what does Botox do botulinum toxin most commonly known by the popular brand name
Botox is well known in the aesthetic field yet at the same time there was a
lot of confusion about what Botox can do for example patients have asked me if
Botox is an alternative to surgery or can it completely make deep lines
completely disappear I'll help you understand what botulinum toxin like
Botox can do for your appearance and how I use it in my practice I'm Dr. Amiya
Prasad I'm a Board-certified cosmetic surgeon and Fellowship-trained
oculofacial plastic and reconstructive surgeon I've been in practice in New
York City and Long Island for over 25 years as an oculoplastic surgeon my
specialty was amongst the first doctors to use Botox for issues like facial
muscle spasms so I've been treating patients with botulinum toxin since 1993
once FDA approval for cosmetic use occurred in 2002 the popularity of Botox
skyrocketed to where it is today so exactly what is Botox or other brands of
botulinum toxins such as Dysport Xeomin and Jeuveau they're all categorized as
neurotoxins and have different chemical structures which fall under the category
of botulinum toxin a neurotoxin like botulinum toxin when injected into
muscles inhibits or limits muscle movement temporarily by blocking signals
from nerves to the muscle it takes about three days for botulinum toxin to take
effect with the peak effect being in about two weeks
these effects can last for three to six months it's important to understand
that what is injected is a liquid that affects muscle movement this is in
contrast to a filler such as hyaluronic acid which is not a neurotoxin but it's
rather a gel used to enhance some volume wherever it's placed hyaluronic acid
fillers have the unique advantage in that they can be dissolved with an
enzyme called hyaluronidase should the need arise botulinum toxin cannot be
reversed you have to allow for a few months to transpire before the effects
wear off with this particular constraint in mind in my practice I started with
more conservative dosing and have my patients come back in two weeks to
evaluate their appearance if additional botulinum toxin is needed I
strategically place more at that time I make note of this for future treatments
one principle behind the use of botulinum toxin is to reduce the
activity of certain muscles which actively contribute to the formation of
deep lines for example an area that can be treated with botulinum toxin are the
crow's feet lines located at the outer aspects of the eyes these lines result
from contraction of a muscle called the orbicularis oculi muscle by inhibiting
movement of this muscle there isn't as much creasing in the skin which can
cause the deep wrinkles to be primarily formed since the eyes are so important
to your appearance my patients often ask about crow's feet lines wrinkles and
discolorations which remain visibly significant after botulinum toxin
treatment this is because the wrinkles and discolorations are the result of
deficiencies in the skin quality resulting from causes such as aging sun
exposure and smoking my approach to these problems is to customize a
strategy to improve the backbone of the skin called the dermis and the surface
of the skin called the epidermis for example I use platelet-rich plasma or
PRP which is derived from your own blood for benefits of the healing and growth
factors that stimulate collagen production and improve your skin's blood
supply I use different lasers to resurface the skin which refreshes the
epidermis as well as radiofrequency technology to help tighten the skin
another area where deep lines can be improved by reducing muscle activity is
the number 11 lines located between the eyes and on top of the nose these are
also called frown lines or glabellar lines which is more of a medical term
these lines have a particularly significant effect on how people
perceive you very often people with deep glabellar lines appear to look like
they're upset or angry by injecting botulinum toxin into the procerus
and corrugator muscles muscle activity is reduced and these vertical creases
become less visible horizontal forehead lines also form due to repetitive use of
the frontalis muscle which is responsible for raising the eyebrows
these lines often accompany glabella or frown lines the frontalis muscle lifts
the brows and the corrugator and procerus muscles move the brows in and downward
since these are opposing muscles the key to satisfactory result is to reduce the
horizontal forehead lines while preventing the brows from dropping too
far downwards in addition to the reduction of lines formed by muscle
activity botulinum toxin can be used for enhancement of different areas of the
face by balancing muscle activity with muscle relaxation for example I use
botulinum toxin for a procedure called a non-surgical brow lift I achieved this
by relaxing the muscles that pull the brows downward which are referred to as
brow depressors these brow depressor muscles include the corrugator procerus and orbicularis oculi muscles by relaxing the brow depressor muscles that
