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Botox-type injectables can help an adult patient of any age improve his or her appearance, not only imparting a more youthful look, but also alleviating an overly concerned look, helping you look better refreshed or even more pleasant. The most commonly treated areas are those where muscle activity influences facial features, such as the following:
Now you know that each of these products contain the same active ingredient: botulinum toxin type A, and are designed to address the same types of wrinkles and other cosmetic concerns. So how are they different? The main distinction lies in their formulation, which influences the dosage used, how much the product spreads, and how quickly a patient might see the results. For example, Botox Cosmetic is formulated with an accompanying protein. Dysport contains a smaller version of a similar protein, while Xeomin doesn’t contain an accompanying protein at all. All three products are FDA approved and have been used safely and effectively for years. Which of these products is best for you will depend on your unique anatomy, your goals, and your cosmetic surgeon’s recommendations.
Many people think that because Botox is advertised in day spas and other non-medical offices, botulinum injections are on the same level as a manicure, facial or haircut. We cannot stress enough that this is not the case! Though non-surgical, injections are a medical procedure that requires specific training, knowledge and skill to administer safely and effectively.
When selecting a provider for injectable treatments, give your decision the same level of care and scrutiny that you would for a surgical procedure. While many doctors begin advertising Botox treatments after attending a weekend course in injectables, ABCS board certified cosmetic surgeons receive specific training performing neurotoxin injections during their year-long cosmetic surgery fellowship. Choosing a board certified cosmetic surgeon means choosing a Botox provider with an extensive knowledge of facial anatomy, a well-developed aesthetic eye, and a surgeon’s skill and precision.
Whomever you choose, make sure your provider has a proven background in cosmetic medicine as well as training and substantial experience administering botulinum toxin injections. Ask to see before & after photos of that provider’s patients. If an R.N. or physician’s assistant will be performing your injections, that person should be working closely under the supervision of a board certified cosmetic surgeon or other qualified physician.
Botulinum toxin injections are non-surgical and typically completed during an office visit. Your initial treatment will begin with a consultation, during which you will meet with your cosmetic surgeon to discuss your concerns and goals.
During your consultation, your cosmetic surgeon will evaluate your area of concern and go over your medical history. Even though there is little risk of major complications for most patients, it is still imperative that you share your medical history fully and openly with your provider before treatment, as certain allergies, skin and neurological conditions, or medications can make treatment unsuitable for a patient. For instance, you need to tell your cosmetic surgeon if you have been taking NSAIDs (e.g., aspirin, ibuprofen, naproxen) or blood thinners.
Just before the actual treatment, you may be given a topical anesthetic to numb the area prior to injection, though many patients find this unnecessary, as the needles used to inject botulinum toxins are very thin and the injections are not very deep. Your provider will reconstitute the botulinum toxin into a solution, and inject this solution into the muscle at strategic points. Most patients describe a pinching feeling during the injection, though not much pain.
You will be able to go back to your normal activities right after treatment, but your cosmetic surgeon may ask you to take the day off from exercise or other strenuous activity, and to keep your head upright for the rest of the day. Mild redness, swelling at the injection site, and bruising are the most common side effects.
Following treatment, you will not see results immediately. This is expected, so do not worry that treatment hasn’t worked. Depending on the patient, product used, and area treated, final results are typically reached 3 to 7 days after initial treatments. If this is your first botulinum toxin treatment, your cosmetic surgeon may initially inject a more conservative amount and touch up the results during a follow up treatment. This helps to ensure natural, optimal results without the risk of over-treating an area.
The wrinkle-reducing effects from botulinum treatments will vary depending on the patient, the area treated, and the product used, but results will typically last anywhere from 3 to 6 months. To maintain your results, your cosmetic surgeon will simply repeat treatment, adjusting dosage and techniques as necessary to ensure optimal results.
While botulinum toxin type A is most commonly used to treat facial wrinkles, cosmetic surgeons can also use neurotoxins to address other aesthetic concerns that are associated with nerve and muscle activity:
With an experienced, qualified provider, Botox-type injectables provide natural-looking rejuvenation with a safe, convenient procedure with virtually no downtime. The best way to learn whether you are a good candidate for botulinum toxin injections is to meet with a board certified cosmetic surgeon for a consultation.
Botox works by weakening the muscles into which it is injected. As facial muscles contract, the loose skin above those muscles wrinkles. By weakening the muscles, the wrinkles are reduced.
The effects of Botox can last up to three months.
The decision to have Botox injections before or after LASIK surgery should be left up to your LASIK surgeon. The injections should be safe. However, the effect of Botox around the eyes can reduce the strength of the blink reflex, which might create a sense of dryness of the eye. This might affect the healing process of the LASIK surgery. LASIK surgery is known to create temporary dry eyes immediately after the procedure.
When injected appropriately, Botox should not have a direct effect on blood pressure. Always consult with your physician prior to considering Botox injections.
When injected in the correct areas under the eyebrows, Botox can raise the eyebrow (“mini-lift”) to a certain degree. There is a relative risk, however, that the same injection could inadvertently cause the upper eyelid to fall.
Yes, Botox has been successfully used to reduce excessive perspiration (hyperhidrosis) on the palms and feet. The side effects are related to the number of muscles that are injected. Weakening muscles in the palm of the hand can affect the strength of one’s grip. The same can occur in the foot; although gripping with the foot is not a normal function, walking may have an unusual sensation.
Prices vary from doctor to doctor. Some doctors charge a single price for a single zone. For example, the frown lines would be one zone, the forehead would be one zone, and the crow’s feet would be one zone. Some doctors charge based on the number of units of Botox injected and, therefore, have a price per unit of Botox. Botox vials come in two different sizes: 50-unit vials and 100-unit vials. The number of units injected depends on the number of wrinkles that want to be alleviated.
This varies from doctor to doctor. I typically give 25 injections per armpit and use two units of Botox per injection site for a total of 50 units per armpit. A bigger person with a bigger armpit might get more injections and a smaller person might get less.
It all depends on where and how much Botox is injected. There are those persons who want their foreheads “frozen.” Your desired Botox effects should be discussed with your doctor prior to the injections. The “where and how much” can be individualized to your wishes.
The main risks and complications of Botox are associated with weakening a muscle that was not intended to be injected. This can include a myriad of symptoms depending on which muscle was inadvertently weakened.
I personally would not inject a woman who is pregnant or nursing. I am not aware of any of my colleagues that would, either.
Tylenol PM should not have any effect on the Botox.
I am unaware of any vitamin or herb that has a direct effect on the effectiveness of Botox. Certain zinc supplements have been studied as products that might enhance the effects of Botox. There are many vitamins (eg, vitamin E) and herbs (eg, clove, garlic, ginger, ginseng, licorice) that have anticoagulant, or blood-thinning, effects. Since Botox is injected, avoiding these products prior to injections may help reduce possible bruising associated with injections.
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