Deep/etched wrinkle still present after Botox (Photo)

at home peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, see link) should be started now to prevent further aging. in office you need more than MNRF, everyone should be getting laser every 3-4 months, botox every 2-3 months ,and peels monthly with facials. botox doesnt get rid of all lines it prevents them from coming long term.

For facial rejuvenation, I would suggest a combination approach of
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Botox is best reserved for treating motion-related wrinkles, such as for the crow's feet when smiling; eleven lines when frowning; and for the worry lines on the forehead when the eyebrows are raised. After years of movement, motion-lines, such as the horizontal lines on the forehead can become "etched" into the skin so that they remain present, as in the case, when the forehead is at rest (i.e. a "static" wrinkle).. In this case, the ideal follow-up treatment to Botox is to use a filler to elevate and smooth the etched-in depression, so that it is much less prominent when the area is at rest. Microneedling is best reserved for very superficial, surface irregularities and less effective for actual wrinkles. And RF is more "bells and whistles" with a lot less hard science and a whole lot more marketing hype to support its use. Make sure that you consult with a board certified cosmetic dermatologist and be sure to ask him/her to show you personal befores and afters before agreeing to proceed. Best of luck.