Botox is a new concept in treating facial wrinkles in the forehead, between the eyes, and in the "crows feet" areas (upper third of the face). Botulinum toxin, or Botox, works by weakening the muscles of facial expressions. Once the resting tone of the treated muscles are weakened, the pull of the muscles relaxes and the overlying skin flattens. This approach is different from the other local treatments for the aging face. Silicone, Collagen, Autologous Fat Transfer, Alloderm, Softform all work by filling in wrinkles or depressions. These fillers are frequently not as effective as Botox in treating wrinkles in the upper third of the face. By physiologically weakening the muscles, wrinkles are lessened naturally.
HOW LONG DOES IT LAST?
Injection of this material into the small muscles between the brows, in the forehead, and at the corners of the eyes causes those specific muscles to halt their function (be paralyzed), thereby improving the appearance of the wrinkles. This paralysis is temporary, and re-injection is necessary within three to ten months. Options for alternative treatments include injection of either Collagen or free fat, or the surgical excision of the muscles, usually through a brow lift.
HOW IS IT USED?
Botox is freshly prepared on the day of injection. Once prepared, the medication needs to be used within 12 hours, as the potency diminishes with time. Because of the short shelf life and the cost, Botox is not available every day in our office. In order for the treatment to be cost effective, more than one patient must be treated on the same day. Using a very tiny needle, small amounts of Botox are injected into the muscles to be paralyzed. Depending on the areas being treated, 5 to 15 needle pricks (or more) may be required. Discomfort is minimal and lasts only a few seconds.
SIDE EFFECTS
Occasionally, the needle may puncture a small blood vessel during the injection, and a black-and-blue area may develop. Such an area can last 5 to 10 days and may require make-up to cover.
If any of the Botulinum toxin reaches a facial muscle not being treated, partial weakness of that muscle may last for several months. (For this reason, you are requested not to massage the injected areas for 12 hours following the injection.) If an untreated area experiences muscle weakness, the only "treatment" is to wait for the effect of the toxin to wear off in several months.
There are no recognized permanent side effects of Botox. Complications are rare but may include paralysis of a nearby muscle, resulting in its temporary loss of function (for example, a drooping eyelid). Botox has been used safely in the treatment of muscular facial spasms for approximately 15 years.
BOTOX IN COMBINATION WITH FACIAL SURGERY
Botox injected in conjunction with nearby facial surgery has caused unwanted facial weakness in at least one patient. For this reason, we will inject Botox only as an isolated facial procedure or treatment.
NOTES
The specific risks and the suitability of this procedure for a given individual
can be determined only at the time of consultation. All procedures have some
degree of risk. Minor complications that do not affect the outcome, occur
occasionally. Major complications are rare.
If you have wrinkles on your face or around your lips that you wish to diminish.
If you desire to have fuller or more defined lips.
If you have deep nasolabial folds (the line between the nose and the corner of your mouth).
If you have scars on your face that you wish to improve.
INTENDED RESULT
Collagen can smooth out, fill in and decrease wrinkles.
Collagen will plump lips and define the edges of the lips.
Collagen can fill in and reduce the depth of the nasolabial fold.
Collagen will fill depressed acne scars.
PROCEDURE DESCRIPTION
You should apply numbing cream for about 60 minutes prior to arriving at the office, unless otherwise instructed.
An injection of numbing medicine (Lidocaine) may be used, if desired.
Collagen is injected into the desired area.
RECUPERATION AND HEALING
There may be some mild swelling after the procedure. Using ice will help to decrease this. Most patients look normal with make-up within one hour.
Occasionally, mild bruising may be seen or small dots may appear at the locations where the needles were inserted.
OTHER OPTIONS
Lips can be enhanced with implants such as Softform or Alloderm. Wrinkles
can be treated with laser resurfacing or Botox. Another type of filling material
can be used, such as fat.
GLYCOLC
ACID PEEL
WHO IS A CANDIDATE?
If you have superficial wrinkles of the face, neck, upper chest, arms, etc.
Uneven pigmentation problems.
Enlarged facial pores.
Superficial acne scars of the face.
"Age spots."
INTENDED RESULT
Smoother, youthful appearing skin of more uniform color.
PROCEDURE DESCRIPTION
These procedures are done on an outpatient basis. Light peels do not require any anesthesia.
After preparing the skin, a glycolic acid concentration from 20% to 70% will be applied.
Weekly facial peels for a period of about 6 weeks are typical for most patients.
RECUPERATION AND HEALING
You will be sent home with specific instructions.
After light peels, the treated skin turns red or pink and heals without crusting.
INSURANCE GUIDELINES
This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.
NOTE
The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All procedures have some degree of risk. Minor complications that do not affect the outcome, occur occasionally. Major complications are rare.
If you have superficial wrinkles of the face, neck, upper chest, arms, etc.
Deep facial wrinkling.
Uneven pigmentation problems caused by sun exposure, prescription drugs or disease.
Enlarged facial pores.
Superficial acne scars of the face.
"Age spots."
INTENDED RESULT
Smoother, youthful appearing skin of more uniform color.
PROCEDURE DESCRIPTION
These procedures are done on an outpatient basis under sedation and local or general anesthesia. Light peels may be done without any anesthesia. Light and medium depth peels do not require any anesthesia.
After preparing the skin, a series of solutions may be applied.
Light, moderate or deep peels are available. A consultation is required to determine which type of peel (if any) will be most suitable for you.
RECUPERATION AND HEALING
You will be sent home with specific written instructions. The treated areas are washed, and medicated lotions are usually applied several times daily.
After light peels, the treated skin turns red or pink and heals without crusting.
After medium or deep peels, a superficial crust or membrane usually forms and peels off 3 to 7 days later like a sunburn blister -- revealing a new skin surface that is smoother.
The skin redness after deeper peels fades in a month or two.
INSURANCE GUIDELINES
This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.
NOTE
The specific risks and the suitability of this procedure for a given individual
can be determined only at the time of consultation. All procedures have some
degree of risk. Minor complications that do not affect the outcome, occur
occasionally. Major complications are rare.
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