Frequently Asked Questions
A. Botox is a toxin produced by a bacteria called Botulinum. Botox blocks the chemicals that cause muscles to contract, thereby relaxing them. Botox has been used for over 15 years to treat a variety of medical conditions. The same product with dosing specific to cosmetic indications was approved in 2002 as Botox® Cosmetic. The wrinkles caused by overactive facial muscles and repetitive facial expressions are called dynamic wrinkles. They include frown lines, crowâ€™s feet, forehead wrinkles and lip wrinkles. Botox can dramatically improve and often eliminate those wrinkles.
The lines and creases that appear in the face result for repetitive muscle movement and the passage of time. For instance, the frown lines between the brows are created by two specific muscles, when they contract, the brows are drawn together. As skin becomes less elastic overtime, repeated frowning will result in moderate to severe lines between the brows. Injecting Botox into those muscles will relax the muscles with improvement or elimination of the frown lines.
A. Our doctors use the smallest available needle in the market called the “Gucci Needles.” Most people experience no pain whatsoever; and some may experience brief mild discomfort as they are being injected. If needed, the areas to be injected are numbed with ice or a local anesthetic cream.
Following injection recovery is immediate, and you can return to work immediately.
A. You will begin to see changes in your wrinkles within 24 hours and continue to see improvement for the next 5 days. Visible results can last up to 4 months. After that, you may be ready to return for a follow-up treatment. Your own results may vary (the range varies from 3 to 6 months). The effects of Botox are not permanent, and are only effective for dynamic wrinkles.
A. Botox has been used safely for over 20 years. It has an excellent safety record and a low incidence of side effects. A few patients may experience mild bruising that disappears within a few days. The most common side effects following injection of Botox® Cosmetic include headache, respiratory infection, Flu syndrome, temporary eyelid droop and nausea.
A. Most doctors charge by area of injection without disclosing to the patient how many units of Botox® Cosmetic will be injected in each area. You must be aware that dilution matters, ask the doctor how much saline solution he or she uses to dilute the vial of Botox® Cosmetic and how many units will be injected in each area. Each vial contains 100 units and should be diluted with no more than 4 cc of saline. If the doctor dilutes the Botox with more then 4 cc of saline, then you will be getting a smaller dose of Botox® Cosmetic which will be less effective and shorter lasting.
When comparing Botox® Cosmetic injection prices among different offices, be sure to ask each office how much they dilute the pure Botox. Be aware that a physician who offers Botox injections at very low prices may be suspect for over diluting the Botox. Highly diluted Botox®will usually give a short and less than optional result – NOT what you want!
You are better off asking the doctor to charge you the Botox® Cosmetic injections by the unit, rather than by area of injection. We charge Botox® Cosmetic injections by the unit.
A. If you are between the ages of 18 and 75 you may be a candidate for Botox® Cosmetic. You should not be treated with Botox® Cosmetic if you have an infection at the proposed injection site. Patients with certain neurological disorders such as ALS, myasthenia gravis, or LAMBERT-EATON syndrome may be at an increased risk of serious side effects.
A. Although many physicians offer Botox to treat frown lines and forehead creases, few have the experience and artistic skills to correct dynamic wrinkles in other areas of the face and body. Our doctors have large experience and excellent results with the use of Botox for the correction of the conditions listed below:
- Frown lines
- Crowâ€™s feet
- Forehead creases
- Brow shaping (Botox injections can be used to alter the shape of the eyebrows to create a more aesthetically pleasing appearance)
- Brow elevation (lift)
- Correction of eyebrow asymmetry (to elevate the lower eyebrow to the same level as the higher eyebrow)
- Elevation of the corners of the mouth
- Upper/lower lip creases
- Marionette lines, â€œdrool groovesâ€
- Lip lengthening to correct gummy smile
- Chin softening (peach pit chin and excessive cleft)
- To improve the appearance of new and old facial scars.
- Neck Rejuvenation:
- Horizontal â€œnecklaceâ€ creases
- Vertical neckbands (turkey neck)
- Chest Rejuvenation:
- Women may exhibit wrinkling of the central mid chest (dÃ©colletÃ©) Botox injections can successfully reduce those wrinkles.
A. Botox® Cosmetic temporarily corrects or eliminates the dynamic wrinkles due to overactive facial muscles by blocking the chemicals that cause the facial muscles to contract resulting in muscle relaxation. Botox is only effective for the correction of dynamic wrinkles. Skin sagging and wrinkles of the face start to develop as we get older, they are the result of thinned and broken collagen. These types of wrinkles are different from the dynamic wrinkles and require the use of fillers to fill out and plump up the depressed areas. The intradermal injection of the filler mask the wrinkle by adding volume. There are several available fillers, they include Restylane, Captique, Collagen, Sculptra, Cosmopast, Cosmoderm, Hylaform and Radiesse.
Because a significant number of women have a combination of both types of wrinkles, Botox®Cosmetic and facial fillers are frequently used in combination, complementing each other.
A. Botox injections have proven to be very useful in diminishing excessive sweating (hyperhidrosis). Hyperhidrosis is a common and extremely distressing condition with a prevalence of 2.8% of the population. For those affected, the condition is debilitating with serious impairment in activities of daily living, social interaction, and occupational activities. It is divided into primary or idiopathic hyperhidrosis which is usually focal and limited to axilla, palms, soles and face, and secondary hyperhidrosis which can be local or generalized affecting the entire body. Secondary hyperhidrosis is due to a variety of causes including underlying medical conditions, drugs, or exaggerated physiological responses to heat, humidity, or exercise.
The most common type is primary idiopathic hyperhidrosis; however, it is critical to be aware of the secondary causes when evaluating a patient with excessive sweating.
Primary hyperhidrosis is defined as focal visible excessive sweating or at least 6 months duration without apparent cause and associated with at least two of the following characteristics:
- Bilateral and relatively symmetrical
- Impairs daily activities
- Frequency of at least one episode per week
- Age of onset less then 25 years
- Positive family history
- Cessation of focal sweating during sleep
Topical treatment: It works only in mild cases of focal hyperhidrosis, aluminum chloride hexahydrate is the most effective topical agent.
Oral treatment: Anticholinergic drugs are the most effective oral treatment. Because the side effects associated with their use (dry mouth, blurred vision, constipation, urinary retention and palpitations) they are generally not tolerable by most patients.
Surgical treatment: They include curettage or liposuction to remove glandular sweat tissue, excision of the axillary vault to remove sweat glands, and sympathectomy. Surgical treatments are generally reserved for patients who fail to respond to other noninvasive modalities.
Botox Treatment of Hyperhidrosis: Our doctors experience treating patients with hyperhidrosis using Botox have proven to be well tolerated, safe, and effective. It offers a viable minimally invasive alternative for the treatment of hyperhidrosis.
The injections of Botox in the axilla create a localized, prolonged, yet reversible decrease in chemical transmission to the sweat glands that results in a diminished sweat production.
We offer the Botox injection alternative to patients who have failed to respond to topical therapy. The effect of Botox is 6-7 months. Dosages for injection range from 50/200 units/axilla. The usual starting dose is 50 units/axilla. Side effects include rare bruising and minimal discomfort.
The treatment of palmar and plantar hyperhidrosis is similar to the axillary approach; however, patients may require regional nerve blocks to minimize pain associate with the injections.