Kenji Matsuhara recently asked:


Which wrinkles and lines bother you the most? Are these lines and wrinkles the type that are best eliminated using Botox?

If you choose to eliminate only the wrinkles that can be treated with Botox, will any of the remaining ones still leave you unsatisfied with your appearance? For example, if you want both your frown lines and marionette lines removed, you will likely need a different cosmetic procedure to have the marionette lines eliminated.

It should point out that Botox injections work best on crow’s-feet (wrinkles radiating from the outside corners of the eyes), worry lines (horizontal forehead lines), and frown lines (vertical lines, also called glabellar lines, that appear be­tween the eyebrows). These are wrinkles that are typically caused by chronic contractions of the muscles under or adjacent to these areas of the face. Laughing, smiling, frowning, and squinting are some of the common facial expressions that can cause these lines. If you have lines and wrinkles on other parts of your face that concern you, you may need other types of cosmetic procedures to eliminate them. With that in mind, consider these questions:

Which wrinkles and lines bother you the most? Are these lines and wrinkles the type that are best eliminated using Botox?

The followings are the types of lines and wrinkles:

From the top of your face down, bothersome facial wrinkles have the following names and locations. Notice that Botox is not the best choice for all types of wrinkles and lines.

Forehead lines: horizontal lines, often called worry lines. These lines form mainly because the underlying frontalis muscle, which stretches across the forehead, moves when you make facial expressions. When you lift your browsometimes referred to as the “aha” or surprised lookthe muscle contracts, which causes the skin that is covering the muscle to pull, wrinkle, and then return to its original position when you relax the muscle. Now consider the countless number of times you’ve used these muscles. As you age, your skin be­gins to lose its elasticity, it suffers from sun damage, and the constant contracting and relaxing of the muscle results in forehead lines. These can be eliminated using Botox or filler injections such as collagen or fat.

Frown lines: vertical lines, also known as glabellar lines, that appear between the eyebrows. These linescan make you appear serious, angry, or stressed even when you’re not. It is for the removal of these lines that the Food and Drug Administration gave approval for Botox in April 2002. These lines are best removed with Botox. If you’ve frowned a lot over the years and the lines are very deeply etched, you may also need wrinkle fillers (e.g., collagen, fat) to eliminate these lines. Your doctor will discuss your options with you.

Crow’s-feet: lines that radiate from the outside corners of the eyes. They’re also known as periorbital lines. If you have these lines, they’re most likely the result of smiling and squinting. If you look in the mirror ands mile or squint, notice how your muscles contract and cause your eyelids to nearly cover your eyes and how the muscles contract at the corners of your eyes where the lines appear. Crow’s-feet are best eliminated with Botox, plus adjunctive treatment such as collagen, chemical peels, or laser resurfacing.

Laugh lines: also known as smile lines or nasolabial lines, they are the two vertical lines that run from the outside corners of the nose down to the top of the outside of the upper lip. Even though they are called laugh lines, gravity and aging are also factors in their development. They can best be eliminated using wrinkle fillers (e.g., collagen, fat, AlloDerm, Cymetra, Gore-Tex, or SoftForm).

Lipstick or smoker’s lines: the tiny radiating lines that appear above the upper lip and below the lower one. It seems as though everyone has a different name for these annoying wrinkles, which are best removed using laser resurfacing, chemical peel, microdermabrasion, or wrinkle fillers tissue augmentation (e.g., collagen in­jections, AlloDerm, fat)in addition to Botox.

Marionette lines: the often deep lines that run down from the outside corners of the mouth toward the chin. These lines develop from a combination of factors, including gravity (the cheeks tend to sag from the force of gravity) and thinning of the supporting tissue that comes with age. These wrinkles are best eliminated using wrinkle fillers or laser resurfacing. Another option is a face-lift, a complex surgical procedure.

If you’ll still be bothered by the remaining lines and wrinkles, are you willing to have other cosmetic procedures done to correct them? Naturally, you will need to discuss all your options and prices with your doctor, but you should be aware that other procedures may be needed for you to get the look you desire. You also should know that while Botox injections don’t involve any recovery time, some other cosmetic procedures do.