Botox

Botox is a natural product that can be used to soften and smooth moderate to severe frown lines between the eyebrows (the glabella). The affects are noticable after 24 hours and reach the full effect by 3 days. It usually lasts from 3 to 4 months, but this can vary from patient to patient. Botox is also helpful in reducing the appearance of crow's feet wrinkles at the corners of the eyes.

What many patients don't know is that Botox can also be used to change the shape and position of the eyebrow. As people age, it is natural for the brow to slowly drop, allowing excess skin to roll over the upper eyelid, giving a heavy, tired appearance to the eyes. Botox can improve this problem by elevating the brow back up into a more youthful position. Botox does this by reducing the activity of muscles that pull the eyebrow down. This allows the muscles that elevate the brow to act with less resistance, thereby bringing the eyebrow up.

The patient shown here is in her mid 30's and has had some normal aging changes to her brow. Notice the excess skin lying over the upper eyelid (Figure 1). After using only 15 units of Botox (2 units near each eye and 11 between the eyebrows) her eyebrow is elevated into a more youthful position (Figure 2). Notice how much more of the upper eyelid is visible, and see how the Botox, when applied correctly, can create an attractive elevation of the lateral brow. Each patient is unique, and these treatments are specially tailored to every patient.

Question:
Some doctors charge for Botox by the area and some charge by the unit. What is the difference?

Answer:
With Botox, the more units you use, the more effect you will have on a particular patient. Therefore, for a more subtle result, less Botox can be used and it will cost less. A more dramatic result may require more Botox and will cost more. I believe the best results can be attained by customizing the approach for every patient and finding the appropriate amount to get the desired results. By charging by the unit, the patient will only pay for the effect requested.

Question:
Can Botox be used around the mouth?

Answer:
Frequently patients request an improvement in the "purse-string" or "Smoker's lines" around the mouth. Despite the name, these lines can be found even in non-smokers and can be caused by repeated use of the muscles around the mouth. Often the presence these wrinkles impart a look of disapproval. A small amount of Botox can be used in this muscle to slightly soften these wrinkles. In the appropriate patient it can significantly reduce these bothersome lines.

Question:
How much Botox do I need?

Answer:
This depends on your anatomy and the desired effect. Some patients only need 15 units, while others require as much as 50 or more. For first time patients, I like to err on the conservative side. We can always add additional Botox as needed.