pull down the brows with botulinum toxin the muscles that lift the eyebrows in
the forehead called the frontalis muscle work unopposed thereby raising the
eyebrows botulinum toxin can be used to enhance the appearance around the mouth
and lips vertical lip lines above the upper lip also called smoker lines are
associated with the activity of a muscle called the orbicularis oris muscle this
muscle is used when puckering kissing and in activities like drinking from a
straw the depth and appearance of vertical lip lines can be improved when
the lips are puckered by using botulinum toxin to limit the activity of the
orbicularis Oris muscle for vertical lip lines that are present when the lips are
not in motion a laser procedure can be used to resurface and tighten the skin
and improve the appearance of those static lines the downward position of
the outer corners of the mouth often seen with the facial aging can be
improved by relaxing muscles which pull the outer corners downward called the
depressor anguli oris muscles when I treat these muscles with botulinum toxin
the muscles pulling the outer corners of the mouth downward work unopposed and so
they lift the outer corners of the mouth resulting in a lift that creates a more
pleasant expression the upper lip can sometimes almost disappear with smiling
I can strategically place botulinum toxin and make the upper lip more
visible when smiling I refer to this procedure as a lip flip some people feel
that too much of their gums are seen when they're smiling
this can be partially due to excess activity of the muscles that lift the
lips this is often referred to as a gummy smile I treat the muscle group
that lifts the lips to levator labii and the levator labii superioris alaque nasi
muscles and I do that with botulinum toxin so the lips don't
elevate as much when smiling and making the gums therefore less exposed a facial
imbalance due to the widening of the is associated with thickening of a
muscle called the masseter muscle the masseter muscle is used for chewing and
moving the jaw an enlarged masseter muscle occurs frequently with teeth
clenching or teeth grinding I inject the masseter muscles with botulinum toxin to
reduce the muscle activity that contributes to this enlargement of the
masseter muscle over time with consistent treatment the muscle size
diminishes and the facial balance is improved multiple small dimples in the
chin which is often referred to as an orange peel skin or cobblestone it can
also be treated with botulinum toxin this dimpling is caused by the mentalis
muscle often seen with aging the bone loss also contributes to this
hyperactivity and greater visibility of the mentalis muscle action on the skin's
surface by reducing the activity of the mentalis muscle with botulinum toxin and
the skin dimpling or cobblestone appearance improves often combine this
with the placement of long lasting hyaluronic acid filler to add projection
to the chin and further smoothen the skin surface botulinum toxin
particularly the brand Botox has become a worldwide cultural symbol for the
natural integration of medical aesthetic procedures into the daily life of anyone
who wants to improve their appearance a consequence of this ubiquity has led to
a lot of aggressive retailing and misinformation in particular
inappropriately minimizing the risks of botulinum toxin injection consumers are
being incentivized to self-diagnose and visit any given botulinum toxin
dispenser some of the most vulnerable consumers fall into two categories
one people who don't have the means or don't want to spend the time and money
necessary to see a higher level specialist for more comprehensive
guidance as to the value of botulinum toxin
for their particular concerns and number two people in their 20s who are being
overly influenced into undergoing botulinum toxin and other procedures
which they really just don't need both of these groups fall victim to
transaction driven lower cost physicians and non-physicians who have financial
incentives to sell as much as possible to anyone who walks into their shop
unlike more established higher level physicians with practices and
reputations these people are less concerned about the long-term
consequences of what they're doing to the people who they treat I continuously
see patients who come in to see me after spending more money and losing time from
work after being improperly treated by these medical retailers botulinum toxin
like lasers and fillers is one tool in the toolbox of potential solutions for
your aesthetic concerns the art is knowing how to use botulinum toxin
optimally as well as when not to use it I help a lot of successful people who
come to my practice from around the world for their aesthetic needs one
aspect of being successful is that they understand how to leverage their time
and resources to maximize certainty in everything they do
caveat emptor I hope you found this information helpful thank you for your
question