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Steven J. Pearlman, MD, FACS Dual Board Certified in Facial Plastic Surgery

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BOTOX® in Manhattan, New York

Img_BotoxBOTOX® 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.

Why use BOTOX®?

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® treats dynamic facial lines and overactive muscles:

  • Glabellar lines: Deep furrows between the eyebrows. These are often referred to as the “angry 11′s”
  • Horizontal lines on the forehead
  • Crow’s feet
  • Platysma bands–the thick bands of muscle in front of the neck, BOTOX® may help stave off a facelift
  • Dimpling of the chin from overactive muscles
  • Raise drooping of the corners of the mouth
  • Fine lines around the lips
  • Fine wrinkles under the eyes

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 NYC

How is BOTOX® used?

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.

What is BOTOX® and is it safe?

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

Q: How long does Botox® last?

Botox® lasts from 3 1/2 to 4 months in most patients, some longer. For some patients who find that Botox® is not lasting long enough, we offer alternative treatment with a very similar product called Dysport®.

Q: How old do you have to be to start?

There is no cut-off or starting age for Botox®. Generally, we treat younger patients (in their 20s) when they have forehead or brow lines at rest.

Q: Is it true after a while you need less of it?

If you keep up with Botox® treatments, repeating every 3 1/2 to 4 months, your facial muscles will start to thin out from disuse. This may increase the effectiveness and longevity of Botox® treatments

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