Botox. A word that triggers strong reactions. Both positive and negative, depending on perspective, experience with it, and pre-existing perceptions. I will try to make sense of it all and hopefully if your perspective has been negative, give you food for thought.
Simply put, Botox relaxes muscles. It temporarily (typically for 3-6 months) stops the communication between muscles and nerves. When this happens, the muscle relaxes. When the muscle underneath skin relaxes, expression lines will often soften or disappear as long as the muscle remains relaxed. Starting this treatment before these lines become very deep helps prevent permanent lines.
It was first identified for its cosmetic indication when it was being used to help correct crossed eyes (Strabismus). In the process of treating crossed eyes, some of these patients became extremely excited when the frown lines between their eyes improved dramatically and sometimes even disappeared.
If you don’t have frown lines, it might be hard to understand the value. For people with frown lines, it can be significant because even when at rest, they can appear sad or angry, even when happy and content. Botox can free those who look angry when they are not from this incorrect assumption by others. See before and after photos here.
Botox is a Botulinum Toxin Type A. There are three Botulinum Toxin Type A products in America at this time. Botox, Dysport, and Xeomin. Each of them are manufactured differently, and currently Botox (by Allergan) has a significant majority of market share. Botox is FDA approved for the frown lines between the eyes, crow’s feet, and forehead lines. For cosmetic purposes it is also commonly used “off-label” in other facial areas such as for upper lip lines, a pebbly chin, the downward pull of the corners of the mouth, and for people who grind their teeth. It is FDA approved for several other medical indications as well, including migraine headaches and spastic bladder.
There has been an issue in the United States in recent years with the proliferation of counterfeit Botox used by some health care providers. This often is the case with deep discounts offered online to lure in new patients. It is a federal offense for a medical provider to purchase counterfeit products and inject them as “Botox” but it still occurs. Buyer beware!
Botox is injected using tiny needles. It is typically sold by the “Unit”, our method of measuring dosing. Some practices charge “by the area”, but we prefer to charge by the units injected, that way you know exactly how much you’re getting. Saline is used to reconstitute Botox prior to injection. While the amount of saline used to reconstitute Botox will increase the amount of overall liquid injected, it does not change the amount of Botox units used for injection. The amount of saline used varies by practice. We calculate our dosing to allow for optimal “spread” of the product with beautiful results.
The FDA Botox dosing used in clinical trials for Botox was 20 units to the area between the eyes (glabella), 24 to the crow’s feet, and 20 to the forehead.
Since anatomy and muscle density varies from patient to patient, Dignity Medical Aesthetics strongly encourages a follow up visit after your first dosing with Botox. This allows our providers and you a chance to evaluate your outcome. At times corrections to dosing is made at this two week follow up and this extra step leads to a very high patient satisfaction rate at our practice. For over 80% of those injected, Botox will have about a 3 month duration. For the other 20%, some people get a longer duration and others a shorter duration. This varies as individual patients all have unique metabolization rates.
Our office offers complimentary new patient consultations where you can ask questions and view before and after photos. You can also see some of those here. Call us to schedule your appointment today! 916-939-3889