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BOTOX® Cosmetic has become one of the most popular cosmetic treatments for the face. BOTOX® can dramatically reduce facial lines from overactive muscles. BOTOX® is a highly safe and effective non-surgical procedure, with minimal side effects. Dr. Pearlman has extensive experience with BOTOX®, having used it since 1993.
Dynamic facial wrinkles are caused by contractions of the delicate muscles of the face every time you express emotions. The more expressive you are, the deeper these wrinkles and lines are likely to be. These lines may be misinterpreted as anger, anxiety, fatigue and, of course, aging. Fillers can plump up these areas and surgical procedures such as browlift and blepharoplasty that can tighten the skin and muscles around these lines, but neither can address the underlying muscle pull, which eventually deepens the facial wrinkles. So for dynamic facial lines from overactive muscles of the upper face, BOTOX® is usually the best treatment.
BOTOX® is now more than just treating wrinkles. For example, the face can be “sculpted” by raising or lowering eyebrows to enhance your look. BOTOX® is an excellent complimentary procedure to overall facial rejuvenation. It can be used alone or in combination with facial fillers and skin care from home treatments to laser resurfacing. Most BOTOX®-related problems are overly sensationalized when reported by the media; complications are rare and generally more common with inexperienced physicians. The number of applications is ever increasing. However, glabellar lines (those between the eyebrows) are the only cosmetic use currently approved by the FDA. Any other places are at the discretion of the treating physician and patient.
BOTOX® Browlift: BOTOX® can also be used to raise your eyebrows to create a more pleasing shape and even mimic a browlift without surgery (see gallery).
This patient had no surgery, only treatment with BOTOX®
BOTOX® treatments typically have minimal discomfort. We use the tiniest needles available; some are hair-thin. These needles are so fine that patients rarely feel the need for topical anesthetic cream. BOTOX® usually lasts from 3 to 5 months. Patients may elect to repeat BOTOX® treatments when it fully wears off. However, if the face is re-treated as soon as the muscles start to move, the facial muscles never regain their “memory”. After a number of re-treatments the interval between may become longer.
BOTOX® is a purified protein that blocks the muscles from contracting. It only affects the area where it is placed. The action of BOTOX® typically lasts from 3 to 4 months. The doses used are a fraction of a percent that might be harmful. BOTOX® has been used safely in cosmetic applications for over 15 years and in non-cosmetic uses for over 25 years. It has been FDA approved for facial wrinkles since 2002.
There has been some controversy in the media recently about the safety of BOTOX®. The studies in question were from non-cosmetic uses, where much larger doses are used and in areas in the lower neck, far away from any cosmetic applications. BOTOX® does not travel or accumulate either in the blood or in the body so cosmetic use is safe. The other reports were when non-approved Botulinum Toxin was used in humans by unscrupulous doctors. This turned out to be thousands of times the dose of approved BOTOX®, which is a name-brand product and highly regulated by the Allergan company and the FDA; not a non-approved “knock-off.”
There are a number of potential side effects to BOTOX® treatments. Since a needle is being used, there may be a small “black and blue” spot which is minimized if pressure and ice are used right away. True drooping of the eyelid is rare, and is most often avoided by proper planning of treatments. More likely, relaxing the forehead to smooth lines may eliminate the habit of raising one’s eyebrows. For patients with heavy eyebrows or eyelids, they may actually need to hold their brows up to relieve heaviness from the eyes. In these patients, the brows may appear to fall from the BOTOX® treatment. This may be avoided by treating only the upper brow lines. Patients with this condition may be more appropriately treated by facial surgery.
Questions? Contact Dr. Pearlman about BOTOX® or any other procedures you might be interested in.
Answers to frequently asked questions about the procedure
Eyelids can look "tired" from a number of reasons. The more common ones are bags under the lower eyelids, excess skin of the upper and/or lower eyelids and drooping of the eyebrows. You don't have any of these.
Your eyelids slant downward towards the sides; the corner where the upper and lower eyelids meet (called the canthus) is lower towards your ears than near your nose. There are a number of surgical techniques that can be used to raise the lateral canthus. Sometimes, there may be some hollowness of the bone of the eye socket as well. This is also treatable. Seek out a surgeon who is versed in this procedure for a more definitive discussion.
A: A rhinoplasty will last for the rest of your life. However, even a nose that has undergone a rhinoplasty ages like the rest of your face and body. As we age, the nose begins to droop. After a rhinoplasty they will age from where they were after the procedure. The procedures we do for an aging nose is often more subtler than a formal rhinoplasty.
A mini-facelift of today was the maxi-facelift of 2 decades ago. Mini or maxi, best to discuss with your doctor. There are many definitions of what a mini-facelift is. For some it's a shorter incision, for other doctors its less work on the muscle called the SMAS. The technique depends more on the doctor's skill and your anatomy. For a patient in their early 40's, you often don't need the same deep plane facelift that someone in their 50's or above might need. Most of these procedures address your jowls.
A: Performing both a quality septoplasty and rhinoplasty is dependent on the individual's training and experience. Generally, facial plastic surgeons start with ENT training before they move on to facial plastic surgery. Although they are not formally trained, many plastic surgeons can also be experience and qualified to perform septoplasty procedures. The main focal point should be how much training they have received and how much experience do they have performing the procedures together and separately. There are subtle signs that could indicate if the proposed surgeon is right for you: