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.
Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery
Philadelphia's Botox® Specialists
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.
Please note - the estimates above may vary by patient.
Calculator is based on $15/unit of Botox. Enjoy a 20% discount if booked on Botox day.
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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.
Price List
| price / syringe | lasts (months) | # treatments | |
|---|---|---|---|
| Botox | $15 / unit | 4-6 | 1 |
| Botox Special | $12 / unit | 4-6 | 1 |
Purchase of a full syringe is required. When only a partial syringe is needed, the remainder can be injected to another area.
All Botox injections are performed by our dermatologists.
We do not employ injectors!
Haverford – Mainline Office
Franziska Ringpfeil, MD.
Board Certified Dermatologist
Dr. Ringpfeil: "Botox is so much more than a wrinkle chaser. It allows me to enhance the attractive features of a face and restore youthfulness."
Philadelphia Office
Jayne E. Bird MD.
Board Certified Dermatologist
Dr. Bird: "Looking carefully at the facial features, I mix art, knowledge, and experience to magically erase these lines and facial depressions that hide your younger look."
Next Botox Appointment: Wed, Mar 20 8:30AM
Botox vs Fillers
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.
BeforeAfter
BeforeAfter
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.
Areas
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.
Other Brands - Botox vs. Dysport and Xeomin
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.
Risks and Safety
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.
Do you do botox injections for hyperhidrosis, specifically for excessive sweating in the underarms and if so, approximately how much does that cost and how long do the results last? We have already researched Miradry and do not want to do that procedure because of concerns with possible lasting side effects and we do not want to do any type of drug therapy either. Thank you for your help.
Our office offers Botox treatments for excessive in the armpits and on palms. The effects set in after 3-4 days and last for about 3-4 months. Cost depends on the dose that is needed to achieve results which depends on the degree of hyperhidrosis, and the hair bearing area in the armpit. It can vary between $800 to $1450 for the armpits and between $900 and $1550 for the palms. Most people with excessive sweating in armpits fall at the lower range. Several insurance plans accept Botox treatment for excessive sweating and cover some or most of its cost after pre-certification. Please set up a medical consultation with one of our dermatologists.
Do you offer botox for the scalp to reduce sweating on the head/hairlines?
If so, what is the cost of that treatment?
We treat sweating of the scalp and frontal hairline. Cost is about $1150 if you need 100 units. This treatment is off-label and therefore cannot be submitted to insurance.
I have suffered with Raynauds in my fingers and toes for 30 years also crest syndrome.
I am interested in receiving digital Botox injects. Does anyone at this practice this procedure?
This treatment is one of the emerging uses of botulinum toxin. Botulinum toxin/Botox appears to work for many spastic and inflammatory conditions. The estimated amount for the fingers is between 50 to 100 units every 3-4 months. It is not yet FDA approved and can therefore not be submitted to insurance. If you are interested, you may schedule an appointment with me. Please mention this blog communication when you are scheduling your visit.
Do you inject botox in the masseter muscle for bruxism at your office?
Yes, we do. Pending the strength of your muscles, between 10 and 60 units of botulinum toxin every 3-4 months might be needed for results.
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Hello,
I was wondering if you provide intradermal Botox injections as a service (for refining pores and reducing oil production)?
Thanks.
We do not currently provide this service because results are not always reproducible.
Is there an additional consultation fee on top of the per unit charge for a first timer?
We waive a consultation fee, if you are interested in Botox and have your treatment at the time of initial consultation. If during this visit you wish to discuss other matters, either medical or cosmetic, and if time allows to address these, additional charges are due. We usually schedule full cosmetic consultations differently than first time Botox consultations, so please be sure to tell our schedulers what you would like to achieve during the visit.
I am a 41 year old white female, fair skin. I am getting married June 2017. I have a semi-deep wrinkle that goes across my forehead. Would you typically recommend botox or something else? I have blue cross insurance, I have a good job. Do I need a referral or can I just book a consultation to get a plan and go from there? Thank you
Static lines take some time to unwrinkle, especially if we have formed them over decades. In a young person who just notices static lines, they will disappear after the first Botox injection. Lines that have been present for many years may be invisible after the third round of Botox injections. The effects of Botox on the forehead are overcome by about 3-4 months at which time it can be injected again. It sounds as if Botox might be the right solution for you. You may book a proper cosmetic consultation with me in Haverford or Dr Bird in Center City and we will guide you through your options. Insurance does not currently cover cosmetic consultation. The fee for this cosmetic consultation is $115.
Dear Dr. Ringpfeil,
I have facial asymmetry resulted from my habit of chewing on one side(I had a tooth problem several year ago and I have dominantly used my left side to chew). Now I found that maybe my masseter muscle on the right side is much stronger than the left side, resulting my right face looks bigger. I am wondering whether botox injection can solve this issue. Thank you!
Botulinum toxin (Botox) treatments can certainly help. It might even be possible that a single treatment will do the job if you know chew evenly. It is also important that we look at photographs of your face prior to the tooth problem so that we can see if any preexisting symmetry was present that might not resolve.
I am interested in having the hollows at my temples filled in. I have had this done in the past with Radiesse filler. Is this something you do on a regular basis and do you feel comfortable doing this procedure? I would like to schedule an apt if you feel you can achieve a good result.
thank you.
Filler injection to the temples are frequently performed in our office since this technique became accepted standard for facial rejuventaion/reflation about 5-6 years ago. I normally use Radiesse for this procedure unless someone has had radiation treatment to the face or has reservations about Radiesse.