Today I thought we'd talk a little bit about Botox
It's a very popular treatment and commonly requested. We get a lot of questions about
these so I thought that we would just make this video to answer a couple of those
questions and educate people
so I'd say that in my practice typically people come to me asking for Botox for a
couple different reasons
Generallly it's for signs of facial aging
I mean there's really a variety of different things that Botox can treat
but really most people are using it for facial aging
I'd say specifically the most common indications or reasons for it are
people who want
improvements in the upper third of the face. This is classically
where Botox is typically used as opposed to fillers which are
classically used on the lower two thirds of the face. Now these are all tools really and
plastic surgeons can essentially tailor these tools for every individual face
but in general that's sort of a framework at least when I think about approaching
patients how I decide which agent is best
So what Botox is
overall is a neuromuscular agent
It's a very weakened form of Botulinum toxin
and what it does, it vary selectively weakens
specific muscles, and so in fact a number of years ago when Botox was first used
I think it was first used for ophthalmologic purposes really for people who had
one muscle that was deviating the eye in a direction that was a little bit asymmetric
than the others
so opthamlmologists would use that to first make the eyse look a bit more symmetric
and it worked very well
but a number of years ago a very smart doctor decided that
if you look at the way that skin wrinkles, typically a lot of times we see
wrinkling when people are are in motion. For example when you
raise the forehead or the brow and you have these furrows, or
when you frown and you have these vertical lines here
or when people smile and laugh they have they have some crow's feet lines
on the side. So he thought well maybe what we can do is we can use Botox to
selectively weaken those muscles
so that when people are having their normal facial motions, the overlying skin won't
really move as much and won't wrinkle. And, they tried it,
it was actually successful and a pretty incredible
cosmetic treatments was born. So i'd say nowadays in my practice
people typically come for Botox for anyone one of three specific areas
The number one most popular are that I see treated it really is these vertical lines
Some people call them the 11's they're really kinda when
furrow your brow and get these outlines in the middle here
and that's probably by far the number one most common area for treatment
The second area for treatment I see is for the crow's feet
These are the laugh lines that you see emanating from the side of the eye
When people laugh or smile you'll see some of these lines on the
sides there. And the number three area is really the forehead
which is where you have the horizontal lines that come across when people
raise their eyebrow
Sort of when you do things like this. Every face is different,
if you watch any of my videos you know that typically I emphasize that people
really need to have all their treatments individualized. Even something as simple
as Botox. I'll see patients for example where
one day they'll have very severe lines here but
nothing on the forehead,
another patient that really has crow's feet and forehead but nothing here
It really is very individualized so that assessment is really
part of the treatment. Botox shouldn't be thought as something that you just
kind of squirt in and it works. It's really not like that it's
actually a very specific
procedure and treatment that can be tailored specifically for the patient.
I think any one of these three areas works very well. Good candidates for the procedure
are patients who have taken a look and have specific areas just like we mentioned, any
one of those three areas
there are other uses for Botox actually too. Other good candidates for the procedure,
one that's less known and is actually more known with
the Asian patient population but not as much known in the
non-Asian population is using Botox
or neuromuscular agents to slim the jaw a little bit
If you feel down heere you'll notice there's actually a muscle here called a masseter muscle
It's the muscle that gives us the ability to chew,
but in some patients that muscle can actually be a little bit thick, or a
little bit large
and it kind of gives a large appearance to the jaw.
In Asian countries there is a very high premium
placed on facial aesthetics. People really care about the facial aesthetics to
a very high degree, and so a lot of these facial procedures are really pioneered in Asia
What they started doing a number of years ago and very successfully
is actually use a small degree of Botox here in these areas
to not specifically weaken the muscle because it wrinkles but really
to actually use enough to help this muscle
come down a little bit in size. Incredibly, it works very well
and can help some people for their jaw appeareance to really come down
in size a little bit.
I see this mostly among asian patients, actually
quite a few asian patients come to see me for that. We do the treatment, and it works very well.
I don't see as much among non-asian patients but my prediction is that
eventually as the procedure becomes more well-known,
you'll see more non-asian patients doing that as well. Things for patients to know,
about Botox. The effect is not immediate. It usually takes about two to four days
to see some effect and seven days to see full effect. That's what I usually tell my pateints
Side effects are very minimal. You can have a some
temporary swelling and bruising, occasionally
In my patients I would say honestly that it's pretty rare. Botox is very well tolerated
I'm pretty careful with injections too, so
bruising is very rare, but it can happen because you're doing a little
injection
just like when you get a vaccination there's always a small chance you can get a bruise.
But overall, it's really a very well tolerated treatment
and it works very well. It's super popular, it usually lasts about three to four months,
and that's about it.