Natural-Looking Treatment for Wrinkles in Forehead and Lips Using Botox, Fillers, and PRP

A 45-year-old woman has number 11s and lines on the sides of her lips. She wants to know the best procedure to give her a natural look.

Oculoplastic surgeons were among the first to use Botox® long before it became used for cosmetic reasons. Dr. Amiya Prasad has been using Botox® for patients since 1993. He is also trained in facial cosmetic surgery boarded by the American Board of Cosmetic Surgery so he does a lot of facial work as well. From his perspective, one of the best areas to treat in the forehead is the number 11s because it has such an impact. This set of muscles are composed of the corrugator and procerus muscles which affect overall facial appearance. If someone always thinks critically and looks at something and frowns, then the number 11s treated with Botox®, Dysport® or any other neurotoxins can be tremendously effective. This woman can certainly do that in isolation without doing the rest of the forehead to avoid the overly smooth look as she described it. She can just do the number 11s first and try the forehead another time.

In Dr. Prasad’s practice, he generally treats the lip lines with hyaluronic acid filler whether it’s Restylane or Juvederm. The lip lines can be tricky because they can be deep lines, fine lines or even crisscross superficial lines, so options should be looked into. Besides using fillers to restore volume for deeper lines as well as to create a nice contour of the lip border, Dr. Prasad also uses fractional CO2 laser or some type of resurfacing modality. He has also used microneedling as well as platelet-rich plasma. Platelet-rich plasma uses someone’s own growth factors derived from their own blood as a concentration of the necessary wound healing factors. PRP is taken in a simple blood draw and can be used to build up collagen.

There are a lot of different options and it all depends on what defines a satisfactory outcome for a patient. In Dr. Prasad’s practice in Manhattan and Long Island, people come to him with a long list of things they want to do. He figures out based on priorities what they can afford and what they are able to do at that time. He’ll give them the most value based on what’s most important to them.

Dr. Prasad suggests that this woman discuss this with the oculoplastic surgeon and her doctor. Most people trained in oculoplastic surgery are trained in facial cosmetic surgery and it is for common oculoplastic surgeons to perform facelifts and other things beyond the limited area of the eye. This woman can be able to get everything in one stop and learn about her options at one place.

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