Botox is an effective treatment for facial expression wrinkles in the upper face:
- Horizontal forehead wrinkles
- Frown lines between the brows
- Crows feet
Excessive muscle contractions can form grooves and creases on the skin. Over time, they can become deeper. Relaxing these muscles can be an effective way to reduce unwanted wrinkles on the skin.
Botox can also be used to lift sagging eyebrows to create a more youthful, energized look for a patient’s appearance.
The injection is safest for use in the upper portion of the face. Applying it near the mouth may impede important motor functions like speaking and eating.
What Exactly Is Botox?
Botox is a type of protein that is derived from the Clostridium bacteria. This extraction then undergoes purification to remove extraneous structures to produce the final non-surgical injection product.
Initially the drug was intended to treat eye muscle spasms. And during the clinical trials, patients often experienced significant reductions in their crows feet wrinkles around their eyes. Researchers then started to investigate Botox’s potential as a cosmetic treatment. In 2002, it was approved by the FDA for use in this area.
Botox is generally administered to patients between 18-65 years of age.
Crows Feet Lines
Crows feet wrinkles are caused by laughing, smiling and squinting. However, their appearance can be improved by injecting Botox to relax the orbicularis oculi muscles for a more youthful looking appearance.
Frown lines result from the contraction of the glabellar muscles between and slightly above the brows. Strategically applying Botox to this area can eliminate or reduce the appearance of vertical creases. Many patients feel that their “elevens” cause them to look angry and unapproachable to others. And this reason is what often causes them to seek treatment with Botox.
Rumpled forehead creases are caused by skin laxity as well as muscle contractions in this area. When used to create a more youthful looking forehead, Botox is injected into the frontalis muscles. Here are two types of contractions that can be targeted:
- lateral brow contractions in the upper forehead which cause patients to appear depressed
- medial brow contractions in the lower and middle parts of the forehead which create the appearance of worry or anger.
When speaking to a doctor about using Botox for the forehead, it may help to clarify the which of these areas to address, if not both.
Due to age, the muscles in a person’s face can atrophy, causing the eyebrows to droop. However, this can be reversed through the use of Botox. The position and movement of the brows are controlled by opposite sets of muscles. So injecting the muscles that pull the medial ends of the brows down (depressor muscles) will cause the other set to lift them upwards by a few millimeters.
How Botox Works
The muscles in our body contracts when they receive chemical signals from nerves.
As an injectable drug, Botox will prevent the release of acetylcholine from nerve fibers. This causes the respective muscle fibers to relax so that they are unable to crease the skin.
The procedure generally takes about ten minutes, more or less with no downtime afterwards. Patients are usually able to see a drastic reduction in their wrinkles within a week.
Results can even be measured through digital imaging analysis. Here is an example of a skin mapping image that is typically generated.
Duration of Botox
On average, Botox can be expected to last between 3-4 months. Once the injection wears off, the original wrinkles will become apparent with their original size and depth.
Who Is Qualified to Inject Botox
Due to the demand for Botox, the injection treatments are being offered by many types of service providers including doctors who specialize in other areas like dentistry or orthodontics. It is also sometimes administered in non-medical settings like Botox parties held at hotels or someone’s house.
Sometimes, Botox is offered at drastically lowered costs. However, anyone who is interested in undergoing these procedures must aim for safe and positive experiences. This involves understanding:
- what qualifications to look for in a service provider
- who is allowed to inject Botox
- the role of the Botox doctor within their business organization
Legally, Botox can be injected by a doctor with only a medical degree. However, a higher level of specialization contributes to a better overall experience and quality of results. The doctor must have a very detailed understanding of the nerves and muscles in the face. A physician who is board certified in dermatology or plastic surgery will possess this level of knowledge. Therefore, it is best to seek help from this type of specialist.
Botox can also be administered by nurses or physicians’ assistants, but only in the presence of a doctor. Some businesses simply hire physicians as directors who are not always present during actual procedures. This is done to cut down on costs. However, it is not allowed by law.
Although Botox parties are performed by physicians, it is recommended that the drug is administered within a medical clinic which is better equipped to handle emergencies should they arise.
What to Discuss With A Botox Doctor
Besides their aesthetic goals, patients may want to discuss the following areas with their provider:
- potential for adverse reactions and side effects
- who will be performing the injections
- whether or not the actual Botox product is being used.
Although rare, some clinics will attempt to use imitation versions of Botox. These products are produced in countries like China and India. It is also possible that strong concentrations of the botulinum toxin (used on research animals) are used and diluted by the practice to reduce costs.
Patients should feel free to request seeing the actual bottle being used for their procedure. Official Botox is manufactured by Allergan and has a hologram on the label.
Contraindications and Side Effects of Botox
Botox has the potential for unwanted side effects like all drugs. Common issues include:
- flu- like symptoms
Botox should not be administered in pregnant women or those with protein allergies.
Botox is often used by regular, everyday individuals to rejuvenate and refresh their appearance. The goal for each patient should be to achieve the most natural and flattering results for their individual appearance.
Despite their cosmetic applications, it is important to remember that Botox requires medical expertise since the muscles and nerves are affected.
The quality of the outcome depends on who is administering it. Results can be very safe and natural looking in the hands of an experienced board certified dermatologist like Dr. Umar.
This patient decided to undergo Botox treatments at age 47. The loss of skin elasticity combined with the action of facial expression muscles had created noticeable lines on her face. Dr. U injected 60 units of the drug into the forehead, 20 units of Botox into the crows feet wrinkles of both eyes and 20 units for the frown lines between the brows.
These photos show a major improvement in the laxity of her skin and the visibility of wrinkles in the forehead and crows feet area.
Here is a patient example. Focus areas for the treatment include:
- eye brow lift
- crows feet lines
- forehead lines
- frown lines
This patient’s procedure targeted forehead lines and crows feet.
The videos for these patient cases can be seen here:
More information about this patient’s treatment experience can be found here.
Dysport – A Botox Alternative
Another botulinum injection which patients can also choose is Dysport (abobotulinumtoxin type A). This drug is used the same way as Botox to relax specific muscles which contribute to unwanted lines in the upper face.
Although the two formulations are very similar, they are also slightly different. Dysport molecules tend to have a fewer number of proteins compared to Botox. Since the immune system is designed to recognize and target foreign proteins, Dysport is more likely to be accepted by the body. And this may explain why it’s results may be better than Botox for some people.
Dysport’s primary differences include:
- lower cost
- faster onset of action
The effects of Botox and Dysport will differ across individual patients. Both are subject to shortened duration. This happens due to the formation of antibodies against them. Therefore, this can be resolved by switch to the other botulinum brand (i.e. going from Dysport to Botox, or from Botox to Dysport)
Here are examples of patients who underwent treatment with Dysport.
In these set of videos, Dr. Umar answers common questions about both Botox and Dysport:
Which Wrinkle Treatment Is Right For You?
The Office of Dr. U offers free consultations to patients who are interested in getting rid of wrinkles with Botox injections. If you are interested in having your questions answered and learning more about which options would be best for your wrinkle treatment goals, sign up for a consultation today. Fill out our online form at the top. Or call us directly at 877-337-6424.