your health, including your skin health.  If you are new to cosmetic procedures, botox is a great place to start, although honestly it doesn't matter which procedure you have done first.  Botox can be very gratifying and if you have botox injected first, you can schedule a 2 week follow-up appointment for a botox touch-up, in case you need it, and have filler injected at the follow up visit.  In regards to the filler, please have a thorough discussion with your dermatologist about your facial structure.  Correcting any volume loss defects in your midface (cheekbone area) may improve the appearance of your nasolabial folds by treating the cause of your nasolabial folds.  Enjoy!

Camille Cash, MD · Answer

I would recommend beginning with the Botox as it relaxes your look, which may influence how you proceed with fillers.  In addition to the skin care regime you have in place, be sure to use sunscreen every day.

Anteneh Roba, MD · Answer

it really doesn’t matter much which procedure you get done first. It all depends on which area you want treated first.

Leonard Grossman, MD · Answer

Ultimately, the decision what procedure to have first should be made by you. Whatever it is you decide to do you first, will be the right choice. If you're having a rough time deciding what to do first simply toss a coin. Good luck for New York City

Mahmood Kara, MD - Account Suspended · Answer

Based on your pictures provided, I am unable to give you a proper assessment. I would recommend consulting a qualified and experienced health professional for a consultation in person. This is the best way to determine what your aesthetic goals are and what procedures would be most appropriate for you. Hope this helps!

Beverly Johnson, MD (retired) · Answer

Once you have the Botox then your appearance improves  so that the creases you may have wanted to fill have softened. I think patients who want or need both should ALWAYS do the botox first for this reason. Wait at least 2 weeks to decide if you still need filler. If you do, there is a good chance that you will need less of it!Hope this helps you,Dr Beverly Johnson

Justin Harper, MD - Account Suspended · Answer

Hi tannyleics, Congratulations on your healthier lifestyle - your skin will love you for it!If you want to prevent the deepening of the lines and formation of more, you would need to prioritize Botox. In fact, it can bring on a more  refreshed and more relaxed look in a matter of days. Changes are very obvious specially if you have a slight brow lift.If you want to have fillers, you can have this procedure together with Botox on a single appointment. Just make sure you have the fillers done first so that there is less chance for Botox to migrate with handling of the face.All the best, Justin Harper, M.D.

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