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Plastic Surgery/Botox and dynamic wrinkle


Hi There,
Thank-you for taking my questions! I am a 38 year old female and I get Botox in a vertical wrinkle between my eyebrows, which is a bit dynamic. This time, I was left after the injection with a headache for three or four days- is this normal? Also, the Botox works great but I still have a crease/indentation. The doctor says filler is not an option between the eyebrows because of the risks, and is recommending laser resurfacing, but the amount of downtime and recovery and possibility of redness for months scares me. What would you recommend?

One final question, if you don't mind: what types of skin creams do you recommend for the face and eye area to prevent wrinkles?

Thanks again!

Hi Ginger,

I generally agree with what your doctor is telling you.

Botox (and the other neuromodulators) weaken the muscles so they soften the lines/wrinkles but do not necessarily eliminate them.  You can try more units in any of the muscles that you are targeting but I don't normally expect, and I don't promise, that any specific line will be "gone."

Headaches can occur for many reasons; even just the trauma of the injections themselves (ie the bit of tissue damage from several needles going through the skin, into to the muscles).  

I agree with not putting a filler there due to increased risks.  But I'm not sure that laser will provide a good enough result and/or be worth the relatively long recovery.  I usually recommend Botox there, possibly with an increased dose, and would otherwise suggest that you leave it at that.

I can't give specific comments on skin care; you'll need to be seen by your dermatologist for specifics on that.

Dr. E

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Alan M. Engler, MD, FACS


Dr. Engler has answered over 6400 questions on social media sites, including over 3500 on AllExperts alone. His expertise includes breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts, lipomas, skin cancers, cysts, etc. Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction." Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), the Dr. Keith Ablow Show and Jerseylicious. Videos of his appearances are available on YouTube (search for "DR. ENGLER"), and his discussion of breast implants, also on YouTube is "How to Choose a Breast Implant." His website is Follow Dr. Engler: @AlanEnglerMD


Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on,, as well as EyeScapes - Plastic Surgery of the Eyelids.

Dr. Engler graduated from Yale University (BA, Russian Studies) and the Columbia University College of Physicians and Surgeons (MD). He did his residency training in General Surgery and, after that, Plastic Surgery, at the Montefiore Medical Center in New York. He is on the faculty of the Albert Einstein College of Medicine in New York in the Departments of both Surgery (Plastic Surgery) and Medicine (Dermatology), and is a Special Lecturer in the Department of Dermatology at Columbia University in New York. He has admitting privileges at Beth Israel Medical Center and Montefiore Medical Center, both in New York.

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