Botox®/Dysport/Fillers
The skin of the face and neck develop an aged look due to effects of sun damage, gravity, sleep lines and muscular action. Years of squinting and frowning can leave deep wrinkles between the eyebrows and may extend to the bridge of the nose. These defects also may appear across the forehead and at the corners of the eyes as "crow's feet."
Botox and Dysport are approved by the Food and Drug Administration (FDA) for the treatment of the lines between the eyebrows and also can be effectively used for "off-label" indications in other facial areas. These injections reduce facial lines by temporarily interrupting the connections between the underlying nerves and muscles. With decreased muscular contractions, the overlying skin smoothes, decreasing the appearance of skin creases and preventing new creases from developing.
Injections of Botox or Dysport are done with very small amounts of the toxin at several points along the muscle with a very thin needle. Patients usually notice a clinical effect 1-3 days following injections and the effect maximizes by 1-2 weeks.
Some patients do not respond to injections. Those with lines or wrinkles caused by sun damage and age-related changes are among this group. Some patients may theoretically have neutralizing antibodies in their blood from prior exposure to the toxin that can be present in spoiled food. Secondary non-responders respond initially but lose the response on subsequent injections due to developing antibodies against the toxin.
