Thank you for your question.
You've submitted two photos of a frown line, and you describe in your question that you
have a single line or furrow, and you want to know about Botox, and how many CCs you
would need.
You say in your question that you're not a fan of the frozen look, and you are also asking
whether or not filler is necessary and how much would you need.
Now this is something that is always an interesting question, because a lot of people, and not
from of lack of encouragement by practitioners who sell the procedures as commodities, it's
very understandable why you want to know these numbers.
To give you an idea of who I am and what I do, I'm a Board-certified cosmetic surgeon
and I've been practicing in Manhattan and Long Island for over 20 years as a cosmetic
oculofacial plastic surgeon—that means I’m Fellowship-trained through a Fellowship of
the American Society of Ophthalmic Plastic Surgery.
I was one of the first doctors to use Botox, because originally Botox was not intended
for cosmetic reasons, it was used for medical reasons, for conditions called blepharospasm
and hemifacial spasm.
So, I'm very familiar with Botox, and once the cosmetic indications became popularized,
suddenly it became a real free-for-all, and people were advertising x dollars for this
many units.
What actually has happened is the market became segmented—there were people who were shopping
for price and getting low prices but they weren't getting this good quality continuity
care, and then there were people who were paying very high amounts, buy a select small
group of doctors who charge a premium.
And then of course the individual patient doing research wonders how do they figure
out what to do.
Well, my own practice philosophy is that I never offer a procedure as an isolated commodity.
So if someone calls us and asks “how much do you charge for Botox”, what we try to
explain is that we have to do an assessment, we have to figure out whether or not it's
right for you, and then we figure out how much you need, and then what to expect.
Our practice is more of a high-end practice, so we have long standing relationships with
our patients and we figure out with them what the ideal dose is.
In terms of Botox, just to answer your question about the CCs, it’s not measured in CCs,
it’s measured in units.
And how a doctor dilutes the Botox and places those units all have an impact on the final
result.
In general, broad strokes, 25 to 50 units can be used to reduce the action of the corrugator
and procerus muscle responsible for the frown line.
If the treatment is done consistently eventually those muscles relax enough to the point where
the line gets softer and softer.
In terms of fillers, it's very important that you be careful with this area.
There are a lot of important vessels in this area and there have been reports of skin loss.
So it's also very technique-dependent and experience-dependent.
So in my practice, we've used hyaluronic acid fillers, we've also used combinations of hyaluronic
acid fillers with platelet rich plasma.
Platelet rich plasma is derived from your own blood and it helps stimulate your body's
own collagen.
We've found that there is a great synergy between the use of platelet rich plasma with
hyaluronic acid fillers.
So when you are exploring this option, it's very important that you be comfortable.
For me, the golden rule is you treat patients like your own family, and you give them the
time and the analysis, and of course with that comes the appropriate care and an investment.
None of the stuff is inexpensive, but when people start shopping price they invariably
spend more, get less, and eventually keep doctor-hopping.
So as far as the frozen look is concerned, I can tell you that this one area being treated
will not result in any way a frozen look that is stereotypically illustrated on TV shows
of a person who's over Botoxed.
This muscle gets a lot of activity in a lot of people, and relaxing this muscle can really
make an impact and really open up the eyes and open up the face.
So I think you should meet with qualified and experienced doctors who you feel comfortable
with.
I think that my suggestion will be valuable to you if this makes sense to you.
So I hope I was helpful and I wish you the best of luck.
Thank you for your question.