New lines can form in some patients using Botox. This is specially seen in patients who have an extremely expressive face. But with an experienced injector most of this can be avoided. Good luck from New York City
Thank you for your question ckpc. I understand your concern. Botox is a purified proteinused to address wrinkles associated with facial expression. When injected intothe skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in theupper face. These include the horizontal lines seen on the upper forehead whenone raises the brows, the vertical lines seen between the brows when one frowns(frown lines), and the crow's feet seen around the eyes when one smiles.A phenomenon seen with Botox is called musclerecruitment and compensation. When a muscle has been relaxed with Botox,sometimes other muscles are recruited and contract when one attempts to makethe facial expression. This serves to compensate for the inability of theprimary muscle to contract. A common example is the bunny lines (caused bycontraction of the nasalis muscle) that are seen on the sides of the upper noseafter treatment with Botox in the glabella or for the crow's feet. Since themuscles in the treated area are relaxed, the nasalis muscle contracts in anattempt to compensate for this loss when one frowns or smiles. In such asituation, the bunny lines can be treated with a small amount of Botox (2-4units per side). In the lower face, compensatory recruitment can occur when theplatysma muscle in the neck contracts after muscles in the lower face have beenrelaxed with Botox. Similarly, this muscle can be relaxed with Botox as well.For my patients, I usually use approximately 10 units per band. If placedproperly it does not affect other muscles. Relaxing the platysma muscle mayalso lead to an improvement of jowls and jawline definition. When suchrecruitment occurs, I recommend prophylactic (preventive) treatment of therecruited muscles at the next treatment.With any injection, there are risks such aspain, bleeding, bruising, redness, swelling, tenderness, and infection. We takespecial precautions to minimize these risks such as using a painless technique.We also treat bruises with a laser as early as the next day. Bruises usuallyresolve within two weeks if untreated. After a laser treatment bruises usuallyresolve in 1-3 days, but may still take two weeks for full resolution.After a Botox treatment, I recommend that mypatients avoid heat exposure, alcohol consumption, and strenuous exercise for24 hours and not lie down flat for four hours. This is because all of theseactivities may possibly lead to the movement of the product and consequent sideeffects such as droopy eyelids as described above. Although there have been nodefinitive studies shown that these actually occur and some physicians do notprovide such aftercare instructions, in the absence of data I err on the sideof caution and recommend that my patients avoid such activities.Please consult with a doctor for specificrecommendations. Good luck!