Some wrinkles are caused by repeated contraction of muscles in the face. Over time, creases formed can lead to a "persistent frown" and a more aged appearance. Precise use of Botox is the best approach to preventing and eliminating these lines. Treated facial muscles become relaxed for an average of three to four months. It may be used in addition to, or in place of other cosmetic procedures. The use of Botox for wrinkles is not covered by insurance and must be paid for by the patient at the time of treatment.
The most commonly injected areas include the forehead, glabella (between the eyebrows) and crow's feet (next to the eyes). The injections are slightly uncomfortable and may cause a temporary headache. Occasionally, there may be some swelling and bruising. Patients may resume normal activities immediately and no recuperation is needed. The full effect of Botox may take two weeks to be noted.
The pictures above show the results for a Baylor Dermatology patient who received Botox treatment.
Additional Information
No long-term side effects have been described with cosmetic use of Botox. Although officially approved by the FDA for cosmetic use in 2002, it has been used to improve facial wrinkles for many years. Botox is very safe and used in much larger doses in other fields of medicine. Rarely, the medication can affect nearby muscles, causing temporary, but unintended, muscle paralysis. Examples include eyelid drooping or double vision seen in a very small percentage of patients treated. Those effects are always temporary and often can be treated with eye drops.
Patients on selected medications or with certain medical disorders are not advised to have Botox. Captopril may inhibit Botox, while aminoglycoside antibiotics may exaggerate the effect. Individuals who are pregnant, have egg allergies, or a neuromuscular disorder are advised to avoid Botox.
After treatment a few simple techniques may maximize the benefit and minimize side effects. Gauze should be held over the skin until pinpoint bleeding stops. It is helpful to frown repeatedly during the first hour after injection. Patients should avoid touching the area or lying down for four hours.
In summary, Botox is a safe, effective, FDA-approved tool that may be used to treat certain types of wrinkles for three to four months at a time. Side effects as described above are minor and temporary. The procedure may be repeated as desired by the patient and may be used in combination with other treatments for a more youthful appearance.
Frequently Asked Questions - Botox
Botox® is the brand name for botulinum toxic A, a therapeutic muscle-relaxing agent derived from the bacteria clostridium botulinum. Originally approved by the FDA for the treatment of eye muscle spasms, Botox® was quickly recognized for its cosmetic value.
Physicians have been using Botox® Cosmetic for years as a treatment to correct visible signs of stress and aging. The medication relaxes the muscles in the face that cause wrinkles. When injected in small doses in specific areas, Botox® injections block nerve muscles responsible for the repetitive actions that cause fine lines and wrinkles. In this way, Botox® smooths the lines in the skin that make you look tired or angry.
A good candidate for Botox® treatment may be anyone looking to enhance their appearance by getting rid of unwanted lines or wrinkles. It is also important that patients seeking treatment with Botox® Cosmetic are in good physical health, are not pregnant or nursing, and do not have a neuromuscular disorder.
Men and women considering Botox® treatment should have realistic expectations of what the procedure can do. You should discuss the desired results with your doctor to ensure that your goals can be achieved.
Using a very fine needle, a qualified physician will inject Botox® Cosmetic into designated muscles in your face that are causing lines and wrinkles. You may experience brief, mild discomfort during the injection, but you can be assured that the treatment is very safe and effective. Taking only a few minutes, Botox® treatment requires no anesthetic and recovery is immediate, allowing you to return to work and resume your normal daily activities that same day.
Even though Botox® is not a surgical procedure, it is very important to choose a highly experienced and qualified physician when deciding to undergo Botox® treatments. Doctors who are less familiar with the technique could leave you looking "frozen" or perpetually surprised. Our doctors are intimately familiar with Botox® Cosmetic, having successfully treated hundreds of patients at our office. Not only that, we also take the time to talk with each candidate before beginning the injections to find out what he or she wants to achieve and to determine how best to correct their problem area(s), so patients can be happy again with their smoother, younger-looking faces.
Immediately following the Botox® treatment, some patients may experience mild bruising, which will go away shortly. You will see your wrinkles begin to fade within 24 hours, with continued improvement over the next five days. The effects of Botox® Cosmetic typically last up to four months, although many have reported results lasting up to a full year. After several Botox® treatments, the results may be prolonged.
Botox® Cosmetic treatment will relax the muscles in your face and soften the skin, giving you a more relaxed and youthful appearance. For optimum results, many patients choose to use Botox® in conjunction with a facelift, skin rejuvenation therapy, and/or laser skin resurfacing.
Side effects of Botox® Cosmetic are rare and are usually mild and temporary. The most common side effects caused by Botox® are headaches and temporary redness or bruising of the skin at the site of injection. In rare cases, slight drooping of an eyelid or asymmetry of expression may occur. Any risk of complication can be reduced by choosing a qualified and experienced physician.
