Information and Frequently Asked Questions About BOTOX ®
How do I know if BOTOX ® Cosmetic is right for me?
Botox injections are not just for the older patient. Botox injections are frequently used in 20-30 year old patients to both eliminate and prevent developing wrinkles. We have found that you can actually prevent the formation of wrinkles when Botox Cosmetics is used preventively in younger patients. Since deep wrinkles and furrows are caused by the repetitive action of facial muscles pulling on the overlying skin, relaxation of these muscles with serial Botox treatments will slow down and prevent the development and progression of wrinkles.
Many older patients in their 40s, 50s and beyond with deeper wrinkles and soft tissue loss from the normal aging process, use either Botox alone or depending on their goals, often combine Botox Cosmetic with injectable fillers such as Juvaderm or Radiesse to improve their appearance.
How does BOTOX ® Cosmetic work?
Low doses of Botox Cosmetic are injected in tiny doses directly into the muscles making the frown lines. By blocking the release of a chemical that causes these muscles to contract, Botox Cosmetic allows them to relax. The muscle activity that causes frown lines is simply reduced, so you can still show expression, such as a frown or surprised look, but without the wrinkles and creases. It has been used for over 25 years and is a safe and effective treatment in experienced hands. Botox Cosmetic has also been shown to be effective for treatment of migraine headaches, excessive underarm sweating, and certain muscular spasm disorders.
Where does BOTOX ® work the best?
Facial wrinkles that respond well to Botox Cosmetic injections include eye wrinkles commonly referred to as the "crow's feet area"(lines around the eyes), vertical frown lines between the eyebrows in the glabellar area (frequently called bunny lines or 11 lines), and the horizontal lines (worry lines) on the forehead. Botox Cosmetic injection can also be used to produce a temporary brow lift when it is injected just below the lateral aspect of the eyebrow. This results in a more refreshed appearance, helping to brighten the eyes. Many of our Botox patients request this effect and are extremely pleased with the results.
Botox injections by our experienced board certified Plastic Surgeons can also be used on properly selected patients to soften the vertical upper and lower lip lines, reduce the downward turn of the mouth that many men and women develop with age, and to reduce muscle bands in their anterior neck area.
Some patients with deep frowns at rest may achieve the best results with a combination of Botox Cosmetic injection and a dermal filler, especially in aging patients who have had soft tissue loss or descent.
What is a BOTOX ® treatment like?
Botox cosmetic is a quick and minimally invasive procedure consisting of a few tiny injections; the overall Botox clinic visit takes about 10 to 15 minutes. Your doctor will first examine the areas to be treated and will ask you at this time to move certain facial muscle. He will then decide where to place the injections to achieve the best results based on his examination. No anesthesia is needed but the treatment areas are cooled with an ice pack prior to the procedure to help reduce any minimal discomfort. In rare cases, our physician may choose to numb the area with an anesthetic cream before the injections in especially sensitive individuals. The Botox is precisely injected into the specific facial muscle to be treated through a tiny needle. The actual Botox injection treatment lasts just one to three minutes depending on the number of areas being treated. There is no downtime afterward and discomfort is minimal and brief. Many patients return to work the same day.
How soon after BOTOX ® Injections will I see a difference?
You can expect to see results starting 2 to 5 days after your treatment and the area may continue to improve for up to a week. Some patients notice a difference the day after treatment. Results last on the average 3 to 4 months. Patients who have had serial Botox Cosmetic injections for a long period of time find that their results may last a bit longer, up to 6 months.
Who should perform BOTOX ® Cosmetic Injections?
Quite simply, we believe board certified Plastic Surgeons are the ideal medical professionals to treat patients with Botox Cosmetic injections. Plastic Surgeons have the most extensive knowledge of the anatomy and physiology of all the facial muscles involved in facial expression and therefore are the most qualified to perform Botox injections. In addition, board certified plastic surgeons have been awarded the highest qualifications by the American Board of Plastic Surgery through extensive evaluations and residency requirements. The physicians at Premier Plastic Surgery are all board certified Plastic Surgeons who have detailed training in facial anatomy and nerve distribution, and extensive experience with Botox Cosmetic. Our experienced Plastic Surgeons can maximize your results with a natural look. At Premier Plastic Surgery and Skin Care Center, patients are only evaluated and treated with Botox injections by one of our board certified plastic surgeons. It is our strong recommendation; whether you receive your Botox treatments at our office or elsewhere that you have your Botox treatment performed by a board certified plastic surgeon.
