Hi, I'm Dr.
Ajani.
Thanks for joining me Today, I'm doing an update on Botox and Botox
like products for your year ahead.
Some of you might just want to start this journey.
Others have been on it.
This is going to update you on not just what's available today.
My opinions, but some new products that are coming to market that
maybe you want to know about this is not sponsored in any way.
It's what I do every day in clinic.
And if you're from United States and Canada, great.
If you're from around the world, I traveled to 23 countries this
year and I went to 18 different congresses, including ones.
Only involving skincare and wellness.
So this is going to be an educational video and I'm going to do one on fillers.
Two Fillers and Botox are different.
Remember, Botox slows down muscle movement to help prevent or alleviate
lines and wrinkles, fillers, plump.
So there's two different things.
I'm also going to pay particular attention to the comments below this video.
I'm going to answer them specifically for you because questions are gonna
come up that maybe weren't addressed here, or you need clarification.
Use the comment section below.
I actually answer my viewers because my goal is education for you.
You need to understand before you think about Botox and fillers, think about.
Nutrition, wellness, your food supply because of food supply's diminishing,
we want to think about supplementation.
Often you're getting fillers and Botox for outward appearance.
Glow reduction of fine lines and wrinkles.
The first thing you need to take care of.
Is the temple.
Let's dive in.
Let's talk about what I first teach the four Ds dilution,
dose, droop and duration.
Let's go through to dilution number one.
All the products in North America and mostly around the world are diluted.
That means they come as some think of it as a powder, and your physician or
provider has to put some type of a sterile water, sodium chloride, saing in there.
To reconstitute it, so you're never going to truly know the dilution.
You can always be faked out.
There's no way to know.
I changed the dilution for my patients based on if I'm doing
high dose for a longer duration, which we're gonna talk about or.
Uh, I want a little less concentration and I want it to spread
more, like say the crow's feet.
I want it to spread the forehead.
I do not want it to spread, so I change the dilution all the time.
Could I cheat my patients?
Absolutely.
I could.
Why wouldn't I?
I want to provide the best type of treatment.
Botox or Botox, like treatment.
We call 'em neuromodulators.
So we'll use that going forward cuz there's many different brands.
Botox is a brand I want to provide the.
Possible neuromodulator in the world because I want to have the best results
so my patients come back for my procedures that I actually make money on, which
is for me, my full face injectables.
Let's go to dose now, you're never going to know what dose you're gonna get.
Could you be cheated a hundred percent?
No one knows what dose I'm giving them.
I can say, yeah, I'm giving you 20 units.
You're not going to know.
You as a layperson, can't measure it.
And maybe I diluted it differently wrongly.
You don't know what my syringe, how it looks, what's in there.
So, but I'll give you the average doses.
We're gonna, when I talk about brands, I'll tell you a little bit
of, of why it's so confusing, but in general, Of the doses for the
forehead, we'll use Botox as an example.
Average FDA approved dose is 20 units.
In clinic, real life, so I don't create droop.
I'm doing 12 units average dose for the frown and the FDA approved dose
is 20 units, the eyes is 24 units.
Let's go to the lower face.
Nothing's approved for the lower face for cosmetic use.
Uh, Six units for the downturn mouth, six units for the chin, six around
the lips, and for the masters of big muscle, usually using 20 units
per side or a total of four units.
Now this brings me into brands because the units aren't the same for each
brand, so you'll never fully know.
But let's talk about the brands I've been.
Since the beginning of each one of these, and the first one that was
introduced, 2001 Botox Cosmetic, um, was the old, it was the king
until 2009 or so when disport came.
So you have Botox, which is a brand you have Disport, which is a brand.
Zein came.
And finally we have Juv.
At the end I'm gonna talk about Doxy, which is a new one, which
is a six month duration one.
But if you take.
Four brands, what's in common?
They're all the same active product, botulinum toxin type A.
What's different?
The binding proteins.
So if you take, uh, Botox, disor and, and, uh, zuo, they all
have binding proteins to them.
What's the body can react to in some people think that you can become immune to
them because the body sees those proteins.
Uh, we'll talk about.
at the end and also have a complete video if you think you're immune to your
Botox or it's just not working as well.
I'll put a link, uh, in the more info below to that video so
you can look up Botox immunity.
It's quite a rare thing, but if you think they have Botox, uh, those
Botox, Products have binding proteins.
Xeomin is the cleanest one, meaning it doesn't have a binding protein,
it's only the botulinum toxin type A.
Now which brand is best?
Which do I prefer?
By far and away?
I use more disport than anything.
Uh, I think it works better.
It lasts longer.
Works quicker.
Then we go Xeomin.
I like Xeomin a lot.
No binding proteins.
It's the cleanest one out there, and I use a little more product for each
person to equal the amount of discord.
Botox, you're seeing a decline in use and Jibo was the new millennium type
People either like it or they don't.
Many people struggled with duration on that.
Some people did great, some people just didn't see it.
So Dysport and Zein are what I use in my clinic the most, uh,
and I think those are two great ones that you can't go wrong with.
And again, that's my opinion.
That's what I use in the comments below.
I'm happy to answer anything specifically for you on that.
