BOTOX® & Facial Fillers
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FOR FROWN LINES AND CROW’S FEET
Dynamic wrinkles are caused by contractions of the delicate underlying facial muscles every time you smile, laugh or frown. The more emotion you show, the deeper these wrinkles and lines are likely to be. While you may have earned every one of your worry lines, you don’t have to show them anymore. Now, thanks to a new use for an approved drug, dynamic lines can be dramatically softened. The procedure known as cosmetic denervation uses BOTOX® injections to improve the appearance of worry lines, frown lines, laugh lines, crow’s feet and other dynamic wrinkles.
HOW DOES BOTOX® COSMETIC WORK?
BOTOX® blocks impulses from the nerve to the tiny facial muscles that are related to expression lines. BOTOX® relaxes the muscles so they do not contract. After treatment, the overlying skin remains smooth and unwrinkled while the untreated facial muscles contract in a normal fashion, allowing normal facial expression to be unaffected.
ARE BOTOX® COSMETIC TREATMENTS SAFE?
BOTOX® injections have been used safely and effectively for over ten years to treat many ophthalmological and neurological disorders. Each year thousands of patients receive Botox treatments for a variety of conditions and it is quickly becoming a popular treatment for reversing the visible signs of aging.
WHAT IS THE TREATMENT LIKE?
Cosmetic denervation with BOTOX® is a simple and safe procedure. Using a very fine needle, a very small amount of BOTOX® is injected, very precisely, into several locations on the face. Because the needle is so fine and only a small amount of liquid is used, the pain associated with the injections is minimal. Most patients compare the sensation to a bug bite. No sedation or local anesthetic is required, and you can resume normal activities immediately. You can even drive yourself home or back to the office. A small percentage of patients experience slight temporary bruising at the injection site. This can be covered with make-up.
ARE THERE ANY SIDE EFFECTS?
Temporary bruising is the most common side effect. In some cases, BOTOX® can migrate and cause a temporary weakness of nearby muscles. In rare cases, there can be a drooping of an eyelid or asymmetry of facial expression. The risk of any side effect depends on the muscles injected. Your doctor will discuss this with you in length before your treatment. Because the effects of BOTOX® are completely reversible, any side effects are temporary, lasting only a few weeks.
WHAT RESULTS CAN I EXPECT?
If dynamic wrinkles make you look older than you are, cosmetic denervation can smooth these out and give you a more youthful and pleasant appearance. However, this procedure cannot improve wrinkles due to aging and sun-damaged skin since they are unrelated to facial muscle contractions. BOTOX® injections will not improve sagging skin or replace the need for a facelift or brow lift.
WHAT ARE THE LIMITATIONS OF BOTOX® COSMETIC INJECTIONS?
Unfortunately, BOTOX® injections are a temporary solution for the treatment of dynamic wrinkles. The effects of the injections last from three to six months. You will need to have injections about two to three times a year. The early clinical studies indicate that the duration of treatment benefits is increased over time so that you should require injections less frequently in the future. Also, the duration of effect varies from patient to patient and may be less effective for those over 65 years of age.
IS BOTOX® COSMETIC USED TO TREAT OTHER SYMPTOMS?
Yes. BOTOX® has been used for over ten years on thousands of patients to treat blepharospasm associated with dystonia.
WHAT IS BLEPHAROSPASM?
Blepharospasm is a localized movement disorder (focal dystonia) that affects the muscles that control the eyelid movement. This disorder is characterized by increased blinking caused by involuntary spasms of the muscles controlling the eyelid. Blepharospasm usually affects both eyelids and can progress to functional blindness (i.e., an inability to open the eyelids for any significant period of time).
Approximately 75% of patients with blepharospasm are female and the average age at onset is 56 years. Although the exact cause of this disorder is unknown, experts believe that it may be caused by a defect in the basal ganglia – a group of nerve cells in the central nervous system.
HOW IS BLEPHAROSPASM DIAGNOSED?
Diagnosis is based primarily on the patient’s medical history. The first signs of blepharospasm include irritation and discomfort of the eyelids and increased blinking. As the disease progresses, blinking becomes more frequent, forceful
and uncontrollable. Exposure to bright, dazzling or flickering lights, dusty or smoky air or high-speed travel by train or car can exacerbate symptoms. Remissions are rare.
HOW IS BLEPHAROSPASM TREATED WITH BOTOX®?