How can I be sure I'm getting real BOTOX ® Cosmetic?
Allergan, Inc., maker of Botox Cosmetic, is the only source for healthcare professionals to purchase the product, and each FDA-approved label has the "Allergan Cosmetic" hologram. Patients need to be cautious when injectables are offered at bargain prices because they may have been purchased through web sites or offshore where practices to assure purity, content, and proper handling and storage may be lax or may result in purchase of counterfeit products.
At Premier Plastic Surgery and Skin Care Center we only use Botox Cosmetic which has been manufactured, stored and shipped in the United States and purchased directly from Allergan in the US where the manufacturer and the FDA maintain proper safety procedures, which often are not adhered to in other countries. Offshore suppliers often have poor quality control on how the product is shipped and handled; there is no assurance that the Botox will not sit in a warm warehouse or dock and allowed to warm, which decreases the efficacy of the product. Botox is temperature sensitive and should be shipped on dry ice.
If you are a patient undergoing Botox treatments and you want to insure your provider is using Botox Cosmetic purchased in the US, ask to see the bottle. The word Cosmetic is a hologram on the bottle. Botox from Europe or Canada is usually not Botox Cosmetic; the bottle typically will just be labeled Botox. In addition, every bottle has a lot number that identifies if it was sold in the US.
Why do some patients treated with BOTOX ® look unnatural?
We have all seen photos of celebrities who have been treated with Botox and have unnatural appearances ranging from brows lifted too high to too low, or a frozen face appearance. The effect of Botox Cosmetic is primarily dependent on three important factors:
- The qualification and experience of the person providing the treatment. (See "Who Should Perform Botox Injections")
- The dose of Botox that is injected – the amount of muscle contraction disruption depends on the amount of Botox that is administered into the particular treatment area.
- The dose has been injected correctly into the appropriate treatment area to achieve the desired effect
The goal of our physicians when performing Botox Cosmetic injections is to provide the most natural-appearing result as possible to meet our individual patient's goals in a realistic manner. The goal for treating the glabella area, the frown lines between the brows, is to completely eliminate them. The goal when treating the horizontal forehead frown lines is more conservative to avoid over treatment. The goal when treating frown lines at the mouth or tiny lip lines is to reduce the lines but not interfere at all with the functional aspect of smiling, laughing or eating.
Dr. Moore, the founder of Premier Plastic Surgery states, "my goal when treating a patient with Botox Cosmetic injections who wants to correct horizontal forehead creases is not to totally eliminate them but rather soften them while preserving the patient's ability to elevate their brows, thus avoiding a "frozen face" look. My goal is not to erase every line and wrinkle from a patient's face. I advise my patients that it is best to focus on those wrinkles or creases that play the largest role in making you look tired or worried. With this treatment approach, patients are very pleased with their natural, rested, refreshed appearance while avoiding the over-treated appearance that you can get by either using too much Botox in an area or not completely understanding the anatomy of the facial muscles and inappropriately injecting Botox in an area that may cause an unnatural look."
Are there permanent alternatives to BOTOX ®?
Permanent or longer lasting improvements in facial wrinkles and frown lines can be achieved with a variety of non-invasive procedures and surgical procedures. What treatment works best for you will be decided between you and your physician based on your needs, your examination, your goals and desires. Our physicians will help you understand the many surgery options available so that your individual needs and expectations are fulfilled to the greatest extent possible.
Non-invasive alternatives to Botox treatments for some wrinkles include laser skin resurfacing. Equally important to prevent and reduce the appearance of fine lines and wrinkles is to maintain good skin health with a quality skin care regimen, such as Obagi.
Surgical procedure alternatives include: brow lifts and corragator resection, which is the surgical interruption of the corragator muscles that produce the frown lines between the eyebrows. These muscles can easily be targeted when patients are undergoing upper lid blepharoplasty (eyelid surgery) or as a separate procedure endoscopically through a small incision at the hairline. The muscles are simply divided and the ability to form the forehead scowl lines is significantly reduced or eliminated.
