Archive for category: Non-surgical

Botox is a specific brand name for botulinum toxin. The toxin is derived from the bacteria clostridium botulinum. The toxin itself causes paralysis of muscles and in high doses can be fatal. However, the cosmetic industry has figured out a way to purify this toxin and give it in very small doses so it can have cosmetic benefits without systemic risk. There are currently 3 FDA-approved brands of botulinum toxin on the United States market currently (Botox, Dysport, and Xeomin), each is slightly different and from competing manufacturers. There are more brands that will also be hitting the market. Botox is the most well recognized brand since it was the first to be approved and has been used the longest. Much like “Xerox” and “Q-tip”, Botox has become synonymous with all botulinum toxin, so when people say “Botox”, they are not necessary referring to the specific brand. They are describing the class of toxins. Even healthcare professionals mistakenly use the term Botox when referring to other brands.

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How does Botulinum Toxin work?

Botulinum Toxin is a neurotoxin. This means that it directly acts on nerves. Specifically, the toxin blocks the connection between motor nerves and muscles. The neve is unable to communicate with the muscle, and the muscle stops working. The result is relaxation of the muscle through partial paralysis. It is only temporary and the nerve function will return after about a few months as these connections heal themselves.

What is the purpose of Botulinum Toxin?

Botulinum Toxin injection are used to improve your looks by reducing the appearance of fine lines and wrinkles that are the result of muscle movements. By relaxing the target muscles, the lines and wrinkles disappear. Take a look in the mirror and scrunch your face.  Do you have lines that appear? Well, those are the lines that are targeted by Botulinum toxin injections.

Botulinum Toxin is commonly used throughout the face and neck to reduce the appearance of:

• Frown lines (the “elevens”)
• Forehead lines
• Bunny Lines on the nose
• Crow’s feet around the eyes
• Lip lines (“smoker’s lines”)
• Dimpling of the chin
• Neck bands

Who is a Candidate?

Basically, anyone with lines or wrinkles that they want reduced can be a candidate for botulinum toxin injections. You should be in good health and without and systemic neuromuscular disease. You should also not have any active skin diseases in the area that is to be injected and have no history of prior adverse reaction to botulinum toxin injections.

You will be evaluated prior to your injections, so your injector will help determine if botulinum toxin injections will produce the result you desire. Sometimes, other treatments like fillers, lasers, or chemical peels may be more appropriate.  Botulinum toxin should not be given to pregnant or breastfeeding women.

How is Botulinum Toxin given?

The toxin comes in a liquid form and is injected directly into the areas being treated. This means that you will get a needle. We use the smallest needles available and you will get multiple small injections to the area, so that the toxin is injected directly into the muscle. This will help ensure a smooth relaxation of the muscle. These injections are very well tolerated and most people feel very little discomfort.  After the injections, you can go back to your normal daily activities.

What is the recovery time?

There is essentially no recovery time after your botulinum toxin injections. Because it is administered with needles, there can be some pain or bruising at the injection site. This is temporary. You can resume normal activities right away, but we do recommend no heavy exercise for a day or two, in order to prevent worsening bruising and swelling.

Will I see it working right away?

No. Botulinum Toxin takes time to work. There is some variation among different brands, but in general it takes a few days to a week for the muscles to be relaxed. Many people do report that Dysport brand toxin kicks in faster, with most people seeing results in about 2-3 days. Some people respond differently so the time to onset may vary.

How long will it last?

In general, the effects of Botulinum Toxin last 3-4 months. But this can vary based on the anatomic location of the injections and the brand of toxin used. There is also some variation between people. Some people are more sensitive to the toxin and require smaller doses, and some require higher doses. Additionally, there is a very small percentage of people who are resistant to botulinum toxin and it just doesn’t work on them.

Can Botox be combined with other treatments?

Of course. It is very common for botulinum toxin to be given together with other treatments. This is because many people require more than one treatment to correct what they are complaining about. Commonly, patients get botox to reduce lines and wrinkles, but also get fillers (like Juvéderm or Restylane) to fill deep folds or deep lines. Most of these different treatments can be performed at the same time.

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Are there other uses for Botox?

While botulinum toxin is most commonly used to treat lines and wrinkles of the face, there are some other, less common uses.  These include:

• Jawline reduction
• Treatment of migraine headaches
• Reducing appearance of a gummy smile
• Treating temporomandibular joint (TMJ) disorder
• Stopping excessive sweating

How does Botox treat sweating?

Excessive sweating, or hyperhidrosis, is a very debilitating condition. Hyperhidrosis can occur on the hands, feet, underarms, and scalp – basically anywhere that there are sweat glands. It can cause significant social anxiety, not to mention damage clothes.  Botulinum toxin has been very effective in treated excess sweating and is FDA-approved for the treatment of hyperhidrosis.

The Botox is injected into the areas being treated. The toxin actually paralyzes the tiny muscles that surround each sweat gland. Most people see significant reduction in sweating within a week and the results can last 6-12 months. Higher doses of toxin are required when treating hyperhidrosis.

If you are concerned about the appearance of your lines and wrinkles, Botulinum Toxin may be right for you. You should be evaluated by a Board-Certified Plastic Surgeon or Board Certified Dermatologist. They will be able to tell you if Botox, Xeomin, or Dysport is best for you. They will also be able to discuss other treatments that may be better to help your areas of concern. To see an experienced injector in New York City, you can contact Board Certified Plastic Surgeon Dr. Matthew Schulman.

What is Botox?

Botox, or botulinum toxin, is a medication that is injected into muscles of the face to temporarily paralyze the muscles. By paralyzing the muscles, facial animation is reduced and wrinkles will smooth. Botox will not paralyze all the muscles of the face. It only affects the very specific area it is injected into. A skilled injector knows where to inject very small amounts of the toxin, thereby targeting the muscles that are causing the lines and wrinkles that you want to disappear. The most common areas to inject are the forehead, between the eyebrows, and around the eyes. This can soften or eliminate the furrow lines of the forehead, the “elevens” between the brows, and the “crow’s feet” on the side of the eyes. The result is a more rested appearance. The effect is temporary with most people get good results for 4 months.

How common are Botox injections?

Botox injections remains the most common non-surgical cosmetic procedure in the United States. According to the official statistics of the American Society of Plastic Surgery (ASPS), 7.6 million botox injections were performed in 2019. This represents a 900% increase in the number of botox injections compared to 2000. The second most common non-surgical cosmetic procedure was fillers, and is a very distant second place at 2.7 million injections for 2019.

What is the right age to start getting Botox?

There really is no right answer to this question, since every person is different. According to the American Society of Plastic Surgery, 1.4 million injections were performed on men and women between the ages of 30 and 39, compared to only 112,000 on people 20-29. This indicates that age time to start getting Botox injections. This seems to make sense, since we know that many other non-surgical cosmetic procedures become more common at age 30, such as laser, fillers, and chemical peels. The most botox injections were performed on men and women between age 40 and 54 (4.4 million). However, since Botox is designed to reduce the activity of facial muscles, younger people with very active muscles of facial expression choose botox injections.

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How is it administered?

Botox is injected into the desired areas using small needles. During each needle stick, a very small amount of toxin is injected just beneath the skin. This delivers the botox to the muscle that is causing the line or wrinkle.

Does it hurt?

A very small needle is used, but since it is still injections, you will feel a small pinch and slight burn. However, this is extremely well-tolerated and most women compare it to having their eyebrows plucked.

Does it work right away?

Botox takes a few days to a week to work. This is because the toxin works by blocking the nerve impulse to the muscle and this process takes some time.

How long will it last?

Most people report that the results last about 3-4 months. The effect wears off slowly, so you may notice that the lines and wrinkles return slowly over the course of several weeks. Botox may last longer in some people and in certain areas of the body.

Can there be complications?

Botox is a very safe procedure with a very low risk of complications when administered by a qualified doctor such as a board certified plastic surgeon or dermatologist. Because it is administered using a needle, there can be bruising. Also, if the toxin is injected into the wrong area, it can paralyze a muscle that was not intended to be paralyzed. The result will depend on which muscle was mistakenly treated. For example, injection to the muscle that keeps the eyelid open can cause the eyelid to droop. Injection into the muscles around the mouth may cause difficulty pursing your lips, whistling, or drinking from a straw. The good news is that these complications are temporary and will usually improve as the toxin wears off. More serious complications have been reported when botox from unofficial suppliers have been used. This is why it is important to select a physician who is obtaining their toxin from a reputable supplier and not cheap suppliers who may be providing counterfeit medications.

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How much does it cost?

The price for Botox injections will vary depending on several factors: who injects it, where you are located, and how much you require. Obviously, certain areas of the country may have higher or lower prices. A med-spa will likely charge you less than an experienced Board Certified Plastic Surgeon but as with everything, beware or prices that seem too good to be true.

Do I have to keep doing it?

No. You can stop having botox injected at any time. Your wrinkles and lines will return and will not be any better or any worse. Additionally, if you have had botox injections and for whatever reason are not happy with the results, you can just let it wear off and there will be no permanent issues.

How do I know if I need Botox or Fillers?

You may complain of lines and wrinkles, and sometimes botox is the answer and sometimes it is not. If you have lines and wrinkles that are the result of facial animation (i.e., the lines get worse as you scrunch your face), then botox will relax the muscles and soften the lines. However, if you have deep lines that are not directly related to the muscle animation, then Botox will not help. These lines are commonly between the nose and the mouth (naso-labial lines) and also the lower mouth (marionette lines). Treating these lines requires filler. Fillers such as Restylane and Juvederm are injected into these lines to fill them and soften them. Your physician should be able to tell you if filler or botox is best for your lines. Commonly, fillers and botox are done together for full correction.

Besides lines and wrinkles, will Botox treat anything else?

One less common, but effective, use for botox is treating hyperhidrosis. Hyperhidrosis, or excess sweating, can occur in the underarms, palms, feet, and scalp. Botox will paralyze the tiny muscle that surround each sweat gland. This will reduce the amount of sweat. Botox is approved for this use and treating hyperhidrosis can be life-changing for those who suffer. Excess sweating can be unsightly and commonly cause low self-esteem, and social anxiety.

Are there other names for Botox?

“Botox” is a brand name, just like q-tip or Xerox. Since Botox brand has been around for so long, it is commonly used to describe all botulinum toxin. However, there are actually three separate brands of botulinum toxin. Botox, Dysport, and Xeomin. Each is manufactured by different companies, but are extremely similar. One may argue that each acts slightly different and some individuals find that they prefer one brand over the other. But again, most people use the term “botox” when they are really referring to the active ingredient, botulinum toxin. Even your physician may use the term Botox when really referring to the other products. In our practice, in order to avoid this confusion, we use the term “toxin” to describe all three brands and only use the term botox when specifically referring to botox brand botulinum toxin.

To learn more about having your botox treatments, or other non-surgical cosmetic treatments in New York City with Dr. Matthew Schulman, please contact our office today.