Dr. Dean Kane Q&A – Can a filler be effective on11 lines after Botox poor result?

Question from Hallandale, FL: After 7 days Botox does not seem to work on the 11 lines.my injector said that she might have to use a filler like volume or restyling. Does this sound right?

 Answer from Dr. Dean Kane, Board Certified Plastic Surgeon from Baltimore:
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​Botox begins to work after 5-7 days and is optimal at 10-14 days following injection. So please be patient before discounting the effects of Botox. 
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​After 2 weeks, revisit your injector to see if there is another set of muscles (called the orbicularis oculi muscles) which may be "recruiting" the skin from the outside brow to create those "11's". If so, it takes great skill to inject these recruitment muscles without causing eyebrow or eyelid droop and stop the skin folding inward towards the middle.
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​If the "11's" are permanent lines from continuous creasing, fillers properly injected and retinol / Retin-A will smooth out those lines. It will also allow the Botox to "work" longer by reducing the amount of squeeze and line formation. 
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​It is imperative that you find a expert injector with these finer techniques. There are risks of complications involved not typical of the more common injector. Please consult with a well experienced, Board Certified Plastic Surgeon, Facial ENT or Dermatologist. 
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​All the best!