Would Botox soften my nasolabial folds and DAO depressions? (photos)

Question

I am a 27F with RBF. My jaw kind of goes straight across to my chin, and despite being a healthy weight, I have a double chin. But what bothers me most of all is my deep nasolabial folds and corner of mouth depressions. With a strong nose, heavy brow, and all of these elements combined, I feel as I look very masculine and unfriendly. While I know Botox is a muscle paralyzer, and won’t help all my issues, would it be able to soften these deep lines?

Randal Haworth, MD, FACS · Answer

Botox can be effective in softening the appearance of nasolabial folds and corner of mouth depressions to some extent, but it is important to keep in mind that Botox is not a complete solution for all the issues you have mentioned.

Nasolabial folds and corner of mouth depressions are often caused by a combination of factors, including loss of skin elasticity, collagen depletion, and repeated facial expressions. Botox can help to relax the muscles in the area and reduce the appearance of wrinkles and folds caused by facial expressions.

However, it is important to note that Botox is not a permanent solution, and the effects typically last for several months before another treatment is needed. Additionally, Botox will not address concerns related to a heavy brow, strong nose, or a double chin. In such cases, other cosmetic treatments or procedures may be more appropriate to address these issues.

It is recommended that you consult with a licensed and experienced cosmetic physician or dermatologist who can evaluate your concerns and recommend the most appropriate treatment plan for you. They can discuss the benefits and limitations of Botox, as well as other treatments that may be suitable for your specific needs and goals.

Best of luck !

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. While Botox can make your jawline slimmer, nasolabial folds generally respond better to filler injections. Hyaluronic acid dermal fillers can be administered to restore volume to the folds and reduce their appearance. A facial fat transfer can also fill and smooth the folds for longer-lasting results. Since you mentioned a double chin as a concern, you may also consider Kybella injections to dissolve submental fat below your chin and create a more contoured jawline. 
I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or expert injector. They will be able to evaluate your concerns and determine the best treatment plan to help you achieve your aesthetic goals.

Jason Emer, MD · Answer

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting,  and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Nelson Lee Novick, MD · Answer

Categorically no Botox for smile lines. This is not done because it can lead to the inability to smile or a crooked smile, at best. The photos demonstrate volume deficit and flattening in the cheeks that is the root of the development of the smile lines and to some extent the marionette lines. HA filler can work very well for these issues in the hands of an experienced, board certified cosmetic dermatology injector. A robust HA filler can not only restore a smoother and more pleasing transition between the lower lid and upper cheek region, but will diminish the smile lines. Additional robust HA filler properly injected at the angles of the mouth can elevate and straighten this area and thereby diminish the marionette lines. Hope this helps. Best of luck.

Camille Cash, MD · Answer

Based on your photos and list of concerns you are likely to have the best result from a combination of treatments.  Botox can be used to help soften the appearance of dynamic wrinkles.  Fillers can add volume and improve facial contours.  Morpheus8 treatments can improve overall skin tone and texture.  I recommend visiting an expert injector near you to learn more.

Leonard Grossman, MD · Answer

Your appearance is primarily based on your father’s anatomy of the face. With your cheeks, being somewhat flat and lacking, the apple, that is normally seen in a woman. The upper eyelids and lower eyelids are rather hollow and are also lacking fat. This can easily be treated with a procedure called fat grafting. When fat grafting is performed by a plastic surgeon with a lot of experience in such techniques, the results are absolutely natural and practically permanent. I hope this helps and good luck from New York City Plastic Surgery.

Brooke R. Seckel, MD, FACS (retired) · Answer

Low doses of Botox can certainly help the marionette lines by reducing the contraction of the DAO muscles.

However I would not utilize Botox to reduce the nasolabial fold lines as this would create a paralysis of the corner of the mouth.

In my experience the most effective method for reducing nasolabial fold lines is restoration of volume to the midface in the zygoma region.  Typically a full cc of a dermal filler on each side in the zygoma starting from the nose and migrating out to the High Point of the cheek can be very helpful.

Would Botox soften my nasolabial folds and DAO depressions? (photos)

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