The removal of deep wrinkles with botulotoxin


The application of botulotoxin and fill material can help remove the deep wrinkles (so-called “frown lines”) on your face.

Botulotoxin is available in two preparations: Botox and Dysport. Dysport is more suitable in the case that larger doses are required to smooth out truly deep wrinkles. Through the use of fewer injections with lower doses, Dysport easily spreads to the area surrounding the site of the injection and can provide longer-lasting results.

On the other hand, Botox easily treats smaller wrinkles and is more appropriate for cases when the spread of the active ingredient is not desired.


Prior to application the area to be treated is cleaned with a disinfectant. Botulotoxin is applied with the extremely fine needle typically used for insulin injections. In the case that a patient has a greater fear of injections, the treated area can be desensitized with a plaster or cream that contains a local anaesthetic.

Botulotoxin binds to receptors for acetylcholine, which induces muscles to contract, or, in this case, to wrinkle. But when the receptors contain Dysport, the command to wrinkle is blocked. “Frown lines”, after all, are not normal mimic wrinkles; instead, they occur due to the long-term frowning of the patient, consciously or otherwise. Wrinkles that are already quite deep are not simple to remove.


Botulotoxin does not smooth out these wrinkles immediately, as is the case with the treatment of fine wrinkles around the eyes. The deep wrinkles will gradually become shallower and may take months or even up to two years to disappear completely. Dysport should be applied twice a year. “Dysport is active from four to six months. The effect is extended by the fact that botulotoxin cures you of your inclination to frown. When you stop using your frowning muscles for a longer period the body takes a while before it remembers this action and begins to frown again,” explains Dr. M. Majerová from the dermatology department at the Asklepion Clinic in Prague.

To help results appear faster, a filler material – hyaluronic acid – is injected. Hyaluronic acid is a normal component of skin.

Updated: 2008-05-27

Discussion to topic

Dr. Omar Fouda Neel  |  Basic member  |  Plastic surgery  |  Montreal, Laval
  • 157 answers
Typically deep wrinkles are removed with fillers such a Juvederm, Restylane, Belotero or Revanesse. This varies according to where these deep wrinkles are located. Please see a board certified plastic surgeon for a proper assessment.

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