Guide to 7 Facial Wrinkles Smoothed By Botox

Getting Rid of Facial Wrinkles

Aging is an inevitable result of living, and wrinkles are a sign of aging. 

As we age, the muscle tone of our facial muscles increases.  This increase in muscle tone along with decreased collagen metabolism (collagen is a component of the dermis or the lower layer of skin above the muscle) results in wrinkles. 

There's nothing wrong with wrinkles, and some people celebrate their wrinkles as evidence of a full life.  Okay, probably no one celebrates her wrinkles; however, some people certainly don't mind mind wrinkles and don't want to spend money or time smoothing them out.  Other people, however, desire to rid themselves of wrinkles.

In addition to certain lifestyle modifications like avoidance of sun exposure and smoking cessation, there are numerous noninvasive treatments for wrinkles including laser, chemical peeling and injection of botulinum toxin (think Botox or Dysport).

Injection with botulinum works best with dynamic wrinkles or wrinkles that appear after the formation of facial expressions like a smile or a frown.  Conversely, static wrinkles remain while your face is relaxed and are best treated with a combination of botulinum toxin and dermal fillers.  In other words, recalcitrant rhytides (medical jargon for wrinkles) need filler, too.

Here are 7 different facial wrinkles treated by injection with botulinum toxin. 

#1: Botox for Glabellar Lines

Treatment of glabellar lines is the most common cosmetic use of botulinum toxin.  The glabella is a patch of skin between the eyebrows and above the nose.  (In people with unibrows--like NBA star Anthony Davis--this patch of skin is covered in hair.)

#2: Botox for Crow's Feet

Crow's feet (AKA periorbital lines or lateral canthal lines) are wrinkles that branch from the outer corners of the eyes while smiling.  Of note, crow's feet that are static thus occurring in both the presence and absence of smiling and are principally caused by photoaging--making them more resistant to treatment with Botox.

#3: Botox for Forehead Wrinkles

The relatively large facial muscle that overlies the forehead is called the frontalis muscle.  When the frontalis muscle contracts, the brow raises and forehead lines appear.

#4: Botox for Bunny Lines

Bunny lines occur on the the bridge of the nose.  They can become more prominent after botulinim toxin treatment for glabellar lines or crow's feet.  Thus, people who have Botox treatment for glabellar lines or crow's feet often return for treatment of bunny lines, too. (Cha-ching!)

#5: Botox for Lipstick Lines

Perioral or lipstick lines are vertical wrinkles above the upper lip.  The formation of lipstick lines is likely multifactorial and photoaging, hereditary factors, puckering and smoking likely all contribute.

#6: Botox for Marionette Lines

Marionette lines are vertical wrinkles that originate at the corners of the mouth and branch downwards towards the chin.  (These lines resemble the borders of the jaw segment of a marionette.)  Marionette lines are usually treated with both botulinum toxin and dermal fillers.

#7: Botox for Chin Dimpling

Chin dimpling gives the chin an orange-peel (peau d'orange) appearance.  As with the treatment of marionette lines, smoothing chin dimples often requires both botulinum toxin and dermal fillers.

Botox: Parting Thoughts

Most people who receive Botox or other botulinum toxin injections are pretty happy with the results and go on to purchase more injections.  However, treatment with such agents is a temporary measure with lines returning after about 120 days. 

Furthermore as with all medical treatments, treatment with Botox carries its own risks of adverse effects (mostly short-lived) including swelling, muscle weakness and pain. For instance, Nicole Kidman famously told La Republica, "I did try Botox, unfortunately, but I got out of it and now I can finally move my face again."

Selected Sources

Cochrane review titled "Botulinum toxin for facial wrinkles (Protocol)" by CP Camargo and co-authors published in 2014.  Accessed on 10/3/2015.

Article titled "Aesthetic Uses of the Botulinim Toxin"  by A Dorizas and co-authors published in Dermatologic Clinics in 2014.  Accessed on 10/3/2015.

Continue Reading