Beyond Wrinkles: Advanced Botulinum Injections around the Eyes to Improve Surgery

John R. Burroughs, M.D.
Cosmetic Oculofacial Plastic Surgeon
Medical Director, Springs Aesthetics
Colorado Springs, CO


This beautiful lady wanted to make her eyes more even and less wrinkled. She competes in beauty pageants and prefers to enter the competitions feeling confidently beautiful about every aspect of her appearance.  The right eye (left in picture) was smaller.  By injecting very tiny amounts of botulinum toxin to the right upper eyelid at the outer and inner portions near the lashes relaxes the orbicularis eyelid muscle in a manner that helps the eye open more as seen in the bottom photo.  The lower eyelid wrinkles were also improved nicely using small but very targeted doses of botulinum.  Other adjustments can be done for asymmetry of the brow positions that was also seen in this patient.

The above pre-injection shows the injection locations to help raise the eyelid margin.  Dr. John Burroughs has over 20 years experience using wrinkle blockers (Botox, Xeomin, Newtox, Dysport).  Injections directly near the eyelid margin are higher risk for bruising and ptosis.  Dr. Burroughs and some other respected colleagues published on injecting in this “pretarsal” orbicularis area for spasm patients with pseudo-apraxia of eyelid opening (“stuck together”) eyelids.  When receiving injections near the eyes its essential to know your injector understands the anatomy around the eyes.  This makes Dr. Burroughs a recognized expert on injecting around the eyes both with wrinkle blockers and fillers.  He has given international lectures on his surgical and minimally invasive periocular eyelid rejuvenation.  He has treated patients from coast to coast, and even from outside the United States.


Safety of Pretarsal Botulinum Toxin for Blepharospasm Associated Pseudo-apraxia: Is Ptosis a Real Concern?
James B Hsueh1, 2, John R Burroughs1 (john at drjohnburroughs dot com) #, Charles NS Soparkar3, John D McCann4
1 John R Burroughs M.D., P.C., 111 E Polk Street, Colorado Springs, CO, USA. 2 Midwestern University Physician Assistant Program, Glendale, AZ, USA. 3 Plastic Eye Surgery Associates, PLLC; Departments of Plastic Surgery/Head & Neck Surgery, M.D. Anderson Cancer Center; Department of Ophthalmology, Baylor College of Medicine; Department of Ophthalmology, Weill-Cornell Medical College, Houston, Texas, USA. 4 The Center for Facial Appearances, Sandy, UT, USA

Say Goodbye to Your Wrinkles with Wrinkle Blocker

When it comes to signs of aging, there are a couple different types of wrinkles. There are the wrinkles that are caused by gravity pulling down on your skin and too much sun damage. These wrinkles are not quite the same thing as another class of wrinkles that result from the way the muscles operate in your face or neck. When the way the muscles move about and contract are behind causing the wrinkles you experience, you cannot treat these kinds of wrinkles the way you would approach treating the other wrinkles. Dynamic wrinkles must be treated with wrinkle blocker.

The causes being different in these situations will require somewhat different approaches to making the different types of wrinkles disappear. In the case of muscle motivated wrinkles, the trick is to get the muscles beneath the skin to relax. To do this, you can inject the muscle tissue with wrinkle blocker. Today, this is a very common and very popular procedure for helping people get rid of dynamic wrinkles.

Wrinkle Blocker in Action

When the muscle tissue under the skin is injected with wrinkle blocker, the purified protein solution goes to work blocking the signal from the nervous system that would normally compel the muscle tissue to contract, which is why we call them Wrinkle Blocker injections. When the nerve signal to the muscle is blocked, the muscle remains in a relaxed state. This helps to make the wrinkles caused by way of muscle contractions fade away for a time. Unfortunately, the results of wrinkle blocker tend to only be temporary, lasting for a few months after each injection. Afterward, you will have to receive more wrinkle blocker injections to maintain the desired effect on your wrinkles. 

Using Fillers and Wrinkle Blockers

Another way to get superb results with wrinkle blocker is to use the Wrinkle Blocker injections in conjunction with medical-grade fillers. A filler is worked in under the skin to fill in the space with substance and provide some lift to the skin. This makes the face look more filled out, helping to support the skin from beneath while further preventing it from having the ability to wrinkle. Usually this combinations of injectables is done when the patient has extremely deep wrinkles, which is fairly uncommon. Sometimes laugh lines can become particularly deep, however, and then wrinkle blocker with certain dermal fillers can be quite effective. 

Contact the team at Springs Aesthetics today to schedule your consultation! We are conveniently located in Colorado Springs.