Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Botox

Q. I went back to have Botox done on my forehead. I was told after two years without doing any botox, my treatment might not work as well as it did before, as my muscles get stronger as I get older. Is this correct? A. There is no reason that Botox should not be effective following a delay in its use. ​ ​Remember that Botox works at the nerve-muscle level weakening all muscles including the muscles of facial expression. ​ ​During aging, the skin thins and with active use, the muscles do become more apparent. You may require a higher dose at the re-start but with time, the amount of Botox will diminish and plateau for your original needs. ​ ​If you find that the Botox works but the forehead skin does not elevate, it is because with aging, the tethering fibrils from muscle to skin stretch / elongate and the skin slides down despite muscle rebalancing. You may need skin tightening or a surgical brow lift. ​ ​If you are using Botox to reduce wrinkles, the skin crease may not disappear even with Botox functioning correctly due to the more permanent dermal thinning during the time the skin was creasing. Fillers, lasers and retinoids will help here. ​ ​Give the Botox a try and see how it works. Always use a Board Certified Plastic Surgeon or other well experienced Botox injector for your best results and consultation. ​ ​All the best!

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.