- 1 Description
- 2 Options
- 3 Anatomy of Facial Features
- 4 Indications
- 5 Fat Injection Procedure
- 6 Recovery
- 7 Frequently Asked Questions (FAQs)
- 7.1 What is BOTOX®?
- 7.2 Who should administer BOTOX®?
- 7.3 How does BOTOX® work?
- 7.4 When do I see the results of BOTOX®?
- 7.5 Is a BOTOX® treatment painful?
- 7.6 What are some of the side effects from BOTOX®?
- 7.7 Will I still be able to make facial expressions after a BOTOX® treatment?
- 7.8 If I decide to stop treatment, what will happen to the lines between my brows?
- 7.9 What makes BOTOX® work?
- 7.10 What is the downtime after a BOTOX® treatment?
- 7.11 What areas of the face can be treated with BOTOX®?
- 7.12 What is the difference between BOTOX® and other injectable fillers?
- 7.13 Can a person get botulism from BOTOX®?
- 7.14 Who makes BOTOX®?
- 7.15 Is BOTOX® poisonous?
- 7.16 Is it true that BOTOX® can be watered-down?
- 7.17 During my BOTOX® procedure, what exactly is injected into my skin?
- 7.18 What causes dynamic wrinkles?
- 7.19 What is the goal of BOTOX®?
- 7.20 What will my skin look like immediately after my BOTOX® treatment?
- 7.21 How soon will BOTOX® wear off?
- 7.22 BOTOX® safe?
- 7.23 How do I know if BOTOX® injections are right for me?
- 7.24 Why should I have my BOTOX® injections at Gabbay Plastic Surgery?
- 7.25 How can BOTOX® treat Hyperhidrosis (excessive sweating)?
Botox is the registered trade name for Botulinum Type A, and was the first FDA approved botulinum agent to be used for wrinkle reduction. There are now several excellent additional Wrinkle Reducing Injectables in use, including Dysport and Xeomin. These products work by blocking communication between the nerves and the muscles in the targeted area, temporarily paralyzing the active wrinkles caused by these facial muscles. This treatment results in a more youthful, refreshed appearance, and may prevent the formation of future wrinkles.
Following its FDA approval for cosmetic use in 2002, approximately 11.8 million Botox procedures have been administered, making Botox the most popular non-invasive cosmetic procedure in America – particularly in Los Angeles and Southern California. At Gabbay Plastic Surgery, located in Beverly Hills, CA, Dr. Joubin Gabbay M.D. has utilized Botox and similar Wrinkle Reducing Injectables (Dysport, Xeomin, etc), to diminish the appearance of his patients’ glabella lines (frown lines between the eyebrows), horizontal lines on the forehead, laugh or smile lines, chin and lip lines (smoker’s lines), crow’s feet, and vertical muscle bands on the neck.
The visible results of Botox and other Wrinkle Reducing (Dysport, Xeomin, etc) injections can be seen 3-7 days following the treatment, and the wrinkle-reducing results last up to four months. Because the effects of Botox are not permanent, patients are advised to set up periodic maintenance injections at Dr. Gabbay’s Beverly Hills, CA office (generally three times per year) in order to preserve their rejuvenated appearance.
Wrinkle Reducing Injectable use with Botox, Dysport or Xeomin is one of the fastest growing and most popular cosmetic procedures in the world – particularly in Los Angeles and Southern California. Botox, Dysport or Xeomin injections are often performed in conjunction with other aesthetic enhancement procedures, such as dermal filler injections (Juvederm, Restylane, Radiesse, etc), face lifts and brow lifts, in order to maximize the success of patients’ surgical results.
Botox is currently the most commonly utilized Wrinkle Reducing Injectable; however, the other products have different features that may make them very useful for your particular needs (for example, Dysport may spread farther from the injection area and show its effects sooner, and Xeomin is free of additives that may result in longer lasting results).
During your initial complimentary consultation in Beverly Hills, CA, Dr. Gabbay will assess your specific aesthetic goals and create a customized treatment plan utilizing the appropriate Wrinkle Reducing Injectable to optimally enhance your appearance. If you would like additional information about Botox, Dysport, and/or Xeomin, please contact Gabbay Plastic Surgery today. We look forward to answering all of your questions, and to setting up an initial consultation with Dr. Gabbay.
Anatomy of Facial Features
The natural facial volume loss that occurs as we age can change the appearance of the face significantly. Fat injections are a simple means of restoring lost volume to the facial contours, thereby rejuvenating the entire facial appearance. Fat injections can be used to treat volume loss around the eyes, brow, lips, mouth, nasolabial folds, hands, buttocks and cheeks.
The soft tissues that overlay the bony framework of the face and body are comprised of three layers:
Deep Tissue Layer: The deepest tissue layer consists of muscles that are responsible for facial expression. All of the movements of your face are due to contraction of these muscles, and when they lose tone during the aging process, stretching and sagging occurs.
The Middle Tissue Layer: The fatty middle layer lies between the muscular layer and the skin. During one’s youth, facial fat is evenly distributed throughout the face; however, with age, gravity pulls the fat down, causing it to accumulate in the jowl area and under the chin, leaving a hollowness in the cheek region.