BOTOX injected directly in the affected eye muscles relieves the muscle spasm. The duration of effect lasts approximately three months at which time the neurotoxin can be reinjected as long as the patient continues to respond and does not have a serious allergic reaction. This is covered by most insurance carriers for this condition or facial spasms.
HOW CAN I FIND OUT IF I AM A CANDIDATE FOR BOTOX® COSMETIC?
If you would like to learn more about your cosmetic options or find out if BOTOX® treatments might work well for you, please call our office and schedule a consultation with the doctor.
With the new FDA approval for cosmetic use, Xeomin now joins the ranks of Botox Cosmetic to reduce frown lines, wrinkles around the eyes and forehead. Worldwide, more than 84,000 people have been treated with Xeomin injections. The U.S. is actually the 20th country to approve this new drug. It will be available in 50-unit and 100-unit vials. This Botox alternative was already approved for use in adults with cervical dystonia and blepharospasm. Cervical dystonia is characterized by abnormal neck pain and movements, and blepharospasm is marked by abnormal, involuntary blinking or spasm of the eyelids. Xeomin is manufactured by Merz Pharmaceuticals.
Xeomin (IncobotulinumtoxinA) is made from the bacteria that causes botulism. Botulinum toxin blocks nerve activity in the muscles, causing a temporary reduction in muscle activity. Is Xeomin better or worse than Botox?
Unlike its predecessors, Xeomin does not need to be refrigerated. This may be an advantage when it comes to distribution. What’s more, Xeomin is”naked.” There are no additives — just botulinum toxin type A. This may lessen a patient’s likelihood of developing antibodies to Xeomin. When your body senses a foreign invader, it responds by creating antibodies and launching an attack. If this were to occur with a neurotoxin such as botulinum toxin type A, it may not have its desired effects.
What are the risks?
There is a risk that all botulinum toxin products may spread from the area where they were injected into other parts of the body, causing potentially life-threatening swallowing and breathing problems. This was predominantly seen in children treated with Botox off-label for cerebral palsy. These issues have not been reported among people who received botulinum products for cosmetic uses or to treat blepharospasm.
Other risks may include:
- Bruising at the injection site
- Allergic reactions such as itching, swelling or shortness of breath.
Your doctor should discuss all the potential risks of this procedure with you during your consultation.
What is Juvéderm™?
As we age, our skin changes. Over time, the natural volume of youthful skin begins to diminish as wrinkles and folds form. But, with Juvéderm™ injectable gel, you don’t have to just sit back and let it happen! Recently approved by the FDA, Juvéderm™ injectable gel is a “next-generation” dermal filler. The smooth consistency gel helps to instantly restore your skin’s volume and smooth away facial wrinkles and folds, like your”smile lines” or “parentheses” (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth).
Juvéderm™ is a smooth consistency gel made of hyaluronic acid—a naturally occurring substance in your skin that helps to add volume and hydration. Your healthcare professional eases Juvéderm™ injectable gel under the skin to provide a smooth, natural look and feels—so everyone will notice (but no one will know)! In fact, studies show superior results of Juvéderm™ compared to a collagen-based dermal filler.* And, almost 90% of all study volunteers who were treated with both Juvéderm™ injectable gel and another dermal filler* preferred Juvéderm™! In addition, Juvéderm™ injectable gel is the first FDA-approved hyaluronic acid dermal filler that is proven to be safe and effective for persons of color.
How Juvéderm™ Works
Juvéderm™ injectable gel is a nonsurgical, physician-administered treatment. Your healthcare professional eases Juvéderm™ under the skin using a fine needle to augment, or fill, the soft tissue of the dermis—the dense inner layer of skin beneath the epidermis—to add volume and diminish wrinkles and folds. Juvéderm™ injectable gel is used most effectively for those wrinkles and folds in the lower third of your face, like your”laugh lines,” “smile lines” or”parentheses” (nasolabial folds), or”marionette lines” (oral commissures).
Juvéderm™ is a”next-generation” filler. It is made from hyaluronic acid—a naturally occurring substance in your skin that helps to hydrate and add volume. Hyaluronic acid may diminish with age, contributing to the formation of wrinkles and folds. Juvéderm™ injectable gel works to correct this by restoring hyaluronic acid in your skin, helping to smooth wrinkles and folds.
Juvéderm™ Ultra and Juvéderm™ Ultra Plus are indicated for injection into the mid to deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds). Side effects were usually mild to moderate lasting 7 days or less and included temporary injection site reactions like redness, pain, firmness, swelling, and bumps.