What are BOTOX® Injections?
BOTOX® Cosmetic injections are the most popular cosmetic procedures in the country and one of our most requested services. Quick, safe and effective, BOTOX® reduces or eliminates facial lines and wrinkles for up to three months with no downtime and little to no discomfort.
Facial lines and wrinkles can be caused by the underlying muscles of facial expression or they can be indicative of skin aging. Muscles of facial expression control movements of frowning, squinting and elevation of your brow. Repetitive and unknowing movements can cause deep lines in and around these muscles. BOTOX® is designed to quiet these muscles and in doing so smooth the overlying skin. Sun damage and aging can lead to thinning of the skin which predisposes to wrinkles. BOTOX® combined with active skincare can help to reduce these wrinkles and deliver a natural and youthful appearance that can be accomplished without the need for plastic surgery.
BOTOX® is the brand name for botulinum toxin A, a therapeutic muscle-relaxing agent derived from the bacteria Clostridium Botulinum. Originally approved by the FDA for the treatment of eye and muscle spasms, BOTOX® was quickly recognized for its cosmetic value. Dr. Trussler has significant experience with BOTOX® and can individualize a treatment regimen that meets your goals and suits your face.
Am I a good candidate for BOTOX®?
Whether or not Botox® is right for you depends on the wrinkles you are seeking to erase and where they are on your face. Botox® only works on “dynamic” wrinkles that form on the surface skin when our facial muscles contract when we form certain expressions. When Botox® is injected into these muscles it blocks the nerve messages sent from the muscle to the brain. The brain never receives the message to contract the muscle, so the muscle remains at rest and the wrinkle that forms on the surface skin above is erased.
Dynamic wrinkles form on the upper third of the face, the expressive area. These are crow’s feet at the outside of the eyes, glabellar/frown lines between the eyebrows, and forehead lines. If these are the wrinkles and lines you want to get rid of Botox® is the answer. For some patients, Dr. Trussler has had success with Botox® in other areas, as well, such around the lips. Dermal fillers do not work on dynamic wrinkles.
If your wrinkles are due to sun damage, declining collagen production, personal habits such as smoking, and other factors they are known as “static” wrinkles. They show themselves at all times and they have nothing to do with muscle contractions. These lines, creases, and areas of volume loss occur on the mid to lower face. Botox® has no effect on these wrinkles. They are the domain of dermal fillers.
What Are My BOTOX® Options?
BOTOX® Cosmetic injections are offered as an in-office service for both men and women. Ideal candidates are healthy patients with realistic goals and defined areas for treatment. During your BOTOX® consultation, Dr. Trussler will review the areas BOTOX® can treat and amount needed to smooth lines in those areas.
Treatment Options For BOTOX®:
Forehead: Can smooth horizontal forehead lines, shape and lift the brow.
Central Brow (Glabella area): Smooths vertical frown lines.
Crow’s Feet: Smooths the lower eyelid and upper cheek fine squint lines.
Lower Eyelid: Decreases prominent lines and can shape the lower eyelid.
Upper Lip: Reduces vertical lines and can lift the upper lip giving the appearance more fullness and volume.
Lower Lip: Reduces vertical lines and can help up turn the corners of the mouth.
Outer Jaw: Reduces muscle bulk in this area for prominent outer jaw muscles (Masseter reduction).
Arm Pits: Reduces excessive sweating or hyperhydrosis.
Through a series of tiny injections localized in the target muscle or skin area, BOTOX® can help smooth fine lines, as well as shape and lift areas to give you a rejuvenated and natural appearance. BOTOX® is dispersed in “units” of the drug and must be diluted with saline prior to injection. The number of units per area is somewhat standard, but can be variable in patients with strong expressions, large muscle bulk and/or in men. The treatment of excessive sweating or hyperhidrosis usually requires a significant amount of BOTOX® which as well can be individualized for the patient.
BOTOX® Injection Considerations
BOTOX® injections can be individualized for each area’s face and each patient. Consider the areas that you would like treated and discuss them during your consultation. BOTOX® injections are prevalent throughout the cosmetic community, but not all injectors have significant experience with facial aesthetics and facial anatomy. If you have had “bad” BOTOX® or BOTOX® that didn’t “take”, it is likely related to the injection technique and not you. Consider that BOTOX® needs to be injected in or near the muscle, and depending on the amount injected there are many variables as to if the BOTOX® is in the right place and in the right amount for you. It is important to try an experienced injector for 2 or 3 consecutive treatments to get your BOTOX® routine down.
BOTOX® affects only one component of the face (muscle), and for a complete facial rejuvenation: skincare and/or skin resurfacing may be considered. Dr. Trussler also encourages preventative skin measures such as sunscreens and smoking cessation.
