 Wrinkle Reduction by Injection
In any facc-to-face encounter, words alone don't tell the whole story. More often, our facial expressions send a stronger message. If you've found that frown lines, forehead creases or other facial-expression lines are preventing you from looking as good as you feel, cosmetic denervation with botulinum toxin (BTX) injections may be good option for you. (BTX is also known by product names such as BOTOX and MYBLOC.**)
Botulinum toxin is a purified therapeutic agent that removes lines and creases in the upper part of the face by inactivating specific muscles that pull on the skin. It works to eliminate the face's dynamic wrinkles - those wrinkles that are caused not by aging or sun exposure, but by years of facial movement, such as laughing, smiling or frowning. Treatment with BTX in the affected areas causes the underlying muscles to relax, Giving the skin a smoother, more refreshed appearance.
You'll find basic information about BTX treatment in this brochure. However, the best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation wit ha plastic surgeon certified by The American Board of Plastic Surgery.
Is BTX treatment right for me?
BTX is most, commonly used to treat adults 30 and older. However, patients of any age can benefit from treatment.
You may be a good candidate for cosmetic BTX injections if you have any of the following conditions:
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frown lines (vertical wrinkles between the eyebrows) |
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forehead creases (horizontal forehead lines) |
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wrinkles near the eyes or "crow's feet" |
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platysmal bands, which appear in the neck as thick bands or "cords" |
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a) Treatment is most effective for frown lines, forehead creases, crow's feet and platysmal bands, which appear in the neck as thick bands or "cords". |
Other uses for BTX
In addition to its cosmetic use, BTX has a long record of sate and effective use in treating other conditions, such as:
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eyelid spasm or eye muscle spasm that can cause crossed eyes |
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facial muscle imbalance |
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spasms of the neck muscles |
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spastic muscles in patients with cerebral palsy |
Newer research has found that BTX may also provide some relief for:
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migraine headaches |
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excessive sweating of the palms or underarms |
BTX has a 20-year record of safe and effective use. The food and Drug Administration (FDA) has approved cosmetic BTX injections in appropriately selected patients for temporary improvement in the appearance of moderate to severe frown lines between the eyebrows (glabellar lines). Treatment for crow's feet wrinkles and vertical neck bands are among the most common "off-label" uses of BTX. "Off-label" means that the FDA has not yet approved BTX for these additional cosmetic uses, even though they are widely and safely performed by qualified physicians.
What should I expect from the consultation?
A personal consultation is the first step for every patient considering BTX treatment. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific treatment goals.
You should arrive at the consultation prepared to give complete information about:
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past and present medical conditions (If you're a woman, your surgeon must know if you are pregnant or are nursing a child.) |
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medical treatments or recent psychological counseling, you may have received |
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medications that you take, including nutritional supplements and herbal remedies |
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any allergies you may have |
during your physical evaluation, your plastic surgeon will assess your bone structure, the texture and elasticity of your skin and the muscle activity of your upper face.
Your plastic surgeon may explain additional procedures that can be performed in combination with BTX injections to better meet your appearance goals. Some of the procedures that might be considered include:
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a facelift, which removes excess skin and tightens muscle in the mid and lower face |
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eyelid surgery, which can correct excessive skin overhang in the upper eyelids and minimize puffy gabs beneath the eyes |
How is a BTX treatment performed?
BTX injections are quick and associated with very little pain. Often, patients remark that the ultra-thin needle that is used makes the injections far less uncomfortable than expected. The simple office procedure typically takes 10 minutes or less and the actual injection take only seconds. No anesthesia is required. However, if you are especially sensitive, your surgeon may elect to use a topical numbing cream.
The number of BTX injection you'll need depends on the areas that are affected. For the neck or forehead, you can probable expect about 8-12 injections; for frown lines between the eyebrows, 5-7 injections; and for lines around the eyes, 2-3 injections for each eye. Your surgeon will target the hyper-kinetic muscles, that is, the over-active muscles that are responsible for movement and expression.
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b) Your surgeon will target the over-active muscles that are responsible for movement and expression.
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c) The injection process typically take approximately ten minutes, with each injection point taking only seconds. The ultra thin needles used causes minimal discomfort.
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Are there other treatment options?
For deep horizontal creases across the forehead or furrows between the eyebrows that are caused by aging, your surgeon may recommend an endoscopic forehead lift.
If the wrinkles on your face are mainly caused by sun damage or aging and are not concentrated to the upper third of your face, your surgeon may recommend a skin-resurfacing technique, such as chemical peel, demabrasion or laser resurfacing, to shrink the wrinkles are create a smoother appearance.
How will I look and feel right after the injections?
Though it is unusual, you may experience some mild discomfort, bruising and/or swelling at the injection site. (If any of these side effects becomes bothersome, your surgeon may give you medication or suggest that you apply ice to the affected area.)
You may return to work or your normal daily activity immediately after the treatment. However, for the first 3 to 5 hours after the injections, you'll be advised to avoid bending or straining. Exercise or facial massage may spread the medication to an area where it is not needed. The goal is for the toxin to be taken into the muscle at the place where is was injected. After a few hours have passed, you may resume any activity or exercise.
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d) The duration of the results may vary. In general, you can expect your results to last for three to five months. |
What should I know about my results?
The effect of BTX may take several hours or even several days to develop. The duration of the results may vary. However, in general, you can expect your results to last for three to five months,
If you find that your treatment did not produce the look that you had hoped for, your surgeon may recommend a repeat treatment.
Patients are typically quite pleased with the results of this quick outpatients procedure. Most are surprised at how simple it is to maintain the results with regular treatments.
How long will I continue to see my plastic surgeon?
To maintain your softer, more relaxed appearance, you will need to see your plastic surgeon every 3-6 months for repeat treatments. You may find that as the muscles gradually weaken form lack of use, your repeat treatment will become less frequent.
However, it's important to be aware that if you discontinue your treatments altogether, the botulism toxin will leave your body entirely and your appearance will return to its earlier state.
At your return visits, your surgeon will assess your results, modify your treatments if needed and address any questions or concerns you may have.
Choosing a Qualified Surgeon
No matter what type of plastic surgery you're considering, one of the most important factors in its success is the surgeon you choose. Although it may seem hard to believe, some of the physicians who are performing cosmetic surgery today have had no formal surgical training at all.
It's advisable to consider the following points before scheduling a consultation:
Find out if he or she is certified by The American Board of Plastic Surgery (ABPS).* Surgeons with this certification have completed a minimum of five years of surgical training following medical school, including a plastic surgery residency program. During this intensive program, surgeons learn to perform surgical procedures for the entire body and face. At the same time, they develop their technical skill and aesthetic judgment. After training, a surgeon must pass comprehensive oral and written exams before being granted certification. The two professional organizations that have prepared this brochure, the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, require their members to be certified by The American Board of Plastic Surgery.*
Ask about the surgeon's hospital privileges
Even if you are planning to have your surgery in your doctor's office or at a surgery center, it is important to find out if your surgeon has operating privileges in an accredited hospital for the same procedure you would like to have performed. Before granting privileges, hospital review committees evaluate a surgeon's training and competency for specific procedures.
*In Canada, The Royal College of Physicians and Surgeons of Canada.
The symbol of Excellence in Plastic Surgery
A public education service of American Society of Plastic Surgeons
American Society for Aesthetic Plastic Surgery
This brochure, including art, graphics, illustrations and images, is intended for educational purposes only, it is not intended to make any representations or warranties about the outcome of any procedure and should not be viewed as a substitute for a thorough, in person consultation with a board-certified plastic surgeon. |
