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Is Botox used around the mouth? My wrinkles are the worst in that area, from smoking I assume…

Dr. Dean Kane Q & A Q. Is Botox used around the mouth? My wrinkles are the worst in that area, from smoking I assume….I am 56 and starting to look 66. My husband died of Leukemia 4 years ago, and when that happened, age took over my face. Can Botox help me look a little younger?​ A. ​An in-person consultation is recommended for you to achieve your desired results which may include Botox. ​I am sorry for your loss and certainly the death of a loved one is very stressful. Your photo suggests moderate sun damage and the light hair and blue eyes with thin skin of northern European descent.  Add to this your history of smoking, age the possible peri-menopausal changes occurring at this time are all reasons to note concern over the physical changes in your facial appearance. I am providing a list of non-surgical, minimally invasive and surgical options to review with a Board Certified and well experienced Plastic Surgeon or ENT Facial surgeon or Dermatologist.​ ​Please consider that there are various ways to reduce skin laxity, sun-damage, lines and wrinkles. Each depends on the level of the wrinkle deformity, ie., epidermis, dermis, fat, muscle and skin color. The most popular of the fillers, Restylane and Perlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting “cousin” Juvederm Ultra Plus are similar skin fillers, used to soften and fill the nasolabial (“parentheses”) and marionette folds, the brow (“number 11”) lines and fill and lift the cheeks and lateral brow or chin. Voluma and Lyft are the longest lasting HA fillers, up to 2 years and 1.5 years duration HA. Each one is used to expand, project or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!. Restylane Silk is a wonderful new addition to the filler family. It is thinner and smoothening, particularly for the lines around the mouth and lips. I have also found it useful for the crow’s feet and forehead lines too. Non-surgical facial contouring is possible with fillers such as Radiesse, a bone mineral for the nose or cheeks, jaw and chin as well. Scuptra is the latest of the injectibles stimulation collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent. Botox and Dysport too have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles even around the mouth! Dr. Obagi’s new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin. IPL and fractionated lasers such as CO2 and erbium and now RF (radiofrequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation. ​ ​Face and neck lifting options will improve skin laxity and redrape skin excess but not fully improve skin texture, skin pigmentation and blemishes. All surgical, minimally invasive and non-invasive procedures and their combinations should be discussed following a proper examination with a fully experienced physician who performs all of these options so you will not receive a biased approach because he or she are  limited in their skills.
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