BOTOX® Cosmetic

While wrinkles are a natural byproduct of aging that is to be expected at some point, the formation of creases and finer lines around the forehead and eyes often occurs before people are ready to see them. In addition, these wrinkles can give you a tired or worried appearance even when you don’t feel that way. Fortunately, there are nonsurgical options to reduce these wrinkles as early as they begin to form. Dr. Barrett offers Botox injections to patients that want to shave off a few years without incisions or downtime.

What is Botox?

Botulinum toxin type A is a natural protein produced by the bacteria that cause food poisoning. Botox – the medicinal brand name for botulinum toxin type A – is a purified low-concentration form of the bacterial toxin. When injected in small doses, Botox can safely and temporarily relax muscles by blocking the chemical signals that cause them to contract. By preventing these muscles from contracting and tightening, the skin will appear flatter, smoother and less wrinkled overall.

Botox has a long safety record, since it has been used for decades first as a medical product and more recently as a cosmetic treatment. The medication was first used to treat challenging medical conditions like cervical dystonia (a painful neck disorder) and blepharospasm (uncontrollable eye twitching). More recently, Botox continues to be used for these concerns, as well as chronic migraines, hyperhidrosis (excessive sweating) and urinary incontinence in some patients. Botox used to address signs of aging is explicitly known as Botox Cosmetic, to distinguish from its medical uses.

What are Dynamic Wrinkles?

Botox addresses a specific type of facial crease, known as dynamic wrinkles. These lines form from repeatedly making facial expressions, such as smiling, squinting or laughing. While the lines may be an indication of a life lived to the fullest, most people that begin to notice the aging signs in the mirror see them that way. At first, you may only notice the line when you make those faces. However, over time the lines can become permanently etched on the face, giving you a persistently tired or angry look.

Dynamic wrinkles usually form on the upper portion of the face, such as:

  • Horizontal creases across the forehead
  • Vertical indentions between the eyebrows (frown lines)
  • Subtle wrinkles fanning out from the outer corners of the eyes (crow’s feet)

There is another type of wrinkle that might cause you some concern as well. Static lines typically form due to collagen depletion in the underlying skin structure. As you age, collagen levels decrease in the dermal layers, leaving skin loose and sagging. Wrinkles can also be a symptom of this process. These lines are usually found around the nose, mouth and chin. While Botox doesn’t work on these creases, Dr. Barrett also offers a full line of dermal fillers to treat static wrinkles. You can opt to have both types of injections in the same appointment if you choose, giving you a dramatic refreshment in just one treatment session.

Is Botox Right for You?

The Food and Drug Administration (FDA) has approved the use of Botox for adults between the ages of 18 and 65. It is considered a safe treatment option for both medical and cosmetic purposes. It is equally effective on men and women and works with any skin type and tone. While this formula is specifically approved to temporarily correct moderate to severe frown lines, forehead creases and crow’s feet, Dr. Barrett also performs treatments to address the following conditions:

  • Headaches
  • Backaches
  • Dimpled chins
  • Skin bands around the neck
  • Bunny lines (horizontal wrinkles at the top of the nose)
  • Areas prone to muscle spasms
  • Hyperhidrosis (excessive sweating)

Even though Botox is a safe and frequently-performed procedure, some patients should not undergo Botox injections. Contraindications include individuals with any of the following:

  • An allergy to any of the ingredients in Botox
  • A diagnosed nerve or muscle disorder
  • Currently pregnant or breastfeeding
  • Active infection at any of the injection sites
  • History of problems with bleeding, swallowing or breathing
  • Recent surgery or surgery scheduled soon

Rest assured that when you come to Barrett Plastic Surgery with cosmetic goals or issues with any of the conditions listed here, Dr. Barrett will take the time to listen to your concerns and help you determine whether Botox is the best treatment choice for you. As a plastic surgeon that prides himself on giving every patient ample attention, you will never feel like just a number at Barrett Plastic Surgery. Our team strives to make all patients feel comfortable and well cared for with every visit.

Who Should Administer Your Botox Injections?

Botox is a common cosmetic treatment that is offered by plastic surgeons, dermatologists – even dentists. However, the prevalence of the procedure should not give you the idea that anyone should administer Botox injections or that you will receive the same level of care and consistency no matter where you go. An experienced plastic surgeon like Dr. Barrett has the extensive knowledge of facial anatomy and an artistic eye to produce the safest and most successful result for you. By choosing your surgeon carefully, you are most likely to enjoy an optimal outcome that refreshes your appearance without making you look like you just had a cosmetic treatment.

Benefits of Botox

For the right patient, Botox offers a host of potential benefits:

  • Quick treatment, no prep before and no downtime afterward
  • Have procedure over lunch, head back to work with no visible signs
  • Injections are relatively comfortable
  • Preliminary improvement immediately after your procedure
  • Full results become evident in about two weeks
  • Enhancements last a few months before a touch-up is needed

Although Botox is a fast, convenient procedure that produces excellent results for many patients, it isn’t the right choice for everyone. Dr. Barrett will discuss your concerns and aesthetic goals in detail to determine whether Botox will meet your needs best.

