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BOTOX® Injection

Located in Raleigh, North Carolina
and serving patients Nationwide

BOTOX ® is a protein complex that interferes with muscle contraction. It temporarily blocks nerve stimulation of muscles where it is injected, so that muscle contraction is weakened or inhibited. BOTOX ® has been safely used for many years to treat spasms of the muscles that move the eye (strabismus) and uncontrollable blinking (blepharospasm). In 2002 it was approved by the FDA for cosmetic use, and since that time it has been marketed as BOTOX ® Cosmetic.

Many facial wrinkles and creases are active lines caused by muscle contraction, which can be blocked by BOTOX ® injection. The effect is temporary, usually lasting 3 to 6 months. With repeated injection, the effect may regularly last up to 5 or 6 months. Although some wrinkles and creases may completely disappear (temporarily), it is important to understand that some may improve but not completely disappear. Some people (very few) are resistant to BOTOX ® and achieve little or no response.

Where does BOTOX ® work the best?

Areas of the face that respond well include 'crows feet' lines around the eyes, vertical frown lines between the eyebrows, and horizontal ('worry') lines on the forehead. BOTOX ® can also be administered just below the lateral aspect of the eyebrow to produce a temporary lateral browlift, which opens up and brightens the eyes.

In some instances, BOTOX ® can be used to soften vertical upper and lower lip lines, to reduce muscle bands in the anterior neck, and even to elevate the nasal tip. While there are some good 'lower face' indications for BOTOX ® administration, in my practice the majority of injections are for 'upper face' (especially eye area) rejuvenation.

One truly remarkable consequence of BOTOX ® administration that I have seen over and over again is the gradual complete disappearance of deep, vertical furrows between the eyebrows (frown or 'scowl' lines). With long-standing muscle contraction, the vertical lines between the brows may become actual physical clefts or grooves in the dermis, resulting in creases that are still apparent even when the skin is spread apart tightly with a finger on each side of the crease. In such instances, the initial BOTOX ® injection will soften but not completely eliminate the deep furrow. With regular BOTOX ® treatment, however, such that the frown muscles are never allowed to fully regain their normal ability to contract, the deep furrows may gradually fade completely.

Some patients with chronic, deep furrows between the brows achieve improvement but not complete correction of these creases with repeated BOTOX ® injection. In these cases, a soft tissue filler can be used to eliminate what remains of the furrow. I have used Restylane for this indication in a number of patients with excellent results, and for several of these patients I have performed structural fat grafting of the remaining furrow to provide a permanent correction.

What is a BOTOX ® treatment like?

BOTOX ® is precisely injected through a tiny needle into specific facial muscles. The areas to be injected are cooled with an ice pack immediately prior to injection to significantly reduce needle discomfort. The complete treatment lasts just one to three minutes (depending on the number of areas being treated) and does not require the use of topical or local anesthetics. BOTOX ® begins to show its effect after 2 to 5 days, although some patients report a noticeable difference the very next day.

Could I get a "frozen face" from BOTOX injection?

As is my goal with facial rejuvenation surgery, I seek to produce natural-appearing results with non-surgical treatments like BOTOX ®. The effect of BOTOX ® is dose-dependent, and thus the degree of muscle contraction impairment can be varied by the amount of BOTOX ® that is administered in any given treatment area. While my goal for vertical frown lines between the brows is to completely eliminate them, my goal for horizontal frown lines is to soften them while maintaining the patient's ability to elevate their brows.

Nobody seems to miss being able to scowl, but everybody wants to retain the ability to express hope, surprise or concern. Thus injection of the forehead to reduce horizontal creases should be conservative. Over-treatment of the forehead will also have the effect of lowering the brows, which is without question an undesirable BOTOX ® result.

Patients will often ask me if I can "get rid of this line" in regards to facial lines and wrinkles that may not necessarily contribute to the appearance of age or fatigue. My strong feeling about the softening of facial lines and wrinkles is this: if it doesn't 'age' you, and it doesn't make you look tired or worried, then don't spend your hard-earned money trying to make it go away. Some lines actually do add warmth and character to the face, and an older face with NO lines usually looks a bit odd.

Who should inject BOTOX ®?

It is my opinion that a surgeon's intimate knowledge of the anatomy and physiology of the muscles of facial expression make a surgeon, or a surgeon-trained and supervised medical professional, the ideal person to perform BOTOX ® injection. A plastic surgeon has, without question, the best three-dimensional understanding of facial anatomy, and therefore also has the greatest ability to perform precision injections that produce exactly the desired the effect (and that avoid unintended and undesirable effects, as well as treatment complications).

Many of my BOTOX ® patients have other aesthetic concerns, some of which are amenable to treatment with other non-surgical technologies, and some of which are surgical issues. Many are interested in discussing the treatment possibilities and in reviewing 'before and after' photographs. By choosing for their BOTOX ® injection the office of a board-certified plastic surgeon, which is fully integrated with a state-of-the-art medical spa and laser center, our patients avail themselves of the full spectrum of medical and surgical aesthetic technology.

Is there a permanent alternative to BOTOX ®?

Permanent improvement in facial wrinkles and creases can be accomplished with a variety of techniques, including non-invasive laser skin rejuvenation, laser resurfacing, structural fat grafting and surgery. Not all wrinkles are appropriate 'targets' for BOTOX ®, so the evaluation and treatment of every face must be individualized.

