BOTOX

Botox® (onabotulinumtoxin A) is a prescription medication that contains small amounts of a highly purified botulinum toxin type A protein refined from the bacterium, Clostridium botulinum. It works by blocking nerve impulses to the injected muscles.

Botox was first approved by the FDA in 1989 for the treatment of blepharospasm and strabismus, making it the first botulinum toxin type A product to be approved in the world.​

 

Many patients confuse the mechanism of action in Botox and dermal fillers. Botox is a paralytic agent which reduces muscle activity by relaxing the muscle around wrinkles, while dermal fillers actually fill the lines and creases with a "filler" substance.

All aesthetic injections should be done at least one month prior to any special event such as wedding, engagement, anniversary, birthday, major holiday, or photo shoot. Bruising and swelling after injections can last up to 14 days in some cases. Please refrain from drinking alcohol, and taking pain medications (NSAIDS) such as Ibuprofen, Motrin, Aspirin or Advil, as well as vitamins, fish oil and other herbal supplements for 3-5 days prior to your visit, to minimize the chances of bruising. Some herbal supplements may increase risk of bruising. Herbs including gingko biloba, ginseng, ginger, glucosamine, turmeric, angelica and clove all have the potential to thin the blood slightly. This can make bruising more likely, especially if more than one of these herbs are taken together. 

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Botox can take up to 72 hours for the results to settle. Please note that it will take 2 weeks to see the full effect.

We follow very strict FDA guidelines when it comes to Botox and Dysport injections. To avoid situations where patients purchase smaller number of units and come back requesting free touch ups. 

Recommended dosing:

  • 20 units of Botox between eye brows into glabellar area, known as frown lines or the “11" lines

  • 20 units of Botox for the upper forehead

  • 12 units of Botox around each eye, known as crow's feet

  • 10-12 units of Botox for nose bunny lines 

  • 50-60 units of Botox for masseter muscle (25-30 units for each side)

  • 50-100 units of Botox for platysmal bands of the neck muscles, known as the Nefertiti lift (25-50 units for each band)

  • 8-10 units of Botox for the upper lip flip

  • 100 units of Botox for palmar hyperhydrosis (50 units for each palm)

  • 100 units of Botox for axillary hyperhydrosis (50 units for each underarm)

Please read important FDA information about recommended Botox dosing here: Allergan Botox Cosmetic PDF

Important pre-procedure information:

  • Every injection carries a risk of infection.

  • As with all medications, allergic and systemic anaphylactic reactions may occur.

  • Some discomfort and pain can be experienced during the procedure.

  • Swelling, redness, pain, bruising, itching and warmth at the site of injection can be seen for up to 7 days following the procedure.

  • Rash and itching may also occur following injections.

  • Flu-like symptoms such as nausea, fever, and migraine headache can be experienced following the procedure for up to 7 days.

  • The body is not symmetrical, and sometimes the injections can have more pronounced effect on one side than the other.

  • Sometimes the procedure will not achieve a fully desired effect and may need to be repeated.

  • Toxin injections are associated with certain risks including drooping of the upper eyelid (ptosis) and abnormal looseness of the lower eyelid.

  • Alcohol, vitamins, herbal supplements, fish oil, anti-inflammatory medications also known as NSAIDs (Aspirin, Ibuprofen, Motrin, Advil) and blood thinners such as Coumadin, Xarelto, and Plavix taken 24-48 hours prior to the procedure can increase the chance of bruising at the injection site.

Aftercare instructions:

For Botox and Dysport aftercare instructions, please click HERE

How long does Botox last?

The results from Botox last anywhere between 2-6 months; the average result lasts about 3-4 months. Our body makes new neurotransmitters all the time, so the “blocking” effect of Botox gradually wears off as these chemicals start circulating in our body again. Nerves will again be able to send signals to the muscles to start contracting. 

 

It is also common for first-timers to notice that it may not last as long initially but may last longer after the second treatment. 

 

Everyone has a unique experience and results may vary.

 

What influences how long your Botox results will last:

  • Your personal metabolism: Your unique body chemistry will process Botox on its own timeframe – for most people, the effect lasts 3-4 months.

