Neurotoxin Injection BOTOX®
Taylor R. Pollei, MD
Fellowship Trained Facial Plastic Surgeon offers Botox in Beverly Hills and Laguna niguel CA
What is the Goal of Neurotoxin (Botox, Xeomin, Dysport) Injection?
Pollei Facial Plastic Surgery offers Neutoxin Injections such as Botox, delivered by top experts in both Beverly Hills & Laguna Niguel locations. Although neurotoxins (Botox, Xeomin, Dysport) were originally approved by the U.S. Food and Drug Administration for the treatment of eye and muscle spasms, it was quickly recognized for its cosmetic value. Since that time it has been extensively researched with thousands of studies confirming its safety and efficacy. The goal in the cosmetic setting is to decrease or completely stop areas where movement results in an aged appearance or can even make patients appear angry or tired. By placing neurotoxin correctly it can help open up the eyes, decrease fine lines, wrinkles, and creases of the skin, and minimize muscle movement related to negative facial emotions such as frowning or scowling.
Now, we can straighten up one of the gigantic misconceptions. Neurotoxin is used to treat lines, creases, and furrows that are created by muscle movement. They will have no effect on wrinkles, creases, or fine lines that are present at rest, which are treated with facial fillers (Restylane, Juvederm, Belotero, Voluma, etc.)
What Exactly is Neurotoxin (Botox)?
First off, remember that Botox is simply the name of a specific brand of neurotoxin. Others include Dysport, Xeomin, and many others that are not commonly used here in the United States. Similar to how “Kleenex” is synonymous with facial tissue, “Rollerblade” is synonymous with in-line skate, and “Q-tip” is synonymous with cotton-tipped applicators, “Botox” is the term we use when referring generally to an injectable neurotoxin
Next, Botox is a neurotoxin that when injected prevents nerve to muscle signaling. It is not permanent, but lasts usually around three months, and starts to slowly wear off. After injection, it starts to work in around 2 to 3 days, and peak effect is reached about one week. I have found that it wears off quicker in patients that have an extremely active lifestyle.
All neurotoxins are measured in units. Much as other medications are measured in milligrams. A unit is nothing more than a created dosing method to standardize production and injection. Certain areas of the face are treated with doses as small as 2 to 3 units, where others may require up to 35 or more units. This depends on the size of the muscle, the degree of muscle activity, your gender, and degree of muscle weakening that you desire.
How is Neurotoxin like Botox Injected?
With the smallest needles possible! Honestly, it is injected with very small syringes and the smallest needle possible that is large enough to inject through. It is manufactured and shipped in a crystal form, and it is reconstituted in the office prior to injection. Is kept frozen or refrigerated from the time of its manufacture up until injection. Usually, a numbing cream is not used, but very often patients prefer to use ice to cool the area and decrease the discomfort of the injection.
What Areas Are Most Often Treated with Botox and other Neurotoxins?
Although neurotoxin can be injected into the chin for dimpling, the lips for excessive puckering or lip movement, along neck platysmal banding, or under the jawline to soften or slightly lift areas of jowling, it is most often used in the upper part of the face. Most patients are interested in treating the heaviness and aggressive creases and lines present between the eyes that are worsened with frowning. This area is called the glabella. It is typically heavier in men than women and requires a reasonable dose. Even vertical creases in this area often called “elevens” can be softened to the point of disappearing with repeated injection. Areas also commonly treated include the crow’s feet or smile lines around the outer part of the eye, or aggressive horizontal creases in the central part of the forehead. I will often also inject a small amount in the outer part of the eyebrow to give a slight brow lift.
Who Is A Good Candidate for Botox?
Botox only works on what are known as dynamic wrinkles. These are wrinkles that form on the upper third of the face when we make common expressions such as frowning or squinting. When the muscles repeatedly contract to create these expressions, over time wrinkles form on the surface skin. By relaxing the muscles and keeping them from contracting, Botox stops dynamic wrinkles from forming.
If these are the wrinkles you’re seeking to erase — crow’s feet, the 11s between your brows, and forehead lines — then Botox is the perfect solution.
If, however, you have wrinkles that show themselves at all times, what are known as static wrinkles, Botox has no effect on them. Static wrinkles are caused by collagen loss, sun damage, personal habits such as smoking, and general aging. These wrinkles need to be filled with dermal fillers such as Juvederm or Restylane.
Dr. Pollei does not inject Botox into patients with autoimmune disorders or in women who are breastfeeding or pregnant.
Do The Injections Hurt?
Dr. Pollei injects Botox with a very tiny needle and it isn’t injected very deeply. Because of this, most patients say Botox injections are not painful, equating the injections to slight pinpricks. However, if you prefer, Dr. Pollei can apply topical anesthetic prior to your injections.
How Long Do Botox Results Last?
Botox temporarily relaxes the muscles it is injected into for about three to four months, depending on the patient. At that point, the muscles will start contracting again and the wrinkles that form above them will return. To maintain your results, you’ll need to schedule another Botox session with Dr. Pollei.
Can Botox Be Used To Treat Migraine Headaches?
Botox received its first FDA approval not for the treatment of wrinkles, but to treat involuntary eyelid spasms. It has since been used to treat a variety of problems, everything from TMJ disorder to excessive underarm sweating. In October of 2010, the FDA approved Botox for the treatment of chronic migraine headaches in adults.
Will Botox Give Me A Natural Look?
Botox provides natural-looking results when a surgeon who is well versed in facial anatomy, such as Dr. Pollei, injects it. By knowing precisely which muscles are creating the wrinkles such as crow’s feet, Dr. Pollei is able to effectively target the Botox injections for the optimal outcome.
Are There Any Side Effects or Risks of Neurotoxin Injection (Botox)?
The more common side effects include slight discomfort, minimal bruising, or injection site swelling. These are all short-lived, and typically do not require any sort of intervention. Patients that are on blood thinners whether prescription, over-the-counter or even in vitamins and supplements are at a slightly increased risk of injection site bruising. Arnica, bromelain, and other bruise treatment options can help in these cases.
Even though risks of the neurotoxin spreading to other areas of the body are basically zero, we still avoid neurotoxin injections in patients with specific autoimmune disorders or in women that are pregnant or breastfeeding.
Contact our practice to learn more about Botox where we serve the Beverly Hills, Laguna Niguel, and South Orange County areas.