Botox™ - Related FAQ's

Q: I have had Juvederm injected into my lip lines for years and before that collagen injections. They work ok, but never perfect. I heard you can also have botox injected into lips. Is this true?

A: Yes. This is an off-label procedure and is used to soften the contraction of the muscle that goes around the mouth that creates an accordion pleating of the skin above it making these vertical lines. Some lines become so narrow and deep that lipstick wanders up the lines during the day (one refers to this as lipstick bleeding into the lines). I inject only one to one and a half units per injection, purposely not diluting the botox as much as some doctors, so that there is less volume needed to be administered per site. There are only four injections across the cutaneous upper lip and bottom lip if needed, so for an upper lip there might be 4 to 6, or at most 8 units, only. I discuss with my patients that they understand there could be a temporary (months until the botox wears off) relaxation of muscle movement that would make it difficult to purse and say certain letters such as "B", "G", "O", "P" and "W" and others, play a reed instrument, sing, and some times the upper lip won't raise as much as usual during smiling so that there is less whites of the teeth showing.

Q: Why can't my friend get the same good result from Botox in her forehead "11" ?

A: The "eleven" of the forehead, or the glabellar frown lines, are a result of three muscle groups and in different people they constitute different masses. Some people have much stronger muscles and need more units of Botox. It is very rare to develop a resistance to Botox and is discussed more than it is truly seen clinically.

Q: If I have had Botox 2 to three times a year for about six years, and now stop, will my lines become deeper than ever before?

A: No. In fact, many people note a better condition of their skin's wrinkles when they stop having Botox for a while. This may be due to a retrained lack of scrunching, frowning, squinting those muscles during facial animation.

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