• Before & After BOTOX® & Filler — 53-Year-Old Woman

    Before and after of 53-year-old woman treated by Dr. Michele Koo with BOTOX and filler for deep forehead lines and glabellar heaviness. Results after 3 months.

    Before & After 3 Months

    Before and after of 53-year-old woman treated by Dr. Michele Koo with BOTOX and filler for deep forehead lines and glabellar heaviness. Results between 6 months and a year.

    At 6 Months & After 1 Year

    Patient Story
    A 53-year-old woman presented with deep, etched forehead lines, glabellar heaviness, and a fatigued appearance. She felt self‑conscious after several unsuccessful neurotoxin treatments at spas/other offices that failed to smooth the lines or maintain a natural brow shape. She also desired subtle lip re-volumization.

    Dr Koo’s Consultation
    Dr. Michele Koo performed a detailed facial analysis, mapping the frontalis and glabellar muscle dynamics and assessing static vs. dynamic wrinkles. She recommended a staged plan to first relax overactive muscles with calibrated BOTOX® dosing, then support residual etched lines with a conservative hyaluronic acid filler. The goal was natural expression without the over‑arched ‘Spock’ brow, and long‑term maintenance with minimal downtime.

    Treatment

    • Botulinum toxin injections (BOTOX® Cosmetic) targeted to the glabellar complex, central and lateral frontalis, with unit adjustments over follow‑ups to balance symmetry and brow position.
    • Filler support: Restylane® Kysse was layered into persistent etched lines and lips after movement was relaxed, to restore softness and structure.
    • Maintenance: Light BOTOX® touch‑ups every 4–6 months; conservative lip filler refresh as needed.

    The Results
    A smoother, more luminous forehead with balanced brow position and preserved facial animation. At 6 months, static lines were noticeably softened; at 2 years, results remained natural and durable with periodic maintenance. The patient reports renewed confidence and comfort in photos and daily life.

    Procedures

    Patient Details

    • Treatment: BOTOX® Cosmetic Injections + Hyaluronic Acid Filler (Restylane® Kysse)
    • Target Areas: Glabellar complex (11s), central and lateral frontalis (forehead), lips; selective etched line support
    • Product Used: OnabotulinumtoxinA (BOTOX® Cosmetic) and Restylane® Kysse
    • Downtime: Minimal; typical injection‑site redness/swelling resolves within hours to 1–2 days
    • Results Timeline:
      • Immediate: mild redness/swelling only.
      • 3–7 days: BOTOX® onset; smoother dynamic movement.
      • 2–3 weeks: peak neurotoxin effect; refine units if needed.
      • 3–6 months: maintained smoothing; filler integrates for soft support.
      • 2 years: natural appearance sustained with periodic BOTOX® and conservative lip filler.

    Gender: Female

    Age: 53

    Skin Type: Fitzpatrick II

  • BEFORE & AFTER BOTOX - UPPER AND LOWER LIPS

    A 48 year old woman before BOTOX treatment on the upper and lower lip from Dr. Michele Koo in Marin County

    BEFORE

    A 48 year old woman after BOTOX treatment on the upper and lower lip from Dr. Michele Koo in Marin County

    AFTER

    A 48 year old woman received Botox to the upper and lower lips, in conjunction with one syringe of Volbella dermal filler.

    Procedures

    Patient Details

    • Treatment: Botox Injections & Volbella dermal filler

    • Gender: Female
    • Age: 48