Dr. Hootan Daneshmand
Orange County Botox®
How does Botox® Cosmetic work?
Botox® Cosmetic is injected into a muscle to produce its effect, but it doesn’t actually do anything directly to the muscle itself. Unlike Orange County dermal fillers, it affects the nerves. For a muscle to work it needs a signal. That signal starts in the brain, goes down the spinal cord and out through the nerves. At the end of the nerve, there is a connection to the muscle across a small gap. For the nerve to tell the muscle to work, a small amount of a chemical is released from the end of the nerve. That chemical crosses the gap and causes the muscle to move. Orange County Botox® Cosmetic prevents the release of this chemical, so nothing is released to cross the gap to tell the muscle to move. Without the nerve to tell the muscle to move, that small part of the muscle is paralyzed. Most muscles have many thousands of nerve endings that tell them to move. Each nerve ending controls only a small amount of the muscle. Since certain wrinkles on the face are caused primarily by the muscles underneath them, these wrinkles can be greatly improved.
What is Botox® Cosmetic?
An alternative to procedures like collagen injections, and a surgical facelift, Botox® Cosmetic is a highly purified protein that is derived from the bacteria that causes botulism. But, Botox® Cosmetic is not botulism! Here is the key part: what is in a Botox® Cosmetic injection is a minuscule amount of the chemical secreted by the botulism bacteria. There is absolutely no bacteria – nothing alive – in the Botox® Cosmetic injection. A Botox® Cosmetic injection does not give you an infection. Botox® Cosmetic injections are sometimes used in conjunction with other treatments, such as Restylane.
Does Botox® Cosmetic work for migraines?
We do not specifically treat migraine headaches. However, over the past several years we have injected (for cosmetic reasons) Botox® Cosmetic in migraine sufferers. They routinely tell me that their migraines occur less frequently and when they do happen, are less severe.
What is Dysport?
Dysport is a type of botulinum toxin type A, presently used in Europe. It is similar to Botox® Cosmetic, however, it is not quite as potent and it may not last as long. It may be available in the U.S. in the next 12-18 months.
What would you consider to be the biggest risks for Botox® Cosmetic injections?
The most common side effect after a Botox® Cosmetic injection is a mild amount of droopiness in an eyelid (it looks like a “sleepy” eye). This is a rare occurrence. In some studies, it occurs in as many as 5% of patients. The average time for the droopiness to go away without any treatment is 10 days. As with any time you get an injection anywhere in your body, a small bruise is possible. Avoiding aspirin, Motrin, Advil, etc. for ten days prior to your injection, you can minimize your risk of bruising.
Do you have patients who become “immune” to Botox® Cosmetic?
Theoretically, one can experience tachyphylaxis to Botox® Cosmetic, but we have not seen it. Patients who receive Botox® Cosmetic frequently for one or two years, require less Botox® Cosmetic, much like when you don’t exercise, your muscles atrophy.
What if someone has had Botox® Cosmetic and does not like the results?
In general, if you wait a few months, the results will return to the pre-injection state. In the brow, it will last the longest and in the lips and eyes for a shorter time period. It is dose-dependent.
How frequently can Botox® Cosmetic be used?
Botox® Cosmetic can be used every 3-4 months and it depends partly on how the muscles respond.
What should someone look for in choosing a doctor for Botox® Cosmetic?
In choosing a doctor, one should look for a board-certified plastic surgeon. Training in Botox® Cosmetic should include theoretical and practical instruction with hands-on patient experience with someone who has expertise in this area.
Can the use of Botox® Cosmetic prevent wrinkles from getting worse? If so, how often would this be required?
Definitely! Botox® Cosmetic is truly prophylactic when it comes to the prevention of wrinkles. In patients that have their foreheads injected regularly, their foreheads often appear younger now as opposed to ten years ago.
What are the long-term effects of Botox® Cosmetic?
Most people tend to have longer-lasting results after regular Botox® Cosmetic injections over several years. However, this does not happen in all patients.
Who should not have Botox® Cosmetic?
Those who should not have Botox® Cosmetic include those who are pregnant, are taking aminoglycoside antibiotics, have neuromuscular disorders, or a history of sensitivity to Botox® Cosmetic. women trying to become pregnant, or women who are breast-feeding.
What problems will Botox® Cosmetic treat?
At last count, there were over 180 medical, non-cosmetic uses for Botox® Cosmetic described in the medical literature. Cosmetically, Botox® Cosmetic can treat frown lines, worry lines across the forehead, crow’s feet lines, smile lines, lines around the mouth, downturned corners of the mouth, chin wrinkles, necklines, “marionette’s” lines running down from the corners of the mouth, as well as excessively sweaty armpits, palms, and feet.
Can you use Botox® Cosmetic and Restylane together?
Combining Botox® Cosmetic with Restylane is a new and hot topic. It is an ideal combination because Botox® Cosmetic smoothes and Restylane fills. The depressor anguli oris is softened by Botox® Cosmetic and the vertical lines can be filled with Restylane to rejuvenate the face. The key to Restylane is to not overcorrect.
Are there any after-effects to an injection?
There are few after-effects to injections. In fact, the small (30 gauge) needles don’t hurt much at all. A commonplace for bruising is at the outer edge of the eyes, but this is easily treated with some pressure and ice to minimize it. These needles for Botox® Cosmetic are much smaller than those used for collagen and Restylane and patients are often surprised at how little it does hurt with Botox® Cosmetic.
What precautions should one take after an injection?
There should be no strenuous activity for 90 minutes after the injection. No going to the gym. After that, it’s pretty much ad-lib.