INJECTABLE NEUROTOXINS
BOTOX® COSMETIC and DYSPORT® 

If your brow and forehead have permanent lines and you look like you are frowning even when you are not, you may want to consider an injectable neurotoxin like Botox Cosmetic or Dysport. These products provide a simple non-surgical procedure that smooth deep, persistent facial wrinkles caused by hyperactive muscles beneath the skin by blocking transmission of nerve impulses to the muscles of a target area. Each product has been aggressively tested and approved by the FDA. Neurotoxin injections have no scarring and result in minimal downtime. Note that because injectable neurotoxins target dynamic muscles, they would not be indicated for patients with neuromuscular conditions such as Myasthenia Gravis or Multiple Sclerosis.

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WHAT TO EXPECT:
Injectable neurotoxins like Botox Cosmetic and Dysport are popular with both men and women. They visibly smooth and soften moderate to severe frown lines between the brows, called glabellar lines, and crow's feet around the eyes. They can also help relax facial lines and wrinkles on the chin and forehead, and the bunny lines that develop across the top of the nose, marionette lines, smile lines and vertical lip lines. Benefit is also seen in treating the mental crease and the orange peel skin texture that appears on the chin with age. People will notice how rested you look. It will be a little harder to move your forehead or frown but you will still be able to make facial expressions and show emotion. At the time of your consultation, we will review common and less common side effects related to this procedure.

INJECTION PROTOCOL:
You will sit on an exam table, upright or partially reclined with a pillow supporting the head, depending on injection site. The injection area is cleansed and a topical anesthetic applied. Each injection point is marked with an eyebrow pencil. The needle is inserted just barely through the skin since facial muscles sit very close to the surface. A highly concentrated solution is used, so only a small volume of liquid is needed. The neurotoxin is quickly injected and the needle withdrawn. Usually a small raised area of skin is left behind and this quickly returns to normal in a short time. Depending on the treatment area, several injections are usually required. As an example, 5-6 injections are required in the brow area (between the eyebrows). The actual procedure takes less than 5-15 minutes to perform, depending on the treatment area.

WILL IT HURT?
The thought of needles in the face cause some people to avoid treatment. In reality, while this procedure is not painless, it is not overly uncomfortable since we use topical anesthetic and very tiny needles that are not injected deeply. Everyone has a different pain threshold but the average person describes a slight pinprick sensation and most agree that it was "not a big deal." On average, the crow's feet injections around the eyes hurt the least and upper lip injections hurt the most.

FOLLOW UP:
To ensure the best treatment outcome, we recommend that patients remain in an upright position for four hours and emote the treated area often (i.e., wrinkle the forehead, smile, frown, etc.) for 1-3 hours after treatment, which helps with the uptake of the product. You should NOT massage the treated area for 1-3 hours, do any exercise (running, aerobics, weight lifting, etc.), or take aspirin or ibuprofen for 24 hours. Tylenol can be taken for headaches. You may see some mild bruising for which you may take oral Arnica or use topical vitamin K. It will take 3-7 days for the full effect of treatment to be achieved.

After the first treatment, we ask that patients schedule a 2-week follow-up appointment, which allows us to assess the response and perform additional treatment if necessary. Our philosophy is that it is better to use less product (especially on the first visit) to avoid overcorrection; it is always possible to utilize additional product if necessary.

BENEFIT DURATION:
Typically this varies from person to person, depending on the amount of product (more product = longer effect), the strength of the muscles, and each person's own unique chemical makeup. The muscle-relaxing effects of your treatment should be expected to last anywhere from 3-5 months. Most regular patients return 3-4 times yearly.   

FOR MORE INFORMATION:

Come in for a cosmetic assessment - we will assess your needs and recommend one or a combination of treatments to achieve your desired results.

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ROBERT G. SHOSS, MD

INJECTABLE NEUROTOXINSBotox Cosmetic

Dysport 

Expires August 31st, 2018
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