Can Micro Botox help with my smile lines? (Photos)

Question

When I smile I have very noticeable smile lines that seem to go on forever, can Micro Botox help with this?

Falguni Patel, MD, FACOG · Answer

One of the major uses of Botox are preventing and treating wrinkles around the eyes, also known as crows feet. It works by relaxing the muscles that contract around the eye. By doing this, there is less extreme movement when being expressive. Without Botox, these wrinkles will worsen over time and be visible when your face is at rest. If it's starting to bother you now, starting treatment sooner rather than later will benefit you in the future.

Jason Emer, MD · Answer

At home peels like cosmelan, enlighten and aerify along with dermarolling (see link) should be started now to prevent further aging. 
 
For facial rejuvenation,  I would suggest a combination approach of: 
1) Skin care with products and PRP/microneedling
2) PDT light therapy a 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 V-beam/excel V or BBL forever young treatment every quarter (3-4 months)
 
Best, Dr. Emer.

John L. Burns Jr., MD · Answer

By microbotox, most are referring to a procedure such as AquaGold where botox is mixed with hyaluronic acid filler, saline, and lidocaine for delivery using very superifical microneedling device like AquaGold.  While this does have a beneficial effect on your skin, the effect on the smile lines you are showing would me minimal at best.  For those lines, better options would be superficially placed filler or skin tightening modalities such as Morpheus8 or AccuTite by InMode.

Nelson Lee Novick, MD · Answer

From the photos you appear to have what are known as parallel laugh lines.  Microdroplet Botox, which is injected intradermally in a grid pattern over the area, would likely help to reduce the intensity of these lines with expression without affecting your ability to smile. A less robust filler, such as Belotero Balance, injected in a fanning pattern perpendicular to these lines can also help to reduce motion-related parallel laugh lines. Make sure that you consult with a board certified aesthetic physician and ask to see his/her personal befores and afters prior to agreeing to proceed with treatment. Best of luck.

Camille Cash, MD · Answer

Botox is a great treatment for the crow's feet wrinkles around the eyes.  For the lines around the mouth you will have the best result from a combination of treatments.  You can consider fillers to give support to the tissues and Morphesu8 to improve overall skin tone and texture.  I've included a video I hope you find helpful.

Sergio Verduzco Casillas, MD · Answer

Hello, thanks for your question. You can have excellent results with Botox to erase crow's feet. The toxin relaxes the muscles under the wrinkles, and you'll have soft and juvenile skin. Visit a board-certified doctor in your area specializing in injections to have an exam and determine the dose you need. Good luck!

Dmitriy Schwarzburg, MD · Answer

Botox can't be injected into that muscle group. You may be able to get Secret RF to help with those lines, however it may not help. I would consult with your doctor to see what skin treatments would work for you.

Harold J. Kaplan, MD · Answer

Hello lmetcalf.  You are a candidate for both laser resurfacing and dermal fillers.  Sculptra would be our filler of choice since you are thin and need collagen in this area for it to look good.  Laser resurfacing (see photos at link) can smooth the area and stimulate the production of collagen, but we would only recommend old school full field CO2 or Erbium resurfacing, not fractional.  Best of luck.

Robert T. Buchanan, MD (retired) · Answer

The lines you have are produced by muscles that you should not inject, even with microdroplet method, a method I have used for over 25 years. The problem is that your skin is losing its collagen and elastin, something that starts around 25 years of age, though it may begin earlier. Treatment is adding tretinoin (Retin-A) and Obagi's ELASTIderm to a good skin care regimen. The former stimulates collagen and the latter elastin to stiffen the skin and make it less likely to pleat like yours.

Can Micro Botox help with my smile lines? (Photos)

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