Frequently Asked Questions - Restylane®
Yes. Clinical studies show that patients injected with Restylane® for the treatment of facial folds achieved an optimal cosmetic result. These results were sustained for a longer period of time (as much as twice as long) than with collagen.
Restylane® works in two ways. Upon injection, into the mid to deep dermis (middle skin layer), the NASHA™ gel adds volume and fullness to smooth facial wrinkles and folds. It integrates into dermal tissue, then attracts and binds to water molecules to help maintain volume.
The average treatment results last six months or longer.
No. Unlike permanent fillers, Restylane® is completely degraded. Over time, NASHA™ gel is eliminated by the body, leaving absolutely no trace of the injected material.
Yes. Restylane® has been used safely by dermatologists and plastic surgeons since 1996 worldwide. Because Restylane® is non-animal-based and fully biocompatible, allergy testing is not required. The most commonly reported side effects were temporary redness and swelling at the injection site. These effects typically resolve within two to three days.
Yes. Restylane® is approved by the FDA for the treatment of moderate to severe facial wrinkles and folds, such as nasolabial folds.
Restylane® requires no pretesting, but patients should take a few precautions. Avoid using aspirin, non-steroidal anti-inflammatory medications, St. John's Wort, or high doses of vitamin E, as these may increase bruising or bleeding. If patients have previously suffered from facial cold sores, there is a risk that needle punctures could contribute to recurrence.
Restylane® is a natural cosmetic filler. Botox® is a drug that blocks nerve transmission and relaxes the underlying muscles. Many patients have been very pleased after receiving treatment with both products.
Bovine collagen is derived from animals and requires an allergy test before it can be used. Because Restylane® is a non-animal-based hyaluronic acid, it can be administered without pretesting. In addition, it delivers a longer-lasting effect than bovine collagen.
Unlike other hyaluronic acid-based products, such as those made from rooster combs, only Restylane® is non-animal-based. This quality virtually eliminates any risk of animal-based disease transmission or allergic reaction.
Restylane® is administered by injection to the site where enhancement is desired.
Dermatologists and plastic surgeons can maximize the intended effect of Restylane® by injecting it into the mid to deep dermis. Contouring after the injection may be optimized by gently massaging the skin.
The procedure is simple and convenient, and results are practically instantaneous. Also, since Restylane® does not require patients to have allergy testing, it is not necessary to wait to qualify for the procedure.
Results are technique-dependent; improper technique can impact the overall cosmetic effect or shorten the duration of the effect. For example, if Restylane® is injected too deeply the gel can shift in the tissue because its particles are too small in relation to the tissue structure at that level. Injecting Restylane® too superficially can result in tissue disturbance or uneven contouring. A touch-up treatment can be scheduled two weeks after the initial treatment to correct any minor irregularities.
Restylane® Before and Afters
(Left) Before treatment. (Right) Immediately after 1 syringe of filler by Dr. C. Helen Malone.
(Left) Before treatment. (Right) Immediately after 2 syringes of filler to the cheeks and chin by Dr. C. Helen Malone.
(Left) Before treatment. (Right) After 3 syringes of filler to the cheeks, jawline and lips by Dr. C. Helen Malone.
(Left) Before treatment. (Right) Immediately after 3 syringes of filler to the chin and prejowl sulcus by Dr. C. Helen Malone.
(Left) Before treatment. (Right) After 3 syringes of filler and 1 1927nm Fraxel laser treatment by Dr. C. Helen Malone.
Frequently Asked Questions - Other
Formerly known as Radiance, Radiesse® is a synthetic injectable filler that reduces wrinkles and creases. Composed of microspheres of calcium hydroxyapatite in a biocompatible gel, Radiesse® is made from the same minerals found in bone, so it carries minimal risk of allergic reaction. Radiesse® can be used on many areas of the body, but the most effective areas to treat are the lips, nasolabial folds (from the root of the nose to the corner of the mouth), wrinkles around the mouth, and depressed scars.
Treatment typically takes 30 minutes to an hour and requires local anesthetic. Side effects such as swelling or bruising are minimal and fade within a few days. Results are visible immediately and can last up to two years.
Hyaluronic acid is a natural substance found in all living organisms. In humans, it is used to provide volume and fullness to the skin. The type of hyaluronic acid used in Restylane® is called NASHA™.
NASHA is a patented, non-animal stabilized hyaluronic acid in clear gel form which is biosynthetically produced. NASHA is the first stable, biodegradable, non-animal form of hyaluronic acid.
No. NASHA is identical to the natural hyaluronic acid found in humans and all living organisms, but it is produced in a laboratory by a natural fermentation process.