For vertical frown lines between the brows, surgical interruption of the corrugator muscles that produce these creases is available. These frown muscles can be approached through an upper eyelid incision (in patients undergoing upper blepharoplasty) or endoscopically through small incision behind the frontal hairline. The muscles are divided, partially removed, and the ability to form the 'scowl' lines is significantly reduced or eliminated.

What about 'BOTOX ® parties'?

BOTOX ® is an injectable pharmacologic agent, and is most appropriately administered in a medical setting. It is my feeling that a 'party' is not the appropriate setting for the administration of a medical treatment, particularly an injectable one. The 'BOTOX party' that is held outside of a medical setting is a marketing strategy used to promote the treatment and to perhaps make it less intimidating to the general public. Before joining the 'party', ask yourself the following questions:

  • Have I been asked to provide a complete medical history?
  • Have I been advised of alternative treatments?
  • Have risks or potential complications been discussed?
  • Have I been asked to give my informed consent?
  • Will I receive adequate follow-up care?

BOTOX ®, like all other injectable medications, belongs in a physician's office. Period.

The Brilliant Distinctions Program

Allows you to earn points for each eligible treatment you receive from your physician. These points are redeemable for dollars off future treatments, as well as select ALLERGAN products and ongoing opportunities for other valuable rewards.

How to Register for Brilliant Distinctions

Visit www.brilliantdistinctionsprogram.com/activate to sign up before your 1st scheduled Botox or Juvederm appointments to start earning points immediately.

How to Deposit Points

Log into your Brilliant Distinctions homepage at www.brilliantdistinctionsprogram.com after receiving an eligible treatment.

All un-deposited voucher points will show up on your program homepage.

Click on "Deposit" for all points to be banked into your account.

**Voucher points expire in 60 days if you do not deposit them into your account.**

How to Redeem Points

Before coming in for your next Botox , Juvederm or Latisse appointment, log onto your Brilliant Distinctions Homepage.

Click on the "Redeem Points" tab, use your banked points to create a coupon.

**Coupons expire 60 days from creation date.**

Any questions, Contact the Brilliant Distinctions Call Center at 1-888-324-2745

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Actual Patient Reviews

M Chandler -
Most comprehensive appointment I've ever had for Botox. Melissa explained each and every move thoroughly, told me what the final result would be and not to hesitate to let her know if I needed any follow up. I highly recommend her and already have to several friends. It has been 5 days since my appointment and the results are the best I've ever had. I can now see how lax the previous dermatologist I used to go to really was. Overall it was the most pleasant experience I've had at a spa period. Their programs to contribute to the community are an added bonus.

A Google User -
I just would like to say that Karin Berg is fabulous at what she does. After my Botox treatments I have no more lines or wrinkles and always get compliments of how young I am looking. I followed her from her previous job a few years ago where she also treated me with laser hair removal, chemical peels and microdermabrasion. She is a beautiful and pleasant person to have as your consultant. Thanks Karin for all of your hard work and professionalism.

crbonfiber -
The most wonderful experience. I just had Botox for the first time in my life at Blue Water Spa. Being my first time having Botox I was quite nervous. However, once I was greeted at the front desk, I began to relax. I was offered water in a chilled glass. (nice touch). After a short wait, the woman who would be giving me the treatment came out and greeted me by name. Her name was Karin I told her that this was to be my first time. She was kind, gentle and confident. I felt at ease in her care immediately. I told her there was NO way the wrinkles on my forehead were going to go away. She just smiled and assured me that they would. Well after a few weeks, amazingly they were gone! When I went to pay, they offered me a nice discount if I made a donation to the Girls and Boys Club of Wake County. I was amazed by this, and it made me feel good that I would be able to do something nice for myself and benefit others. What a great philosophy. I'm so happy, and can't thank the staff at Blue Water Spa enough.

Shannon -
Amazing experience every time I visit! I started going to Blue Water several years ago when they first opened for Botox injections. They have always done an excellent job--just enough product to make me look younger and wrinkle-free, but no "surprised" look :) I recently started laser skin tightening and within two months, people are commenting on how fabulous and young my skin looks! Yesterday, I had a lunchtime chemical peel (which I was scared of, due to reading too many horror stories) but the esthetician was amazing, kind, and gentle. My skin looks better now than it did when I was 18! I highly recommend Blue Water and its wonderful and skillful staff!

Rossi -
Best Experience!!!!! Blue Water Spa was a refreshing change compared to other medical spas I have frequented in the past. I went there for a peel and Botox could not have been in better hands. The front desk reception was warm and professional and made me feel more comfortable than I expected. Heather performed a chemical peel that left my skin smooth and noticeably glowing. She made me feel relaxed and answered all my questions about my aging skin. I then went on to Karin for Botox. She was professional, listened to my concerns and gave me the result I have been looking for without having a "frozen" look. I am so happy with my visit to Blue Water Spa I have already scheduled my next treatment for Juvederm. Look out 25 year High School reunion here I come!

Dr. Michael Law

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Blue Water Medical Spa has created this website about aesthetics including microdermabrasion for informational purposes only. The content provided here should not be perceived as formal medical advice, nor does the understanding constitute a formal medical relationship with Blue Water Medical Spa. Contact our Raleigh Day Spa office to schedule an appointment for formal advice with our plastic surgeon and skin care specialists. We proudly serve North Carolina clients in Raleigh, Durham, Chapel Hill, Cary, and surrounding areas.

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