BOTOX 101

What is Botox? 

Botulinum toxin (BoNT), often shortened to Botox, is a neurotoxic protein produced by the bacterium Clostridium botulinum and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction, thus causing flaccid paralysis. The toxin is also used commercially for medical and cosmetic purposes. Botox injections are noted primarily for the ability to reduce the appearance of facial wrinkles in cosmetics. Injection of botulinum toxin into the muscles under facial wrinkles causes relaxation of those muscles, resulting in the smoothing of the overlying skin. In cosmetic applications, botulinum toxin is considered relatively safe and effective for reduction of facial wrinkles, especially in the uppermost third of the face. Botox has been in existence and has safely been used for over 20 years. Botox cosmetic from Allergan was the first drug to use botulinum toxin. Other commercial forms are marketed under the brand names Dysport/Azzalure from Galderma and Ipsen, Xeomin/Bocouture from Merz, and Jeuveau from Evolus, manufactured by Daewoong. Each is a little different, particularly when it comes to dosage units, so they aren't interchangeable. How Long do wrinkle smoothing treatments last? In general, muscle relaxing treatments last about 3-4 months. There will certainly be patients in which in lasts longer, in that 4–6-month range, or shorter, in that 2-month range. 

What areas does botox treat? 

While BOTOX® Cosmetic (onabotulinumtoxinA) is only FDA-approved for only 3 areas- moderate to severe forehead lines, lateral canthal lines, and/or glabellar lines, it is usually applied to multiple areas of the face and neck for wrinkle reduction. 

Common other areas for its use are: 

Forehead Wrinkles: Forehead wrinkles are one of the first facial features to show signs of aging. Since they are difficult to hide, they are one of the most common areas for Botox. 

Forehead Frown Lines (11’s): The lines that appear on your forehead between the eyebrows or popularly known as the “11’s” when you frown are also called forehead frown lines. If not treated, these lines can progressively get deeper.  These lines can make you look tired, upset, or angry. Botox reduces the depth of these lines. 

Brow Lift: A Botox brow lift is a procedure that gives a temporary lift to the eyebrows through strategic use of a neurotoxin. 

Crow’s Feet: These are the small, fine lines that extend from the corners of your eyes when you laugh or smile. 

Bunny Lines: Bunny lines refer to the fine lines that appear on either side of your nose when you wrinkle it. Like many types of facial wrinkles, bunny lines are caused by repeating certain facial expressions. 

Gummy Lines: A gummy smile is one that shows more of your gumline than you'd prefer. It's also known as excessive gingival display. This occurs in patients with dynamic upper lip muscles. 

Smoker’s Lines: Also known as perioral lines or ‘barcode’ lines, these are the little vertical above the upper lip that run vertically downward into the lip. One may not necessarily be a smoker to have the appearance of smoker’s lines on their faces. A small amount of Botox can treat these lines that appear when you purse your lips. They can appear due to overuse of straws, those who whistle or generally purse their lips a lot. Improvement of these lines can help your lipstick or foundation sit better in this area. 

Lip Flip: A Lip flip is the use of botulinum toxin injections to relax the muscles around the mouth (the orbicularis oris muscle), causing the upper lip to roll up and outward. This is for those who want more “show” of the lip, without actually plumping it with fillers. 

Marionette Lines & Corners of The Mouth: These lines run vertically between the corners of the mouth and chin, which can also create sagging in the lower half of your face. Marionette lines get their name from marionette string puppets, which are known for having split jaws so puppeteers can help them talk. The skin around your mouth is particularly prone to wrinkling because it’s thinner compared with the rest of your face. These lines are best treated with a combination of a muscle relaxer and fillers. 

Dimpled Chin: A dimpling on the chin occurs because the muscle underneath is contracting too much.  Muscle relaxers stop the contraction of the muscle, resulting in a smoother chin. 

Neck Bands: Neck bands or cords appear when the platysma muscles begin to sag. Once Botox is injected, it causes these muscles to relax and makes the appearance of neck bands less visible. Botox for the neck area also relaxes the muscles of the jawline, giving you a neck lift. One thing to keep in mind is that neck fat will not respond to Botox treatment. 

Other Areas That Botox Treats That Are Non-Wrinkle Related 

Botox for Migraines: Botox for migraines has been FDA approved since 2010. Injections may include: Bridge of your nose, temples, or forehead, your neck, the back of your head and the area above your shoulder blades, depending on type and severity of your symptoms. Most patients respond best after at least 2 sessions. Results are evident within 1-2 weeks after the injection, and can last for upwards of three months. 

Botox for TMJ: Commonly known as TMJ, the temporomandibular joint connects your jawbone and scull. Chronic pain and disorders result from injury or trauma, inflammation, arthritis, or overuse due to aging or teeth grinding. Botox reduces TMJ pain by reducing tension in the jaw, relaxing muscles for ease of movement, and relieving associated headaches. Injections may be injected into your jaw, temple, or forehead. 

Botox for Masseters: Most people don’t associate their jawline with aging or any sort of cosmetic concern. When we think of an aged-face, we think of wrinkles.  A desirable female face tends to be the widest around the eyes and the narrowest near the jaw and chin. As we get older, our faces square off or become wider at the jawline. This is often thought of as delicate, oval-shaped and smoothly contoured.  The masseter is located on both sides of your jaw as a rectangular-shaped muscle in your face and jaw and is one of the primary muscles of chewing. This muscle works just like another other muscle in the body. It can be “worked out” and can “bulk up.” The more the masseter muscle “exercises” and contracts, the bigger the muscle gets. This can leave someone with an over-developed muscle and a less desirable square face. It can be bulked up from decades of chewing, grinding their teeth (bruxism), clenching their jaw, or dental  problems. Certain habits like frequent and excessive gum chewing can also accentuate masseter size over time. Some ethnicities e.g., Koreans, the Chinese, and other southeast Asians who seem to be genetically predisposed to a thicker masseter and shorter, wider faces. These injections weaken the injected muscle over time. Within a week or two, most patients notice their jawline feels softer when they bite down and touch it. A more rounded jawline is usually noticeable within six weeks. Masseter muscle injections should be repeated every 3 to 6 months to maintain the result. However, after multiple sessions, upkeep can be spaced out to 9-to-12-month intervals. Excessive Sweating: Hyperhidrosis is a medical condition that causes excessive sweating even without the usual triggers of exercise, heat or stress. Those who suffer this condition may sweat up to five times more than the average person, making daily activity uncomfortable, embarrassing, and stressful. Botox injected into the underarm can bring sweating back to normal levels, and is life changing for those with this disorder. Treatment areas can also include the forehead, upper lip, groin, or back. 

The Bottom Line

Botox is often seen as a quick and effective way to achieve a natural-looking youthful face. According to the American Society of Plastic Surgeons, Botox injections have increased 28 percent since 2010 amongst 20 to 29-year-olds. Millennials swear by “Preventative Botox”, which involves using Botox to prevent the formation of lines and wrinkles, rather than in a corrective way once lines and wrinkles are already established. However, you view wrinkle treatments, we can all agree that they are successful at maintaining a youthful look as we age. Getting the treatment from someone who is not qualified can do more harm than good. To learn if you are a good candidate for Botox schedule an appointment with   Sleek Aesthetics Dallas Today!