Who should not take BOTOX ® Cosmetic
You should not receive Botox Cosmetic if you:
are allergic to any of the ingredients in Botox or Botox Cosmetic
had an allergic reaction to any other botulinum toxin product such as Myobloc® or Dysport®
have a skin infection at the planned injection site
You should not be treated with Botox Cosmetic if you have:
- have a disease that affects your muscles and nerves (such as amyotrophic lateral sclerosis [ALS or Lou Gehrig's disease], myasthenia gravis or Lambert-Eaton syndrome)
- allergies to any botulinum toxin product
- had any side effect from any botulinum toxin product in the past
- a breathing problem, such as asthma or emphysema
- swallowing problems
- bleeding problems
- weakness of your forehead muscles, such as trouble raising your eyebrows
- drooping eyelids
- any other change in the way your face normally looks
- are pregnant or plan to become pregnant. It is not known if Botox Cosmetic can harm your unborn baby.
- are breast-feeding or plan to breast feed. It is not known if Botox Cosmetic passes into breast milk.
When is the best time to have BOTOX ® injections prior to a wedding, reunion or other special event?
If you are considering Botox Cosmetic for the first time prior to a special event, such as a family or school reunion, or a wedding you should schedule an appointment approximately 4 months prior to the event to allow for an initial consultation and treatment. This will allow you to undergo an initial treatment as a "trial" to see how the treatment will look and to refine any other additional treatment areas if you decide on subsequent treatments. For established patients on Botox, you should schedule a treatment 3 to 4 weeks in advance of a special event.
Click here to learn more about Cosmetic Procedures or Skin Care Treatments prior to reunions, weddings and other special events.
What do BOTOX ® Cosmetic injection treatments cost?
Cost of Botox Cosmetic injections will vary according to how many areas are treated and the total number of Botox units used. Premier Plastic Surgery provides very competitive pricing for Botox Cosmetic Injections in the Kansas City area. In addition, we are happy to offer our Botox patients our Botox Cosmetic Benefits Program.
Are BOTOX ® parties safe?
Over the past decade with the increase popularity of Botox injections for cosmetic purposes, some providers of Botox treatments have staged "Botox Parties" outside of a medical facility as a marketing strategy to increase business and to make the treatment less intimidating to consumers. Many times at these parties, standard medical care is compromised. Medical histories and informed consent are not obtained, patients are not advised of alternative treatments or risks, and adequate follow up care is not arranged. Cosmetic treatments including Botox treatments should always be administered in a medical setting. Doctor's offices or other medical facilities are the safest place to have injectables administered. Homes, malls, conference rooms or hotels do not have the same standard for cleanliness and emergency care that a doctor's office does. The FDA states that, "botulinum toxin products should be administered in an appropriate setting using sterile instruments and all staff should be trained in sterile procedures so as to avoid contamination, re-use of needles and infections.
Patients love Botox because of how accessible it is and for how minimally invasive it is, but the ease that people perceive its administration is exaggerated. The American Society of Aesthetic Plastic Surgery issued the following statement, "providing Botox injectables outside a doctor's office put patients at risk of improper technique, inappropriate dosages and unsanitary conditions". Dr. Moore, the Medical Director of Premier Skin Care Center, states that just because Botox injections are becoming more and more commonplace, the injection of a pharmacologic agent should never be done in a casual or frivolous manner.
Dr. Moore and his partners, Dr. Storm and Dr. Gonzalez, understand that a patient interested in, but unfamiliar with Botox injections may be anxious and would benefit from the support of a friend or two. For this reason Premier Plastic Surgery and Skin Care Center schedules private Botox events by appointment only on Friday evenings and Saturday in the safety and privacy of their medical office. A brief presentation and question and answer period is followed by each patient receiving a private consultation and treatment. Standard medical care including medical history taking, explanation of risks and benefits, informed consent and scheduling of appropriate follow up is provided. If you are in the Kansas City, Olathe or Overland Park area, click here to learn more about Private Botox Office Hours.