BOTOX® Injection Expectations
BOTOX® is a reliable cosmetic treatment that is safe and effective for smoothing creases, fine lines, and wrinkles in the face. BOTOX® is delivered through small injections likened to a TB test or insulin shot. It is performed in the office using topical numbing cream and/or ice for comfort. The procedure takes approximately 15 minutes to complete. A variable number of units of BOTOX® is injected depending on what areas are treated and how much muscle activity there is. In general 25 units to 45 units are injected at a time. The time to onset is 2 days and the final result will appear in 5 to 7 days. With the proper injection technique and the right amount, BOTOX® can deliver a natural, refreshed look.
The most common complication of the injections is bruising at the site, and others include continued muscle activity, droopy eyelid(s), and headaches. The length of action for BOTOX® is approximately 3 months.
Men and women considering BOTOX® treatment should have realistic expectations of what the procedure can do. It is also important that patients seeking treatment with BOTOX® are in good physical health, are not pregnant or nursing, and do not have a neuromuscular disorder or previous adverse reaction to the product. You should discuss the desired results with Dr. Trussler to ensure that your goals can be achieved.
BOTOX® is a cosmetic in-office procedure that is safe, reliable with little to no downtime. The areas of treatment are identified, and then topical anesthetic and/or cooling packs are applied to the areas to help make the injections comfortable and limit bruising. The BOTOX® is injected with a fine needle as a suspension in liquid form in very small volumes to deliver a relatively standard amount (units) to the treatment areas. Ice is applied after the injections to limit swelling and bruising. The entire treatment may take 15 minutes and you can return to normal activities that same day.
Facial procedures such as microdermabrasion, photo-facial and laser resurfacing should be performed before any BOTOX® treatment or approximately 5 days after the injections. Fillers such as Juvederm® and Voluma® can be injected in the same appointment, though these are typically injected in different areas than BOTOX®.
Immediately following the BOTOX® treatment, Dr. Trussler emphasizes the use of ice packs every 4 to 6 hours for the first day. This will help limit any potential bruising at the injection sites. If bruising does occur, it is common in the lower eyelid and crow’s feet area. This is temporary and can be covered with light makeup. Swelling after BOTOX® is limited usually to just the volume of injections and may be present at the time of check-out from the procedure. Ice can help with this. Normal activity including physical activity is permitted the day of the procedure.
You will see the BOTOX® take effect in approximately 48 hours, with continued improvement over the next 5 days. The effects of BOTOX® Cosmetic typically last up to three months. After several BOTOX® treatments, the results may be prolonged.
Are BOTOX® injections painful?
Dr. Trussler injects Botox with a very tiny needle, and it is not injected into great depth. Most patients equate the feeling of these injections to that of a pinprick. Because of that most patients do not feel the need to use topical numbing prior to their Botox session.
Are there any complications or risks with BOTOX®?
Botox® has been injected millions of times around the globe and has proven to be a safe and effective aesthetic treatment. Before it received its myriad FDA approvals, Botox® was thoroughly tested and researched.
After these injections, you may have some minor redness and slight swelling at your injection sites. Some patients can develop a slight headache. These issues resolve usually within a day.
The real potential complication with Botox® is that it is injected into an incorrect muscle. This can lead to problems such as a drooping eyelid. That’s why you should never have Botox® injected at a nail salon or other business where aesthetics are just a sideline. Dr. Trussler handles all of the Botox injections at his practice. This ensures his board-certified skills, training, and experience will deliver the results you seek.
One thing that is important is to not rub your Botox® injection sites for 24 hours after your session with Dr. Trussler. This can cause the Botox® to migrate to an unintended muscle.
How does BOTOX® compare to other neuromodulators?
Dr. Trussler offers three neuromodulators for his Austin patients: Botox®, Xeomin®, and Dysport®. All three are made primarily from the botulinum toxin type A. All three have the same mechanism of erasing wrinkles by relaxing the muscles they are injected into. There are subtle differences between the three.
Botox® is the most popular and has been used aesthetically since 2002. It consists of the botulinum toxin and some additional proteins.
Dysport® was first approved in 2009. Made from the botulinum toxin and some additional proteins, it is a little thinner than Botox, so it can spread out a bit under the skin. This makes Dysport possibly better for treating larger areas. But it also makes it less effective for treating smaller areas.
Xeomin® was approved in 2010. It is sometimes called “the naked injectable” because it consists of only the botulinum toxin and nothing else. If a patient has had reactions to the proteins in Botox® and Dysport®, Xeomin® can be a good alternative.
How are neuromodulators different from dermal fillers?
As mentioned above, neuromodulators only work on dynamic wrinkles that are the result of muscle contractions under the skin. The neuromodulator (Botox®, Dysport®, or Xeomin®) is injected into the muscle forming the wrinkle and the botulinum toxin relaxes the muscle for about four months. This erases the wrinkle.
Dermal fillers only work on static wrinkles that form due to skin damage and declining collagen production. When injected beneath a crease or line, a dermal filler simply fills in space and pushes the skin back up. This erases the wrinkle or crease. Some dermal fillers can also be used to return the volume to larger areas such as the cheeks and the backs of the hands.