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Answer:
Botox can be used to lift the brow, to help open the eyes. Injections are done between the eyes as well as above each eyebrow. The lift achieved is not as dramatic as that of a brow lift, but it can give you an idea of the type of result a brow lift might give you. The downtime with Botox is virtually nonexistent, as opposed to a brow lift which has a downtime of about 7 days.

It is true that a blepharoplasty, which is surgery for the upper and lower eyelids, will not address the wrinkles of the forehead or even the wrinkles around the eyes, known as the crow’s feet. Usually, we tell patients that even after a blepharoplasty they will still need injections of Botox to get rid of the wrinkles in these 2 areas and also in between the eyes. Depending on the placement, we can get a lift of the brows with the Botox if it is place in between the eyes and a little bit over the eyebrow. With these injections, we can usually get about a quarter of an inch lift of the brows. Some patients do not need a brow or forehead lift, so we can use the Botox for what we call a chemical forehead lift or chemical brow lift. Around the eyes, however, no surgery, either blepharoplasty or even a facelift, will address those wrinkles and only Botox will help in getting rid of the crow’s feet.

Regarding the difference between Dysport and Botox, it is first important to know that they are the same type of product in that they are both Botulin toxin. However, Dysport does seem to take effect more quickly than Botox after the injections. Botox usually starts taking effect within 5 days, with full results showing after 10 days. With Dysport, results usually start within 2 days with the full effect showing by 5 days. I prefer starting with Botox, and reserving the Dysport for patients who do not have a complete dissolution of their wrinkles from the Botox. Usually they both last about 3-1/2 to 4 months.

Botox. In theory, Botox should work every time you get injected, regardless of whether it is injected in the forehead, between the eyes, or around the eyes – the crow’s feet. We have noticed, however, that after the age of 60 or so, the Botox is not lasting as long as it once did. Usually, after receiving Botox injections in the same area 4 or 5 times, the effects will last longer, on average going from about 3 months to 6 months. This is especially true the wrinkles in the forehead and between the eyes. In the crow’s feet, however, the effect usually stays at about 3 months. We also find that sometimes fewer units of Botox are needed after several treatments. For example, if 20 units were used between the eyes, after 4 or 5 times it may be possible to go down to 15 units of Botox. For the forehead, if starting with 20 units, after about a year and a half we may be able to go down to 10 units for the same result.

Yes both issues can be addressed with some sort of Laser Skin Resurfacing. The settings (depth, power ect..) are differents but can be performed at the same setting. Usually a topical anesthetic cream is used in conjunction with a oral relaxant and sometimes a local anesthetic is injected in the areas to be treated. Pain in general is minimal.