What is BOTOX®?
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 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. Although very few, some people are resistant to BOTOX® and achieve little or no response.
Injection of BOTOX in glabellum
(Lower photograph taken 2 weeks following treatment)
Where Can BOTOX® Be Administered?
Areas of the face that respond well to BOTOX® include lines around the eyes (crow’s feet), vertical frown lines between the eyebrows (furrow or angry look), and horizontal lines on the forehead (worry lines). 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.
Additional areas where Botox responds well include jawline to soften or relax the area reducing jowls and restoring a youthful angular appearance. The jawline injection can also reduce symptoms of clenching or pain from TMJ.
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. Some “lower” face injection from BOTOX® Cosmetic include the depressor anguli oris (or DAO’s) which pull down on the angle of the mouth.
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 5-7 days, although some patients report a noticeable difference the very next day.
Could I Get a “Frozen Face” from BOTOX® Injections?
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. The philosophy at Blue Water Spa/ Michael Law MD has always been conservative and natural.
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 if they 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. Our 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.
Why Blue Water Spa/Michael Law MD?
Here at Blue Water Spa/Michael Law MD we have surgeon-trained and supervised nurse injectors that are the ideal person to perform BOTOX® injection. The nurse injectors at Blue Water Spa/Michael Law, MD only inject BOTOX® Cosmetic and dermal fillers. It is what they do all day long, every day not just “occasionally” between other services. Our nurse injectors have injected over a quarter of a million units of BOTOX® to date and are among the top 1% providers of BOTOX® Cosmetic in the country. Our injectors have a “no pressure” approach and are skilled at providing the least amount of BOTOX® cosmetic possible to give optimal results. At Blue Water Spa/Michael Law MD you don’t have to worry about having a new nurse injector every 6 months, Karin, Melissa and BJ have been with Blue Water Spa/Michael Law MD for years and have mastered the art of BOTOX® and dermal fillers. Our clients are continuously pleased with their performance.
“I don’t trust my face to anyone else but BWS! Melissa does my Botox and she knows exactly what I need to look more refreshed without looking frozen!” -Nicole, Cary
“Karin is the BEST! I can’t say enough good things about her. She has done Juvederm and Voluma on me and I love it!” -Tricia, Raleigh
Is There a Permanent Alternative to BOTOX®?
A truly remarkable consequence of BOTOX® administration 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.
Permanent improvement in other 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 and assessed by an expert.