Indications
Botox has 2 basic roles in anti-aging and cosmetic surgery.
Treatment
It treats the wrinkle by relaxing the muscle. This is the most common reason people use it. If you don’t like the lines between the eyebrows for example, then Botox will soften them. We also use it as purely as a cosmetic treatment. We can elevate the eyebrows (brow lift); elevate the corners of the mouth etc.
Quantity
Botox is measured by units, not cc’s or by area. The active component of Botox is what you are paying for. So when you get 25 Units of Botox injected, the dilution of the Botox is not important. Each injector uses different amounts during its standard treatment.
As a general consideration, the more you put, the more frozen the muscles are and the longer the effects last. Many, of my patients, don’t like the “frozen” look. I don’t either. So in my practice, I inject the least amount I can to get the desired effect. Remember, if you charge by the Unit, you get what you pay for. I want my patients to pay the least and get the most out of it. If you get flooded with Botox, not only will you not know what is the least amount it takes to get the desired effect, but you end up paying more than you should. My definition of the ideal amount is slight movement.. so it looks natural, but not so much movement that it causes wrinkles. This takes art and experience to strike this balance.
Adverse Effects
largely related to misplacement. This results in an asymmetry, potential sagging eyebrow or eyelid. These potential side effects are significantly avoided when an experienced person is performing the injections.
Duration
Now, this brings me to the issue of duration. How long does Botox last? Typically, each treatment lasts 3-4 months. Many people wish it lasted longer. However, in my opinion, a shorter-acting process is a good thing if for some reason you didn’t get a good result! If you don’t like the result… you don’t have to wait long before it goes away on its own.
Quality
This brings us to the issue of injection quality. The fact is Botox injections are not totally trivial. Believe me, though it seems straightforward in concept.. it requires a real understanding of what makes a face look attractive and better (an aesthetic sense) in addition to a sound understanding of the muscular anatomy. There is a lot of interplay between the different facial muscles and understanding how to manipulate the dosages in each patient is important to get a customized and natural result. So you must do your investigation. Price either high or low is not an indicator of a good injector either. However, at the very least good training and consistent results should be sought after.
Prevention
To prevent lines from forming in the first place. If you are a little more proactive with your anti-aging program, you would use our La Jolla Botox treatment to prevent wrinkle formation. Think about it… if you can’t move the muscle, you can form a skin crease, and you won't form a wrinkle.
To me, this is the most important benefit. Aging of the upper face, forehead, glabella (the region between the eyes and eyebrows), and crows feet (laugh lines around the sides of the eyes), is the most difficult to treat once the wrinkles transition from dynamic to static. Therefore, it’s best to prevent the lines from forming in the first place.
I tell my patients, even if they did it 2x/ year, you are effectively decreasing the factors that lead to facial aging by over 50%. Because, 50% of the year, the muscles are not leading to wrinkling formation.
In fact, a study using identical twins showed this anti-aging benefit after 13 years of treatment in one twin and no treatment in the other.