What can I expect from Botox? I plan on having my forehead done. What can I do to make sure I get the most benefit?

shutterstock_77039506 Question from Tacoma WA: I find that I have a pretty pronounced from in by brow/forehead especially between my eyes, will Botox tighten it up or just freeze the movement? I am hoping for a smooth appearance in the outcome. Should I add the eye area, too? How long after the injection until I have full results? Hours or days? Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers: Most patients begin with Botox Cosmetic between the eyebrows to reduce the production of the “11’s”.  Following years of forming these “11’s”, permanent creasing appears in the dermal skin where the skin folds which is not improved by Botox. For these patients, like it appears in your photos, you may need a filler. Hyaluronic acid fillers will raise and fill the skin to a more even and smoother level. ​ ​Botox also raises the middle part of the eyebrow upward and outward creating for some, a surprised-look. This appearance is counter-balanced by the recent approval of Botox by the FDA for use in the “crow’s feet” or lateral brow area to relax these muscle-made folds and lines with the advantage of raising the lateral eyebrow and reducing the natural hooding in this area. ​ ​You can expect initial relaxation of muscles with Botox in 5 days and maximum improvement (using the correct amount of Botox) in 10-14 days. My recommendation is to wait the 2 weeks prior to injecting filler for your best results as any residual muscle movement will squeeze the filler away. Your filler injection should provide near instant gratification with swelling and softening over the next 3 days to 3 weeks. ​ ​There are many unqualified and poorly experienced injectors in the medical community. Be wise and select a board certified, well experienced “core” injector (ie, plastic surgeon, ENT, Dermatologist, ophthalmologist) who understands the muscle anatomy and re-balancing techniques of injecting this and other muscle relaxers. ​ ​I hope this was helpful! All the best!   Dr. Dean Kane www.DrDeanKane.com DeanKane@DrDeanKane.com 410-602-3322
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