Botox: further wrinkles or illusion?
7 March 2003
Botox injections may lead to wrinkles in untreated parts of the face appearing more prominent, according to a US dermatologist.
Dr David Becker, assistant clinical professor of dermatology at New York's Weill Cornell Medical School, said this effect may be due to ‘muscle recruitment’, may be an illusion because patients pay closer attention to their face, or a coincidence.
Dr Becker noted increased wrinkle prominence after a patient remarked on the development of fine lines following botulinum toxin therapy for glabellar (vertical frown line) wrinkles.
‘Paralysis of a set of muscles might lead to recruitment of other muscle groups in an attempt to reproduce the conditioned activity being blocked — resulting in more prominent muscle activity (and resulting rhytides (facial lines or wrinkles)) in adjacent regions,’ he wrote in Cosmetic Dermatology (2002; 12: 35-36).
Dr Robert Sinclair, spokesman for the Australasian College of Dermatologists, said he had seen the effects of muscle recruitment after botulinum toxin treatment in the forehead and glabellar area.
‘I think it happens to a lot of patients to a minor extent, but because the overall benefit and effect is positive, they don't worry about it,’ he said.
‘Doctors can minimise this risk by altering their technique to include potential accessory muscles when rectifying an abnormal expression — so you weaken all muscles, not just the ones responsible for the expression.’
Last Reviewed: 07 March 2003
- 1. Medical Observer Weekly 7/03/03
