Botox and Laser Resurfacing in Combination

BOTOX® injections are a great way to minimize or even eradicate facial lines. Although BOTOX® has been used “off label” on “crow’s feet” for years, 2013 saw the FDA officially approve BOTOX® for that use. BOTOX® works best for patients whose facial lines are due to muscle contractions rather than loss of dermal elasticity. These are hyperkinetic facial lines caused by years of muscle contractions until the dynamic line resolves into a static line, or lines at rest as many people call them. Basically, when you smile, the muscles around your eyes cause the skin to crinkle and over the years this action produces crow’s feet.

Laser resurfacing, on the other hand, removes lines caused by loss of skin elasticity, the results of gravity, and loss of collagen. As you know, photo damage from the sun breaks down the supporting tissues beneath the skin. The loss of collagen in combination with loss of elasticity allows gravity to pull the skin down forming lines. Now around the eyes, there is often a combination of these two processes causing exaggerated lines. So both muscle contraction and skin damage contribute to crow’s feet.

A study examining the use of BOTOX® following erbium: YAG laser resurfacing found that more benefit was gained, particularly for “crow’s feet” rhytids (wrinkles) than either procedure alone. In the research study, it was found that ” Adjunctive therapy with BOTOX® and laser resurfacing demonstrated a greater reduction in rhytids.”

I would interject at this point that we use the erbium Sciton Profile laser here at Little Rock Cosmetic Surgery Center because studies show that the erbium laser is less damaging than CO2 lasers. I believe better results are achieved with the erbium Sciton Profile laser than with the erbium: YAG laser.  Another study reported that the “Er:YAG laser provides mainly superficial ablation and little thermal benefit for deep collagen growth.” The erbium laser we use actually promotes collagen growth, a secondary goal which contributes to overall facial rejuvenation and continued wrinkle reduction. When it comes to laser resurfacing, the debate is always over what one author calls the ‘‘Risk/Recovery/Result Ratio.’’ Is it better to have several more superficial procedures spaced a few months apart to lower discomfort and recovery time yet having less dramatic results? Or is it better to risk a deeper resurfacing, a bit more recovery time and discomfort and have a much better looking result? My only compromise is to use the gentler Erbuim instead of a CO2 laser. I say get it over with and look great!

The real point is that by using laser resurfacing on the area around the eyes, the periorbital area, there is a reversal of photodamage, a reduction of brown patches on the skin, and improvement in skin texture that is increased when used in conjunction with BOTOX®. Come talk to me about either or both procedures in your consultation at Little Rock Cosmetic Surgery Center if those crow’s feet and age spots are starting to bug you. You can count on individual, experienced care at CSC.

Dr. Branman

Please call Melinda to set up your consultation 501 227-0707