How long should Botox and fillers last?

Hi Dr. Irwin, First, I love your blog. You answer so many of my questions. I have been seeing a dermatolgist for approximately one year now. I have had perlane and restalyne and botox with him . But, I am very concerned over the staying power. In September of 2009 I had two vials of Radiasse placed in my cheeks (for some hollowing) and nasolabial lines. It looked fabulous for about 3 -4 weeks. In october I needed another vial. End of November 2 more vials and 90 units of botox (forehead, eyes, lines around mouth, chest) Now it is approaching Feb and I see that that I have hollowing again on the right side, and the laughlines are back (not as deep, certainly, but defintely back). I also get about 90 units of botox approximately every 2-3 months. This is breaking my bank! Is this normal? Prior to the Radiasse, I had almost 6 vials of perlane starting back in March of 2009 through August. I believe I have spent over $10,000 in less than a year on fillers. The Dr is now recommending Scuptra. I don't know anyone who has this problem. What do you think? Is this normal? I can send you a picture.

Thank you –  I LOVE doing this blog! 

 Something seems odd to me.  In  18 years of practice, I’ve never seen anyone go through so much product, unless you are in your 70s or 80s.  And, I can’t think of a single female patient in our practice (smaller muscles than males) who needs that much Botox every 3 months.   Although if you’re treating a large area on the chest, it could account for the high number of units.  I would really recommend getting a second opinion from a reputable dermatologist or plastic surgeon in your area who does cosmetic work.  Dr. I

Dr. Brandith Irwin, MD

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