Permanent option to Botox? (Photo)

Question

The first 2 photos are before Botox and the last photo is after 2 Botox sessions (3 months apart). Botox def softened the lines but I see them coming back every 2-3 months. Is there something else I can do in addition to Botox to possibly stop these deep forehead creases from coming back so strong? Is Botox safe to perform long-term? I’m in early 50s but don’t want to inject Botox for the rest of my life. Any suggestions for possibly a more permanent solution?

Jill Hessler, MD · Answer

Botox is one of the best treatments for upper face and forehead lines and I would say there is not really any comparable permanent alternative. 
If you have really low brows or a significant amount of upper eyelid skin then an upper blepharoplasty and/or brow lift and indirectly help with the facial lines. Although these surgeries do not replace the effects of Botox.

Nelson Lee Novick, MD · Answer

There are two components to most facial wrinkles; the dynamic component, i.e. the movement of the muscles below the skin that lead to scrunching and pleating of the skin above and a static component, i.e. the creases etched into the skin after years of repeated movement of the muscles of facial expression. To address this, a neuromodulator, such as Dysport, Botox or Xeomin, when injected properly, can quiet the underlying muscle--i.e. address the underlying cause of the wrinkles (in this case the horizontal "worry" lines) and following that an appropriate filler can be used to elevate and smooth the creases that have been etched in after years of daily muscular movement. One way to possibly prolong the effects of the Botox would be to undergo an initial series of treatment sessions, usually between three and four sessions spaced at a fixed four month intervals (regardless of whether there has beenreturn of the wrinkles or not). Once this cycle is completed, many people have such prolonged responses that many fewer subsequent treatment sessions are required. I suffered from the same problem as here, and following my four treatment sessions (given to myself every four months), I have been going about 18-24 months before needing to retreat myself. I wouldn't suggest permanent fillers, as these can translate into permanent complications that may begin five, ten or even twenty+ years later. Subcision would be a possible add-on for achieving more lasting improvements. You would be wise to make sure to consult with an experienced board certified cosmetic dermatologist injector. Hope this helps and best of luck

The Aesthetic Edit ATX - Cedar Park · Answer

Hi Jim! Congratulations your Botox results look amazing! With that said Botox typically only lasts 3 months and it is typical to see movement start to return around 2 1/2 months. The only way to increase longevity is to increase the dosage however this is not always advised because it can cause unwanted aesthetic outcomes. There really is no "permanent" solution. We often encourage our patients to pair their botox with device work medical grade skincare which will increase the collagen in their skin and decrease the static lines.

Camille Cash, MD · Answer

Botox works by affecting the ability of the injected muscle to contract, softening the appearance of lines and wrinkles.  It is safe to use long term.  In addition to Botox you can consider Morpheus8 treatments to improve skin tone and texture.  We also recommend using medical grade skin care products like Transform MD, and wearing sunscreen every day.

Robert Rampton, DO · Answer

Botox is safe long term. Other things that you can do are using physical blocker (sunscreen) to prevent further degradation of elastic fibers within the dermis. Daily moisturizers help with fine lines. Laser resurfacing would help with deeper lines and smooth out appearance.

Beauty Bar - Ooltewah · Answer

Hi!You've had wonderful improvement thus far with your Botox treatments! The lines have softened substantially. Once these lines form from repetitive facial expressions, it is difficult to completely get them to go away. The benefit of continuing your Botox treatments would be to prevent new lines from forming and softening these existing lines even more. I would also recommend radiofrequency microneedling, this will improve your skin texture and boost collagen production. This is performed as a series, normally 3-4 starting out, 4-6 weeks apart. I hope this helps!Thank you!

Oakville Plastic Surgery &amp; Medspa · Answer

There really are not alternatives to using botox. Sometimes a different brand of neuromodulator can last longer in certain individuals. I do not find there is a one-size-fits all consistency with this to say that one brand is better for all my clients across the board. Regarding the safety of botox, I can comment that I have personally used it for 10 years with no health issues and also have many clients who have used it much longer.

Leonard Grossman, MD · Answer

Botox, generally lasts anywhere from 2 to 4 months. There are exceptions to the rule in some patients it can last over a year from a single treatment, but that depends on the individual whose antibodies breakdown Botox. What you can do is try different alternative such as Xeomin, Juveau or dysport. This way you will know which product last longer in your case. Also, you need to find a reputable Plastic Surgeon, who does not overdilute the product which needs some dilution in order to reconstitute it. I hope this helps and good luck from New York City Plastic Surgery.

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