The Outermost Tissue Layer: The skin is the outermost tissue layer, and as we age, the skin loses elasticity, causing the formation of wrinkles, folds, lines, and creases.
Fat injections are useful for treating the aesthetic problems caused by facial volume loss and the breakdown of collagen and elasticity.
Some of the visible signs of aging that can be treated with fat injections include:
- Brow furrowing
- Deepening upper and lower eyelids
- Loss of support of the outer angles of the eyes
- Scleral show (excessive show of the white of the eye)
- Fat herniation under the lower lids
- Malar (cheek bone) groove depression
- Malar sagging and drooping
- Nasojugal groove (depression of the inner lower eyelid)
- Deepening of the nasolabial folds and grooves
- Drooping at the corners of the mouth (Marionette Lines)
- Softening of the jaw line
- Formation of jowls
- Loss of lower lip volume
- Flattening of upper lip due to volume loss
- Creases in the chin
- Aging hands
- Drooping/sagging buttocks
- Flat or small buttocks
If you would like to correct any of the aforementioned cosmetic issues, you may be a good candidate for fat injections, which offer a number of benefits, including:
- Lasting results
- Outpatient procedure
- Because the fat used in the injections comes from your own body, there is no potential for an allergic reaction
- Minimal discomfort during the treatment
- Good option for individuals who are allergic to bovine collagen
- Can be used in conjunction with other synthetic facial fillers, such as Juvederm®, Restylane® or Radiesse®
Fat Injection Procedure
Facial fat injection is a procedure that uses the patient’s own fat to treat facial volume loss in. The injected fat will not move or shift because it becomes incorporated as living tissue. Fat injections can offer long term results and require minimal post-treatment downtime.
Fat injection treatment steps include:
- Anesthesia: anesthetic options include: oral sedative, injections of sterile saline, Lidocaine, light IV sedation (Twilight), and/or a local anesthetic.
- Fat Removal: the patient’s own fat is extracted (usually from the abdomen, inner knee, thigh, saddle bags, or hip) with a small hypodermic needle or a special cannula with limited suction. Whole, healthy fat cells produce optimal re-implantation results, which is why Dr. Gabbay manually aspirates the fat using a gentle hand-harvesting method that will not compromise the quality of the transplanted fat.
- Fat Purification: the extracted fat must be spun in a centrifuge to extract excess fluids and to separate the damaged cells, leaving only whole, intact fat cells for re-injection. In some cases, other ingredients are added to increase longevity of the treatment (ie. vitamin C, serum albumin).
- Fat Re-implantation: using a separate, smaller hypodermic needle, the purified fat is slowly injected thru tiny skin incisions into the tissue of the recipient site using a micro-droplet technique to ensure smooth results.
Following the fat injection procedure, you may experience mild to moderate bruising and swelling, the majority of which will subside within 24-48 hours. Restricting movement in the treated area for the first 3-5 days will give the newly injected fat cells a better chance of surviving. Within one week you will notice visible results from your fat injection treatment. Some of the potential although rare complications of facial fat injections include: adverse reaction to anesthesia, facial asymmetry, hematoma, infection, bleeding, swelling, bruising, fat necrosis, fatty cysts, blood clots at the treatment sites, and development of scar tissue.
Frequently Asked Questions (FAQs)
What is BOTOX®?
BOTOX® is a prescription medicine that is injected into muscles and used to improve the look of moderate to severe frown lines, in people 18 to 65 years of age, for a temporary period of time.
Who should administer BOTOX®?
BOTOX® should always be administered by a healthcare professional because it is injected directly into the muscles, and works by blocking nerve impulses to the injected muscles. The knowledge of facial anatomy is imperative for the success of a BOTOX® treatment.
How does BOTOX® work?
BOTOX® is a prescription medicine that is injected into muscles on your face, and it works by blocking nerve impulses to the injected muscles. BOTOX® temporarily reduces muscle activity that causes moderate to severe wrinkles and lines to form.
When do I see the results of BOTOX®?
Within days after your BOTOX® procedure you will see a marked improvement in your wrinkles, and improvement will continue for up to 30, days with results lasting up to four months.
Is a BOTOX® treatment painful?
Because the needle used for injection is so small, discomfort is usually minimal and brief. Prior to injection you may choose to have the targeted area numbed with a cold pack or anesthetic cream. The entire procedure takes approximately 15-30 minutes, and most patients leave the office with no downtime.
What are some of the side effects from BOTOX®?
Some of the side effects of BOTOX® can include localized pain, infection, inflammation, tenderness, swelling, redness, bruising, and/or bleeding.
Will I still be able to make facial expressions after a BOTOX® treatment?
Although the results are visible, a treatment with BOTOX® (onabotulinumtoxinA) will not radically change your facial appearance, or make you look as if you have had any work done on your face. The muscle activity that causes frown lines between the brows is temporarily reduced, so you will still be able to make expressions, without the wrinkles and creases.
If I decide to stop treatment, what will happen to the lines between my brows?
If you do not continue your BOTOX® treatments, the moderate to severe frown lines between your brows will gradually return to the way they looked before BOTOX®.
