What is Botox?
Botox is an FDA-approved treatment that weakens muscle movement and thereby has many cosmetic applications and even functional ones. For cosmetic purposes, Botox is very popular to treat and prevent lines and wrinkles on the forehead, upper face, crow’s feet, and more. This facial rejuvenation procedure provides incredible, natural results and is popular among both men and women.
Botox can create a dramatic yet natural enhancement to dynamic facial wrinkles (wrinkles caused by repetitive movement). To diminish the appearance of these dynamic lines and wrinkles, Botox is injected to relax muscles and soften the overlying skin. This injection is most commonly placed between the eyebrows to treat the “11” lines, on the crow’s feet at the corner of the eyes, and throughout the forehead for horizontal forehead lines. The injections may also be performed in underarms, palms, or soles for excessive sweating. Other common uses are for chronic migraine headaches, amongst other applications.
Neuromodulator injections such as Botox are individualized to every client, depending on your needs and desires. These treatments cannot stop the aging process. However, they can temporarily diminish the appearance of wrinkles caused by certain muscle groups. In fact, neuromodulator injections such as Botox are best begun in the early 20s to prevent wrinkle formation. Botox injections may be performed as an isolated procedure or as an adjunct to a non-surgical or surgical intervention (dermal filler injections, browlift, facelift, etc.).
What Types of Neuromodulators are there?
Botox is classified as a medication called “neuromodulators” and has become perhaps the most popular cosmetic treatment worldwide today. There are multiple neuromodulators available on the market today with Botox being the first and most recognized one. Other similar neuromodulators are Dysport, Xeomin, and Jeuveau. All four neuromodulators work via the same mechanism with very similar clinical effects even though subtle differences exist between the four compounds. Even though the FDA-approval varies slightly among these medications, they are often used interchangeably for the same purpose. Should you want to learn more about these products, please discuss with Dr. Walker what the differences between these compounds are and which substance may be best suited for you.
Botox Cosmetic is FDA-approved for the treatment of crow’s feet, frown lines between the eyebrows (commonly called the “11 lines”), and forehead lines. Not only do injections in those areas decrease wrinkles, but they also lead to a subtle but favorable brow elevation if administered properly, contributing to a more refreshed look. All other areas of the face and neck, such as the lower eyelids or neck bands, may be treated safely with Botox in an “off-label” fashion. Botox is also approved by the FDA to treat many other conditions involving excessive sweating of the underarms and hands (hyperhidrosis), chronic migraine headaches, crossed eyes (strabismus), eyelid spasm (blepharospasm), cervical dystonia (stiff neck), musculoskeletal pain disorders, motor disorders of the facial nerve (VII cranial nerve), and most recently, urinary incontinence.
Dysport is FDA-approved to treat moderate to severe frown lines between the eyebrows and cervical dystonia (neck stiffness). Other areas of the face and neck, such as crow’s feet wrinkles, forehead lines, and neck bands, may be treated with Dysport in an “off-label” fashion.
Xeomin is FDA-approved to treat moderate to severe frown lines between the eyebrows and cervical dystonia (neck stiffness). Other areas of the face and neck, such as crow’s feet wrinkles, forehead lines, and neck bands, may be treated with Xeomin in an “off-label” fashion.
Jeuveau is FDA-approved to treat moderate to severe frown lines between the eyebrows and cervical dystonia (neck stiffness). Other areas of the face and neck, such as crow’s feet wrinkles, forehead lines, and neck bands, may be treated with Jeuveau in an “off-label” fashion.
Who is a Good Candidate for Neuromodulators such as Botox?
Botox is used for adult individuals who desire to diminish and soften the appearance of dynamic wrinkles, lines, and many facial expressions. Even if dynamic wrinkles have not yet formed, please keep in mind how often we tend to make facial expressions.
Popular treatment areas (FDA-approved and off-label uses):
- Frown lines (11-lines).
- Crow’s feet.
- Forehead lines.
- Jelly roll under eye (to open the eye with smiling).
- Non-surgical Brow lift.
- Lines around the mouth with puckering.
- Peau d’orange (orange peel skin).
- Gummy smile.
- Platysmal neckbands.
- Jawline narrowing (masseter hypertrophy).
- Excessive sweating in underarms, palms, or soles.
If you have deeper lines, a combination of Botox and a filler may be a better option for you.
Botox for cosmetic purposes can only be utilized in adult patients. Anyone with a known hypersensitivity to botulinum toxin should not undergo any neuromodulator injection. Women who are nursing or pregnant should not undergo these treatments as the safety is unknown. Caution is advised in individuals with difficulty swallowing (dysphagia) and breathing difficulties in the treatment of Cervical Dystonia. Caution is advised in people with pre-existing neuromuscular disorders.
How Are Botox Injections Performed?
Dr. Walker is typically able to perform your Botox treatment at the time of your initial consultation. You will be asked to make various facial expressions, which will allow Dr. Walker to see where the injections need to be placed. Your skin will be cleansed with alcohol, and a cold compress will be applied to prevent any minor discomfort and minor bruising. Although available, a numbing cream is typically not used, as icing has been found to be more effective for Botox injections than numbing creams. Botox will be injected just under your skin using the smallest possible needle. Dr. Walker advises his clients to refrain from strenuous activities and alcohol consumption for the rest of the day to minimize the risk of bruising. You will also be asked to sleep with your head elevated if possible, for the first night. It is important to understand that there is always a slight risk of a tiny bruise, especially when taking blood thinners such as aspirin, ibuprofen, Advil, Motrin, and Aleve.
Botox is a quick in-office procedure that typically lasts 10-15 minutes, requires no anesthesia, and is associated with no downtime. It can often be done at the beginning or end of your workday, or even during your lunch break. There will be a slightly raised area at the injection site similar to a mosquito bite for 5-10 minutes following injection. Makeup can be immediately reapplied and nobody would know you had these treatments done once the small bumps subside after a few minutes. Discomfort is usually minimal or absent. Very few clients may experience some injection site redness, minimal bruising, and on occasion, a minor headache at the injection site which may last up to 24 hours. These reactions are usually minor and clear up quickly. Most patients can return to normal activity immediately after receiving the injections. It is important that you do not massage the area in which the injections were administered because you can cause the medication to spread and affect other muscles other than the ones that were targeted.
Even though slight differences exist between the various neuromodulators, you can begin to see results followinginjections within 48-72 hours with the full effects within 10-14 days. This is typically the time when Dr. Walker asks his clients to return for re-evaluation and for a possible minor enhancement to make sure you have the best and most natural result. Treatment results usually last three months.