  • The size and depth of your wrinkles: People with fine lines may enjoy Botox longer than those with thick scowls or bulky muscles.

  • Your activity level: “Gym rats” who do cardio exercise more than 5 times a week may notice that Botox wears off more quickly​.

  • Your facial expressions: Some patients are lucky and develop muscle memory. They “forget” to use their facial muscles even after the effects of Botox begin to wear off. Their results will last longer than those who are extremely animated with their facial expressions.

  • The amount of Botox injected: Larger muscles require more Botox.

  • Other factors: Some people will experience a shorter Botox benefit if they are ill, under stress or perform intense physical activity.

  • How often you have Botox treatment: Consistent Botox injections every 4-6 months will have longer lasting effect.

  • How do you know your Botox needs refreshing? You’ll start to notice a return of muscle movement and a deepening of the wrinkles. At this point, it’s best to return for another treatment.

Botox for men:

Men can be treated with Botox for cosmetic procedures in the same way as women but require higher doses of Botox in all treatment areas due to genetic differences in the muscle mass. Men have much greater muscle mass than women. Similarly, it has been a common clinical observation that larger, stronger men need even more units per treatment area than slender men. The most common cause of inadequate results in male patients is under-dosing, which may lead to men requiring additional Botox injections.

Glabellar lines in the male have been the most well-studied with a recommended starting dose of 40 units. Some men may require up to 80 units in the glabellar complex. Lateral canthal lines can be treated with a starting dose of 15 units per crow's foot.

 

Journal reference: Timothy Corcoran Flynn (2007). Botox in men. Dermatologic Therapy 20 (6), 407–413. doi:10.1111/j.1529-8019.2007.00156.x

Botox in masseter muscle:

  • Reduces teeth grinding: teeth grinding, or bruxism, is typically treated with mouthguards and lifestyle changes. If you have severe bruxism, Botox injections may be more effective. As the toxin weakens the masseter, it relaxes the jaw. This stops the jaw and teeth from involuntarily clenching, reducing symptoms like: tight jaw, pain in the jaw, neck, or face, tooth sensitivity or pain, dull headache, tooth damage and ear pain.

  • Reduces symptoms of the temporomandibular joint (TMJ): TMJ often coexists with bruxism and masseter pain. When Botox is injected into the masseter, it can relax the muscle and help relieve TMJ symptoms. This includes: jaw pain, headaches, TMJ damage, poor range of motion in the jaw, jaw, face, ear pain, and jaw locking.

  • Slims your face shape: masseter muscles can give the face a square shape. If you want your face to look slimmer, Botox into masseter muscle may be an option. The weakening effect of Botox reduces the size of your masseters. This creates a slimmer V-shaped jawline. When used for this purpose, Botox into masseter is also called "jaw reduction" or "masseter reduction".

Masseter Botox is generally considered safe. However, it’s possible for the procedure to cause side effects such as:

  • Pain or swelling at the site of injection

  • Bruising

  • Headache

  • Flu-like symptoms

  • Crooked smile

  • Drooling

What is a Nefertiti lift?

A Nefertiti lift is a temporary way to restore a youthful look without surgery. It is a cosmetic procedure performed with Botox injections in the lower part of your face, jaw, and neck. The procedure is named after the ancient Egyptian Queen Nefertiti, known for her elongated, thin neck. Muscle contraction in the neck can cause wrinkles and other signs of aging. Botox temporarily blocks nerve impulses in neck muscles to prevent contraction. The Nefertiti lift targets the platysma band of muscles that run vertically from the bottom of the face to the collar bone.

 

Nefertiti lift will:

  • Lessen lines around the bottom part of the face

  • Smooth dimpled skin on the chin

  • Reduce folds or sagging of the lower part of the face

  • Even out the symmetry of the lower face, jaw and neck

  • Remove lines on the neck

  • Create a more pronounced definition of the jaw

Baby Botox technique:

While many plastic surgeons inject botox in just a few areas so that they can get through patients faster, that technique can result in a strange frozen look, sometimes with complete immobility in one area of the forehead and movement in another. At Anastasia Medical Aesthetics, we use “baby Botox” technique. This process injects smaller amounts in more places, resulting in a more natural look.