Holiday season is fast approaching and everybody wants to look their best for this time of the year. Schedules are hectic, time (and money) is tight and surgical procedures which entail downtime (and markedly increased cost) are not an option (or even needed in many instances). This is the time of the year I am frequently asked about “quick fixes” for fine lines and wrinkles of the face or how to improve the overall appearance of the skin. By “quick fix” I am talking about nonsurgical interventions with little or no down time but which can produce immediate results with impressive improvements.
The most frequently and popular nonsurgical procedures include Botox, injectable dermal fillers such as Juvaderm , or other hyaluronic acid products (Hydelle, Restylene, etc.) and/or skin resurfacing procedures utilizing laser technology. Today I will limit the discussion to the benefits of Botox.
Botox as you know is a locally acting muscle paralyzing agent which is injected into specific muscle of the face. Botox acts directly on the muscle where it is injected to reduce lines and wrinkles produced by the contraction of those muscles. No muscle contraction means those lines will either disappear or be marked reduced. The most common areas I am requested to address are the frown lines between the eyebrows, the horizontal lines across the bridge of the nose and / or forehead and of course, the crow’s feet region around the eyes.
Once Botox is injected it begins to take effect in just a few days. The lines begin to lessen as the muscle activity decreases. Full effect is seen at about 5 days. If there are residual fine lines which persist after the muscle no longer has function, then a dermal filler, such as Juvaderm can be injected to give an almost perfectly smooth result.
An additional benefit of Botox is the ability to raise the brows in select individuals. If the muscle which depress (lower) the eyebrows no longer function, then the muscle which elevates (raises) the brow acts unopposed. In this situation, not only can the forehead wrinkles lessen (without additional Botox injections into the forehead itself), but more importantly the eyebrow can be effectively elevated several millimeters to give patients a noticeable improvement. This is sometimes referred to as a “chemo-browlift”. (as opposed to an endoscopic brow lift which is a surgical procedure.)
The injections are done with a very fine needle so the discomfort is extremely minimal. In my experience, even the most “needle phobic” patients tolerate the Botox injections without any problem. There is no need for even a topical anesthetic, but that is always available by patient request. Botox injections are done in the office and takes only a few minutes to perform. The majority of the time is spent with the patient to determine if their areas in question will respond satisfactorily to Botox and of course, exactly where the Botox is needed in order to provide the maximal improvement.
The most common side effects seen in my practice is the rare localized bruising at one or two injections sites which resolves in a few days and is always easily concealed with make up. These patients usually are new to my practice and have ingested aspirin, motrin or some other non steroid anti-inflammatory drug (NSAID) or had red wine sometime before their Botox injections. Take home message here is: do not take anything which acts as a blood thinner for 10 to 14 days before your Botox injections and your chances of have post injection bruising is exceedingly low.
Hope this has provided you with a bit more information on one of the most popular cosmetic procedures available. Botox provides patients with a non-surgical option for the reduction or elimination of facial fine lines and wrinkles. This may be the perfect “quick fix” for this time of the year (or any time of the year for that matter!). Call Mary Ann for more information and about our holiday specials regarding Botox and our other non-surgical skin care options. In future blogs I’ll discuss what dermal fillers such as Juvaderm can do to eliminate or reduce facial wrinkles or enhance the lips and also the benefits of laser skin resurfacing. Until then, thanks for your time. Tim Bradley, MD