Now, let's talk duration.
The more units you use of any one of these products, the longer it's going to.
But the more side effects you could get.
So I stick with pr, pretty standard dosing, as I
mentioned earlier, those doses.
However, I have people who don't want to come back for maybe six or eight months.
I concentrated, I increase the dose, I get more duration.
Again, disor and Xeomin respond very well to those increasing.
And longevity.
So if immunity is something you're particularly worried about or you
think that you're developing immunity, it's not working as well as Xeomin
might be one to go for all of those.
Botox, Xeomin, Jibo and Discord are approved for three to four month.
Durations using the standard doses.
Once again, Dysport Xeomin seem to come out the winter for me in my practice.
One of the benefits of Xeomin is you don't have to store it cold.
So if people have trouble with storage, the fridge goes out.
Maybe people don't get to the box when it arrives and they don't
get it to the fridge quick enough.
Uh, it can warm store until we dilute it and then.
cool it down.
So it, it, it's a little, it can be a little more stable from that point.
Keep in mind, old product doesn't work as well.
So if you're going to a clinic where they don't do this all the time, it may
have sat in their fridge for three weeks.
It's losing its efficacy.
So you want to go to a place that's knows how to do all this.
You wanna go to an expert, but someone who's using more product is a little
busier, typically are going to have fresh.
And that does make a difference.
The final of the DS is droop.
Now where you're gonna get the drew from is the forehead.
The forehead is what lifts.
I have complete videos on droop.
I'll put again the links and the more info below.
This video for droops the lid droop is what everyone fears.
In 2001 to 2005, it was a 4% chance.
It's now about 0.05 because we know the depth to put it and where to.
So it's not a big issue.
The lid droop for most people, but what about the brow droop?
Yes, that can happen and you need to see someone experience, and it happens from
treating the forehead, uh, or potentially the frown, but not around the eyes.
The eyes is the safest one of the injections from that point of view.
Let's mention something about fake product.
Can you get fake?
A, a large, uh, amount of product in this country is fake, meaning
it's not bought from the companies.
Uh, it's imported.
Part of the big problem here is transport.
You don't know about transport.
The effectiveness tends to wax and wan.
So clinics, uh, they're trying to cut costs.
So when you see things below 10 to $12 per unit, uh, you
start thinking, is that correct?
I'd say $10 below $10.
You, you're losing money.
A real clinic would lose money.
The going rate is about 12 to $22 per unit.
My clinic, I'm charging 16 to $20 per unit.
Um, and you're seeing that increase as inflation goes up too.
Now let's talk new products.
Doxy, you're gonna hear a lot about this.
It'll be in your vogue.
New beauty.
All the magazines come get a six month toxin.
Uh, I'm not overly excited about it.
We can get six month duration now with existing tox.
We know exactly how they work.
We can offer better pricing cuz this product is going to be more expensive.
If you had a droop or a problem and you believe it does last six
months, eight months, which is what they're saying, then you have a
problem for six or eight months.
What I can tell you, I get panic calls all the time, particularly on my other social
media accounts from injectors or patients.
All around the world.
Oh my gosh, I'm four days out.
I've got a little lowering of the eye.
I'm freaking out when people, when their brows aren't even.
And that could last two to four weeks.
Uh, with the products we have now.
it, it drives 'em crazy to her.
They, they, they lose their mind.
Uh, and of course it comes back after two to four weeks, typically.
So now imagine if you're going to tell me something's lasting six
months or eight months and you're someone who wants to start this
new, you haven't done it before.
Your newbie or your real, your in front of people, you're on
camera, your look is important.
The holidays, you're coming.
You're gonna freak out because a lot of people doing Botox and like
products are new entry people and they're very attuned to how other
people see them and oh my, then maybe they think I got something done.
Our group of people coming in 20 to 35, which is the biggest group
of people we're seeing for new treatments now and that are involved
in these aesthetics from social media.
And, you know, the like to young people, they could care less.
Oh, it's a side effect.
No problem.
It's the 50 year old plus that comes in.
Um, they're not happy.
So if, if you're thinking you want a longer product, just keep in mind if your
indeed does last longer, you're going to have more side effects with this.
The other thing is for clicks, they're gonna have to talk to people about a new
product and there's going to be 30 to 40% of people that do not get six months.
Cuz as it starts to come, People go, oh, I got a little bit of movement.
It didn't last.
Remember, a treatment means 60 to 80% of the muscle movement goes.
It's probably what I have now.
Last treatment I have was eight, eight months ago.
Okay?
So, uh, probably have 60, 80% or, or 20 to 40% came back.
That still is working by the books, by academia.
So keep that in mind.
So, uh, for me, it's not something I'm going to be bringing in.
If you're using it, let me know how you like it.
Feel free in the comments below.
I want you to realize with these like products, more
importantly is your skincare.
More importantly, building collagen and elastin by doing your home
treatments, using your home devices, and getting fractionated RF treat.
Uh, that actually bill collagen elastin, because that is the root of youth building
those, and it all comes from the inside.
First, your Nutra cosmetics.
Stay tuned.
Give me the questions below.
Keep your skin and body beautiful, healthy and vibrant.