Dr. Sam Lam Plastic Surgery Forum

i hav,nt had botox and i personally dont think i could go that route.
i have seen quite a lot of folks with a kind of drooping(above eyes especially ) after they have had it for several years,and the only way they can get it corrected is by surgery.!
is it the case that with its long term use,it can become more ageing.?
i must confess it does bother me.

no, no, no. the sagging eyelids are caused by aging. botox is the single most important anti-aging treatment you can do for your face other than avoiding sun and smoking. botox will break bad habits of lifting your brows or frowning so that the collagen can begin to heal. please read and watch my learning modules and virtual consultations in which i talk about your skin like a shirt. every day you "wear your shirt" that is your skin. just like exercise, the more you do it, the better you will be. botox over the long term is the most critical thing you can do to reverse wrinkles. remember this, every year you do NOT do botox your wrinkles are getting progressively worse. every year you do botox, your wrinkles are getting progressively better to the point that they are gone in most cases.

let's say you decide to wait 5 more years to do botox, not only do i have to reverse your current wrinkles, but you have already slid down the path toward worse wrinkles significantly. let's say you do botox for the next five years. you will be 10 times better off so that even if you quit in 5 years you are light years ahead of the person that waited. look at the study with two identical twins that was in Allure magazine this past month or read that study in my RSS feed on my home page. The twin that had consistent botox after 13 years looked amazing. The twin that had inconsistent botox looked significantly older and more wrinkled.

you are knocking out the source of the problem, which is movement of the skin causing wrinkles. no other photofacial, lift, peel can do the job because after you "iron the shirt" (with peels, lasers, etc.) you are wearing your shirt again (moving muscles). botox is so important but so poorly and wrongly understood. WATCH MY VIDEOS ON THE SUBJECT.
best,
sml

i guess as with all things cosmetic,its the skill of the doctor / injector.?

absolutely. that is why 10% of my botox patients actually fly in for my work, even school teachers!

I started using botox about 8 months ago.
The first time the doctor how injected the botos did it on the usual plaves, forhead, crows feet, between the eyes.
I had feelings like someone knocked with a hammer on my head for two months.
Also swollen upper eyelids for about the same time.

The second time I went to another doctor, same places where treated, but I had the impression the injections where more superficially then the first doctor did. anyway after one week I noticed I have droopy upper eyelids now, the eyebrows are not down just the eyelids, giving me a tired and angry look.

Is there anything I can do about it, how long does that last?

Thanks.

the superficial nature of the injection is not what caused that problem. i inject the forehead and eyelids superficially because that is where the muscle is located. i inject between the eyes deeply because the muscle there sits on bone. You need to have an injector know how to do Botox well. Despite my best efforts, I see on average once a year to twice a year a dropped eyelid even in my hands (keep in mind I am doing about 1500 plus areas of Botox so that is a pretty small percentage). Unlike most doctors' offices, I stock Naphcon A which is over the counter at Walgreen's and can help open the eyelid up a little. If the drop is small, it will come up. If it is large, it won't help too much. The product is over the counter so you do not need a prescription. A few caveats: 1) do not use it if your brow is down instead of your eyelid because it won't help. 2) read the package instructions for precautions: if you have glaucoma or bladder issues, don't take it. 3) your vision can be blurred because your pupil will be dilated so be careful driving. 4) if you have light blue eyes the effect may be worse because you will see a widened dark pupil on one side (then you might benefit from prescription iodipine). The way the product works is by activating a secondary lifting muscle (Mueller's muscle) instead of the normal lifting muscle, the levator.

Most mild cases resolve in 2 weeks. However, a few cases can take a month or 6 weeks. I really have not seen anything beyond that but theoretically it could take 3 months.
best,
sml