Fine lines and wrinkles

Expression lines commonly appear on the forehead, between the brows, and around the eyes. If lines appear primarily with facial expression but soften at rest, a neuromodulator may be an appropriate option.

These are muscle lines. Lines that remain when your face is relaxed are skin lines, and each type responds to a different kind of treatment.

How we evaluate fine lines and wrinkles

We’ll evaluate your face both at rest and in motion, with one relaxed photo and one animated photo taken in natural daylight. Comparing them shows how much of each line comes from muscle movement and how much is in the skin itself.

For muscle lines, we use Botox and the other neuromodulators. Botox and Xeomin are approved for frown lines, forehead lines and crow’s feet. Dysport, Jeuveau, and Daxxify are approved for frown lines only, and using them anywhere else is off-label. In Botox Cosmetic’s glabellar trials, 74 percent of people had responded by day 7 and 25 percent were still responding at day 120, per the prescribing information. Daxxify held a none-or-mild result for a median of 24 weeks in its pooled trials, per JAAD, which means half of people had it for less time. Individual results vary.

Skin lines call for a texture treatment. Microneedling with hyaluronic acid is our starting point: three to six sessions four weeks apart, and you’ll be pink for a day or two. Morpheus8 adds radiofrequency through the needles and is FDA-cleared for contraction of soft tissue. We recommend it when lines come with laxity. If you have a few etched lines without much laxity, microneedling is usually the better first step.

Pregnancy, breastfeeding, and a neuromuscular condition rule toxin out, so we’ll ask you about these first.

Your questions, answered

Can I go back to work right after Botox?

Yes. You may have small bumps at the injection points for about 20 minutes and possibly a pinpoint bruise, and after that there’s usually nothing to see. The lines won’t change for 3 to 7 days, which is expected. Strenuous exercise should wait until the next day.

Why don't you price Botox by the unit?

Units aren’t comparable across brands and dilution, so a per-unit number doesn’t tell you much about your result. Instead, we’ll create a written treatment plan and price that plan. Our Botox cost guide explains why a low advertised per-unit price can be misleading.

Is it too early to treat faint frown lines?

Not if they linger for a moment after you stop frowning. Preventative dosing is lower and less frequent, and the goal is to keep the line from etching in without freezing your expression. If they clear right away, treatment isn’t necessary yet. Wear sunscreen daily, and we’d suggest a follow-up visit in about a year.

Related treatments

Botox and neuromodulators

Five products to choose from, priced by your plan, not the unit

From $480 a visit

Microneedling

A first step for pores, fine lines, and texture, using hyaluronic acid serum

From $347

Skin tightening (Morpheus8)

RF microneedling for jawline laxity, neck skin, and acne scars

From $1,200

From the clinic