LAM FACIAL PLASTICS

I read your explanation of the working of botox, but it is all based on the assumption that the muscles cause the lines. I am not convinced of that. Can you explain this?

I think it mostly has instead to do with volume loss. My face folds in ways that it would not if there was something giving it support in the middle of my face. Your advocacy of fact injections supports this.

Yeah, to me botox and fat grafting seem at odds. How can they be reconciled?

Now, I could see the possibility of two antagonistic muscles being out of balance with each other - in that case I would say the fix is to train the weaker one, rather than weakening the stronger one.

So are you saying some of the muscles in a normal person actually hypertrophy with aging?! I still think it is all atrophy of one tissue or another, and sometimes the relative difference may seem like an increase in size to the untrained eye. I mean, sure the masseter and temporalis could maybe grow for someone who cracks nuts with their teeth and sometimes eats bones like me, but I don't see why the muscles of facial expression would.

And it seems to me that botox could only encourage atrophy, which would then in turn compound the real problem, even though the less significant [i]symptom[/i] of 'wrinkles' may seem to improve.

I am just trying to understand how it all works and how botox could actually be a good thing, as you describe, beyond the superficial lessening of 'lines'.

Thanks.

Okay, I just answered this question 2 minutes ago at least somewhat in another forum question. Please read the last forum response. However, to make it clearer, I DON'T think that our muscles where Botox is placed hypertrophies as we age. I think that they cause wrinkles. Therefore, to knock out these lines with Botox is critical. I do think wrinkles around the eyes and forehead can be a major issue that detracts from one's looks far outweighing any slight volume loss you may have with Botox.

As far as the midface, I agree the folds and transitions that are seen there are primarily volume issues. I don't do Botox there. In summary:

BOTOX: Forehead, between the eyes, sides of the eyes for wrinkles
FAT GRAFTING: brow, under the eyes, cheeks, chin, etc.
thanks for the question,
sml