What makes BOTOX® work?
BOTOX® uses a natural, purified protein, that is administered at very low doses, to reduce the contractions of the muscles that cause those persistent frown lines that develop over time. While the results are dramatic, it will not radically change your facial appearance; since the muscles are simply relaxed, you can still make expressions.
What is the downtime after a BOTOX® treatment?
BOTOX® procedures are fast, simple, and minimally invasive, and no anesthesia is required. Injections are administered with an ultra-fine needle, directly into the area being treated, and discomfort is minimal and brief. Once your treatment is complete, there is usually no discomfort and most people return to work or resume normal activities immediately.
What areas of the face can be treated with BOTOX®?
BOTOX® treatments can be used in a number of locations, including between your brows, eye area, smile lines, mouth, and neck.
What is the difference between BOTOX® and other injectable fillers?
BOTOX® temporarily eliminates or improves dynamic wrinkles caused by overactive facial muscles, by blocking the chemicals which cause facial muscles to contract, allowing the wrinkle to relax. Wrinkles caused by facial volume loss and the breakdown of collagen, are a different type of wrinkle and they should be treated with facial fillers, as they address different underlying causes.
Can a person get botulism from BOTOX®?
Extremely small amounts of BOTOX® are administered to treat wrinkles, and the quantities are insufficient to cause botulism.
Who makes BOTOX®?
BOTOX® is manufactured by Allergan, which is the only pharmaceutical company that makes BOTOX® in United States.
Is BOTOX® poisonous?
Most medicine can be considered poisonous if improperly administered, however, when used correctly, medications like BOTOX® can achieve results without adverse side effects.
Is it true that BOTOX® can be watered-down?
BOTOX® is shipped at low temperatures in powdered form, and it must have sterile saline solution added before injection, because the powder alone cannot be injected. The volume of solution can vary, but what is important is the units of BOTOX® used to treat a particular area, because it is the amount of BOTOX® units that will affect your results. To achieve the best outcome, it is crucial that you have your BOTOX® treatments performed by a reputable professional, such as Dr. Gabbay.
During my BOTOX® procedure, what exactly is injected into my skin?
BOTOX® Cosmetic was formally called Botulinum Toxin Type A, and it is a therapeutic neurotoxin used safely and effectively in anti-wrinkle treatment. The botulinum toxin serum is injected into your skin, allowing it to block nerve impulses from the nerve within the specific muscle, causing your wrinkles. The treatment relaxes that muscle and allows the skin to smooth out and become “unwrinkled” without affecting the untreated areas.
What causes dynamic wrinkles?
Every day our facial muscles are used many times to help create expressions, and over time these repeated muscle contractions cause the lines and wrinkles that appear on our face. Aging, genetics, family history, lifestyle, and excessive sun exposure also factor into the wrinkle creation process.
What is the goal of BOTOX®?
The main goal of a BOTOX® treatment is to improve the apparent age of your skin, without making it too noticeable. By reducing your wrinkles, your face will have a more relaxed and youthful appearance.
What will my skin look like immediately after my BOTOX® treatment?
Immediately after your BOTOX® procedure, the treated areas will look like mosquito bites, and this redness will subside within hours. Your skin will feel normal with no unusual sensations, and in rare cases, patients experience slight bruising and swelling that resolves within a few hours to days.
How soon will BOTOX® wear off?
Each person metabolizes BOTOX® at a different rate, and although the average time is four months, some results may last longer. When your BOTOX® wears off, you will begin to see your facial expression lines again, and if you want to keep the wrinkles away you will need to schedule another treatment.
BOTOX® has been used safely for over 20 years, it has an excellent safety record, and a low incidence of side effects.
How do I know if BOTOX® injections are right for me?
If you are concerned about the dynamic wrinkles and lines on your face that are making you look older and you are in good physical health, you may be a candidate for BOTOX®, which will be determined during your consultation with Dr. Gabbay.
Why should I have my BOTOX® injections at Gabbay Plastic Surgery?
Although many physicians offer BOTOX® to treat frown lines and forehead creases, few have the experience and artistic skills to correct dynamic wrinkles in other areas of the face and body.
At Gabbay Plastic Surgery, Dr. Gabbay has experience and has achieved excellent results with BOTOX® when correcting:
- Frown lines
- Crow’s feet
- Brow elevation (lift)
- Brow shaping to alter the shape of the eyebrows to create a more aesthetically pleasing appearance
- Forehead creases
- Correction of eyebrow asymmetry
- Elevation of the corners of the mouth
- Upper and lower lip creases
- Marionette lines
- Lip lengthening (to correct gummy smile)
- Chin softening (peach pit chin and excessive cleft)
- Facial scars (old and new)
- Horizontal neck (“necklace”) creases
- Vertical neckbands (turkey neck)
- Wrinkling on the central mid chest (décolleté)
How can BOTOX® treat Hyperhidrosis (excessive sweating)?
BOTOX® injections have proven to be very useful in diminishing excessive sweating (hyperhidrosis). Hyperhidrosis is a common and extremely distressing condition, and for those affected, the condition is debilitating with serious impairment in activities of daily living, social interaction, and occupational careers.