The Power of Combined Therapies: BOTOX and Ablative Facial Laser Resurfacing

Abstract

Introduction: The etiology of facial rhytides is multifactorial. Static rhytides are caused by environmental factors and heredity, whereas dynamic rhytides are caused by the repetitive action of muscles during facial expressions. A successful multifactorial therapeutic approach is to use ablative laser resurfacing to reduce the static component and BOTOX to soften the dynamic component of the facial rhytide. Materials and Methods: We retrospectively analyzed the charts and photographs of 53 consecutively treated subjects to evaluate the relative strengths of the static and dynamic treatment modalities on the individual's final aesthetic result. To remove any potential for bias, the treatments were all carried out by author J.C. The photographic and chart reviews were performed by author A.C., and the subjective patient questionnaire was completed by author A.Z. Results: Adding BOTOX to CO2 laser resurfacing improved the result objectively from 30% to 60%. However, adding BOTOX to Erbium:YAG laser resurfacing improved the result only marginally (40% to 47%). Discussion: Combined therapy with CO2 laser resurfacing and BOTOX gave the most pronounced aesthetic benefit. Combined treatments with Erbium-YAG laser resurfacing and BOTOX was a less powerful treatment blend.