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BOTOX® in NYC with Dr. Nina Naidu

BOTOX® Introduction

Botulinum toxin an injectable treatment which is used to temporarily reduce facial fine facial lines and wrinkles.

What is BOTOX®?

Botox® is the brand name of botulinum toxin marked by Allergan. This was the first brand of cosmetic toxin on the market, which is why it is often used to describe all other brands as well.

How Do BOTOX® and Facial Fillers Differ?

Botulinum toxin is used to relax fine lines and wrinkles, while facial filler is used to add volume to deeper folds.

How Does BOTOX® Work?

Injections of botulinum toxin block the nerve signals to the muscle in which it was injected. Without a signal, the muscle is not able to contract, which decreases the appearance of fine facial wrinkles.

Is BOTOX® the Only Type of Botulinum Toxin Available for Cosmetic and Medical Use?

The main forms of cosmetic botulinum toxin in the USA at present include Botox®, Dysport®, Jeuveau®, and Xeomin®. Myobloc is intended for medical use, as in treating spasticity.

What Cosmetic Issues Can BOTOX® be Used to Address?

Botulinum toxin can be used to treat glabellar lines, crows’ feet, fine lines around the lips, chin dimpling, hypertrophic jaw muscles, gummy smile, vertical banding on the neck, and transverse lines across the forehead.

Who is a Good Candidate for BOTOX® Injections?

Good candidates for botulinum toxin include patients who wish to diminish the appearance of fine lines and wrinkles, and who have realistic expectations.

Is There Anyone Who Should Avoid Getting BOTOX® Injections?

Patients who have a known allergy to botulinum toxin and those who have unrealistic expectations should not undergo botulinum toxin injections.

What to Expect During a Treatment with BOTOX®?

You will have a consultation at which time your goals and anatomy will be reviewed. The areas of injection are usually marked and the injections are performed. This takes 10-15 minutes in most cases. Anesthesia is not required for most patients, but topical anesthetic or ice can be provided if desired.

How Long Will It Take for Me to See Results?

In most cases, it takes 3-7 days for full effect to be seen following injection, but some brands note faster onset of action than others.

How Long Will the Results Last?

Results should last 3-4 months.

Can I Have More Than One Treatment with BOTOX®?

Patients can have multiple treatments but should not receive the equivalent of more than 100 units per treatment session to avoid toxicity.

How Often Can I Have BOTOX® Injections?

Injections are generally spaced at least 3-4 months apart.

Are There Any Side Effects Associated with BOTOX® Injections?

Potential side effects following Botox® injection include bruising at the site of injection, mild pain and swelling at the injection sites, transient headaches, and temporary eyelid droop if the medication has traveled into the upper eyelid muscles.

What Are the Risks and Complications Associated with BOTOX Injections?

Potential risks of botulinum toxin include allergic reactions, migration of product to other parts of the face, limited response, or antibody formation, which would lead to future ineffective responses.

About BOTOX®

Over time wrinkles, lines and furrows in the skin are created by the action of the facial muscles. Weakening the contraction of these muscles can reduce or eliminate the lines and wrinkles in the overlying skin. Botox® is a purified form of botulinum toxin that temporarily blocks nerve impulses to muscles. Some studies have also suggested that Botox® can relieve migraine headaches and excessive sweating under the arms. The goal is not to create a frozen face, but rather one that appears smoother and more refreshed.

Botox® is injected into the muscles of the face using small needles. The most commonly treated areas of the face are the transverse wrinkles of the forehead, the vertical furrows between the eyebrows, and the crows’ feet around the eyes. The procedure takes 10-20 minutes to perform in the office, and patients can return to normal activity immediately.For patients who are concerned about discomfort associated with the injections, a small amount of topical anesthetic can be applied prior to the procedure. Results are apparent within 3-7 days. Botox® treatments last approximately three to four months, although some patients note longer durations of action with repeated treatments.

Botox® is frequently performed in conjunction with fillers for non-surgical rejuvenation of the face. Filler is generally used for deeper folds, such as those found between the nose and the lips, and from the lips to the chin. It can also be added to the cheekbones for subtle volume restoration of the mid-face, and into the lips to restore youthful fullness naturally.

Dr. Naidu recommends that patients avoid exercise, eyebrow waxing, threading, and facial massage the day of treatment in order to prevent unwanted diffusion of the toxin which can lead to heaviness of the upper eyelids.  Dr. Naidu performs all injections herself; treatment is not delegated to an assistant.



What is the Difference Between Botox and Fillers?

Botox is a medication that blocks the release of acetylcholine, preventing the muscle from contracting. It is best used for fine lines. Fillers are made of a substance that literally “fills” an area of the face, so it is ideal when used for deeper folds or providing volume.

How Long Does Botox Take to Work?

The onset of action varies slightly from one brand to the next, but in general expect to wait 3-7 days to see the full effects of Botox injections.

How Long Does Botox Last?

Botox generally last for 3-4 months, which is the period of time it takes for the effect of the medication on muscle contraction to wear off.

Alternatives to Botox for the "11" wrinkles between eyebrows?

If your wrinkles are very deep, you may be a candidate for filler to this region. This injection is potentially dangerous and should only be performed by an experienced injector.

Can Botox Create a Thinner-looking Face?

Botox injections to the masseter muscle, which runs to the jawline, can narrow the jaw when viewed from the front, and thereby make the face appear thinner.

Do Botox Injections Work on the Neck Bands?

Yes, Botox can be injected into the platysma muscle bands in the neck, decreasing their appearance. However, this does not raise a heavy neck, and can cause some difficulty with swallowing in certain patients.

Can Botox Be Injected Under the Eye?

In very select cases, Botox can be injected under the eye to reduce the lower eyelid “roll”, which is seen when smiling. It will not reduce bags under the eyes.

Can Botox Injections Be Reversed?

No, Botox injections cannot be reversed, but the effects of the medication will wear off naturally in 3-4 months.

Eyelid Drooping, Ptosis from Botox. What Can I Do to Fix the Problem?

Eyelid droop after Botox can result from the medication diffusing into the levator palpebrae superioris muscle. This is self-limited and will resolve in 2-3 weeks. Alpha-adrenergic agonist eyedrops can be used 2-3 daily to help counteract the symptoms during this period.

How can I avoid Botox side effects?

To avoid side effects from Botox, follow your injector’s instructions. Keep your head elevated for several hours after the injection, do not massage the site injected, and avoid exercise, aspiring/ibuprofen, and alcohol for 24 hours.