What is Botox?
Botox is actually a brand name of neuromodulator. The 4 neuromodulators currently on the market in the US are Botox, Jeuveau (Newtox), Dysport, and Xeomin. All of these come from the same base molecule, Botulinum Toxin-a. The basic science behind all of these products is that when they are injected into a muscle they block the pathways that allow muscles to contract. When you can’t squeeze the muscle, you can’t make the wrinkle!
Why so many types?
Each of the 4 types has some unique properties. Some of these properties are proven by studies, others are based on personal preference. For simplicity sake, I use Newtox and Botox. They both give very similar results and are dosed the same.
Where can you use Botox?
The upper third of the face is the most common area for use of Botox. The area between the eyes- (the 11’s or glabella area), the forehead, and around the eyes (crow’s feet). When these areas are treated it can produce relaxation of worry lines and frown lines. And give the face a more youthful appearance.
Lips- Fine lines around the mouth can be relaxed as well as the new “lip flip.” By relaxing the muscles that pull up the upper lip when smiling, you can slightly increase the volume of the upper lip and decrease a gummy smile.
Facial Slimming/ Masseter/ Teeth grinding- By injecting the large chewing muscle- the masseter- Botox can decrease the size of the lower face and improve teeth grinding and clenching.
How Long Does it Last?
The short answer is about 3 months. Botox is a protein and just like anything else it gets metabolized by our bodies. Those who are rapid metabolizers, avid exercisers, and over animators will metabolize it quicker. Typically, the first 1-2 treatments last about 8-10 weeks. With regular use, most patients can increase their treatment times to 3-4 months.
Will I see it immediately?
It takes 5-7 days for the effects to take place. It will increase over the first 2 weeks. It then slowly wears off at the 10-12 week point. If you re-treat before it is completely gone, then you won’t have the 5-7 day lag time between treatments.
That depends! Everyone’s facial size, shape, muscle strength and desired affect is different. On average treating the 11’s is 15-25 units with 5 injections, forehead is 8-15 units with 4-6 injections, crow’s feet is 9-15 units with 3 injections per eye, and masseter is 25 units with 3 injections per side.
Botox is measured and priced in units- Units do not equal number of injections!! My price is $12/unit.
Does it hurt?
Not really! I use a tiny needle and most patients are pleasantly surprised at how little they can even feel the injection.
What can go wrong?
It is common and normal that you may get bruising at an injection site. Although I do my best to navigate the thousands of vessels in your face, sometimes they just get stuck. Some patients get a heavy feeling after their forehead is treated. This can be from the actual muscle freezing or from the needle pokes. This usually resolves in 1-2 days.
Uneven eyebrows- The anatomy of the forehead and the working of all the muscles together to animate the face is a bit like conducting an orchestra. Some people use their forehead more than others to keep their eyelids lifted and their eyes open more than others. When you begin freezing these muscles you can get a heavy brow or lid. This can sometimes be combatted, other times it is a sign that you may need less freezing in that area. Botox is a bit of trial and error. Stick with me and we will find the perfect treatment for you!
What age should I start?
Botox can be used for wrinkle prevention or wrinkle correction.
Preventative measures can begin as early as your 20’s. These typically need less units and may only require 2-3 treatments in a year. Wrinkle correction requires full doses and regular treatment- 3-4 times a year to correct the set in lines. If you have etched in lines at rest then we are trying to stop the muscle from moving so that the skin can repair itself and heal the lines. The deeper the lines the more aggressive we need to be with keeping your muscles frozen.
What happens if I stop?
Your muscles move again and you will form more lines and wrinkles! There are no adverse problems with stopping Botox treatment. You have not done any irreversible damage.
Can I have Botox while pregnant or nursing?
Sorry Charlie! Pregnancy is definitely a no-no. There have been some new studies showing it is ok during nursing, but that has not been approved across the board so I do not offer it while you are nursing.
- Stay upright for 4 hours
- Don’t rub the area, wear hats or headbands
- No sweaty exercise for 24 hours
The liquid is placed in the muscle very precisely and if you go get a massage or go to yoga or decide to run 5 miles, all of those things have the risk of the toxin traveling outside of where it was placed and causing problems! That is the reason for the above rules!
Botox is such a great treatment to really preserve the youthfulness of the face. There are not enough creams and peels in the world to make the same difference as a treatment of Botox. Once you start, you will be able to see such an amazing difference in the quality of your skin, less tired appearance and overall more youthful look. A treatment takes less than 15 minutes!