Combining Botox with Other Treatments

Dr. Barrett frequently has patients ask if Botox can be combined with other nonsurgical treatments to enhance their results further. In some cases, the answer is yes. However, the ability to do so will depend on the different procedures you are interested in as well as their level of intensity. For example, combining Botox with light chemical peels is usually a very safe option. Dermal fillers can also be performed at the same time as your Botox injections; a process sometimes referred to as a “liquid facelift.”

If you choose a more intense treatment like laser skin rejuvenation, we can often do the procedures together if they are performed in the proper order. If Botox injections come first, it is best to allow the skin about one week to heal before following up with the laser process. However, if laser treatments are performed first, they can often be followed up with Botox injections at the same treatment session. The concern would be spreading the toxin beyond the treatment area with the additional procedures, which is why doing the Botox injections last typically works well.

Preparing for Your Treatment

While no preparation must be done before a Botox treatment, there are steps you can take to minimize your risk for bruising after the procedure and ensure the best possible results. Some of those steps might include:

  • Avoid aspirin or nonsteroidal anti-inflammatory medications in the week leading up to your treatment. These medications can increase your risk of bruising around the injection sites. Blood-thinning medications like Warfarin can also cause bruising, so talk to Dr. Barrett if you take any of these medications.
  • Discuss with Dr. Barrett or a member of his staff if you take supplements like St. John’s wort or vitamin E, as these substances can have a similar effect to the medications listed above.
  • Stop smoking before your injections, as smoking can also make bruising after treatment more likely.
  • Consider Arnica supplements in the week or so before your procedure, as this has been shown to minimize bruising and swelling after any procedure.
  • Avoid scheduling any significant social occasions in the week following your procedure, in case any bruising does develop. Plan Botox injections at least one week before big events to be sure you can be confident when you make your entrance.

Dr. Barrett will cover any other preparatory steps you might want to take at your initial consultation, which will be based on your medical history and current conditions. Our goal is to address any potential variable that could affect the outcome of your procedure, so you are left with the best possible results.

Procedure Overview

A Botox treatment usually takes about fifteen minutes to complete and involve mild discomfort as the injections are administered. Dr. Barrett will place multiple doses in strategic locations in the treatment area to target the muscle rather than the wrinkle itself. The needle for the injections is small and the quick nature of the treatment is designed to maximize patient comfort.

Fortunately, most patients find the pain very tolerable, eliminating the need for anesthesia beforehand. However, if you are concerned about your comfort level, Dr. Barrett and his team can apply a topical numbing cream to the treatment area before your procedure. Please allow an extra 20 to 30 minutes if you opt for this addition. To determine how many injections and sessions you will need to achieve optimal results, please schedule a consultation with Dr. Barrett today.

After Your Botox Injections

You will be able to return to your normal activities immediately following your Botox treatment. In most cases, there will be few telltale signs you just had a procedure done. In situations where mild bruising does occur, it can be covered up with makeup. If you have any soreness after the treatment, ice packs or cold compresses can be used to relieve the discomfort. Over-the-counter pain medications can also be used, although it is rarely necessary.

Botox injections are relatively safe, but side effects and complications can occur in some cases. These might include:

  • Pain and bruising at the injection sites
  • Skin redness
  • Headaches
  • Nausea
  • Flu-like symptoms
  • Temporary facial drooping (such as eye drooping)

These side effects are not common and typically subside within a matter of hours. If you experience trouble swallowing, slurred speech or breathing problems, it is possible the toxin has spread beyond the original treatment area. If this occurs, you should contact us immediately.

Fortunately, Botox injections require no downtime and produce almost immediate results. However, Dr. Barrett recommends minimal exercise and physical activity for the first few hours after your treatment to avoid potential spread of the medication or unnecessary bruising or swelling. The full effect of the injections usually appears after about two weeks. Keep in mind that Botox is not a permanent solution and the muscles will once again begin to constrict and tighten over time. Most patients enjoy their refreshed appearance for about three to four months. To maintain your look, you will need to schedule follow-up injections with Dr. Barrett on a regular treatment program.

Results You Can See

Fast There are many good reasons why Botox is a top cosmetic treatment today. The procedure is quick, relatively comfortable and the results are nearly instant. You can stop by our office on a lunch hour, get your injections and head back to work without anyone knowing where you spent your break. With regular treatment sessions, you can extend your positive results indefinitely. To learn more about the benefits of Botox, contact Barrett Plastic Surgery today at 310-598-2648.

The information about botox cosmetic was reviewed by Dr. Daniel Barrett. If you have any questions, please don’t hesitate to contact us using our contact form below.


Case #5325

Female, 35 yo, Caucasian
Botox to the Lateral Eyes

Case #5246

Forehead: 15 units
Brow: 18 units
Lateral eyes: 20 units

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