Botox - Patients ask Dr. Ringpfeil answers
Please feel free to use the blog below to share information about Botox or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Botox became a common household term in recent years and is one of the most popular cosmetic services. It works. It is safe. It is predictable and provides noticeable results with virtually no downtime.
Basic Botox treatment hides facial wrinkles created by repeated movement. Advanced use of Botox affords shaping of facial features. If performed conservatively, your family and friends will appreciate that you look more relaxed and younger but they will not be able to figure out how you did it.
|Forehead||8-12 units||10-18 units|
|Glabella||15-25 units||20-35 units|
|Crows Feet||10-20 units||12-20 units|
|Brow Lift/Upper Lids||10-20 units||10-20 units|
|Lower Lid Lines||2-4 units||2-4 units|
|Vertical Upper Lip Lines||4-8 units||4-8 units|
|Vertical Lower Lip Lines||4-8 units||4-8 units|
|Pebby Chin||4-6 units||3-6 units|
|Vertical Neck Bands||10-40 units||10-40 units|
(*)90% of people will fall within this range
|price / syringe||lasts (months)||# treatments|
|Botox||$15 / unit||4-6||1|
|Botox Special||$12 / unit||4-6||1|
Dynamic Lines - Lines visible with forceful movement of muscles. (Usually treated with Botox)
Static Lines - Lines/wrinkles visible at rest. (Usually treated with dermal fillers)
Note: Sculptra and Artefill can be used in place of Radiesse. Usually, several treatments are necessary to achieve desired volume correction. Their upfront cost is substantially higher, yet, fewer treatments are needed in the long run.
To address volume and wrinkles in areas indicated by 7,8,9,10, and 11 see similar illustration on the Dermal Filler Page.
Unlike filler placement to areas of the face where aging causes loss of volume of the skin, the underlying fat and bony structures, Botox targets facial wrinkles that are created by dynamic movement. As we age, loss of skin elasticity allows repetitive muscle movement to create a visible crease in the skin. Botox weakens this muscle movement and prevents the line from forming. Many times, it even reverses wrinkles that have already settled.
Let’s take the eyes, for example. With every smile, our body releases endorphins which keep us happy. It would be unhealthy not to smile anymore, But with the help of Botox we can now have a guilt-free smile without fearing that we deepen the dreaded crows feet. On the other hand, we can untrain the forehead muscle and those between the brows to no longer look constantly strained or angry.
Botox works best to prevent wrinkles. Once wrinkles are visible at rest it will take some time until the skin returns to its original shape. Deep static lines may need help from a filler if they have not resolved after 3 Botox injections 4-6 months apart.
The most common areas for wrinkle relaxation are the frown lines between the brows, crow's feet on the outside of the eyes, forehead lines and vertical lines above and below the lips where lip stick may bleed.
In addition to wrinkle relaxation, advanced use of Botox allows shaping of brows and lifting of brows and eyelids. We can up-turn corners of the mouth and soften a puckered chin. We can also reduce prominent vertical bands in the upper neck, minimize a gummy smile and turn a square face into a more triangular one.
Botox is currently FDA approved for cosmetic use for frown lines between the brows and for the treatment of lines on the outside of our eyes that occur with smiling and squinting. The use in all other areas is off label, just like the use of aspirin is for prevention of heart attack or stroke.
Botox brand was the first neuromodulator approved for cosmetic use in the United States and it is the only one currently approved for medical diagnoses in this country. Dysport and Xeomin are equivalent neuromodulators that have since been approved by the FDA for wrinkle reduction on the upper face.
Dysport differs from Botox brand by a slightly smaller molecule size and therefore slightly wider spread. Xeomin is almost identical to Botox brand but it is bit more pure which reduces the risk of tolerance formation.
Cosmetic Botox has an excellent safety profile. You should not receive Botox during pregnancy or while nursing a baby. It is contraindicated in anyone with a neuromuscular disorders or a first degree relative with neuromuscular disorder. You should not receive Botox when you are sick. In addition to this, Dysport should be avoided with a cow milk allergy.