Botox

When is the best time to start getting Botox and am I too young?  These are just some of the many questions that Dr. Fenske hears from his patients on Botox.  The video link below helps you determine when the time will be right for you.

Click video link When is the best time to start getting Botox

Botox

When is the best time to start getting Botox?

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Botox

As a cosmetic practitioner this question is common dialogue with patients in our practice on a daily basis. I am sure that other cosmetic providers can agree that we often hear “I’m not ready for Botox … I really don’t need it yet”. The truth of the matter is that most people that think they “aren’t ready” are the ones that can benefit from Botox the most. What do I mean by this? Let’s take a quick moment to learn the basics of Botox so that you too can make an education decision on whether or not Botox is right for you.Pre and Post Botox

Botox is actually a preventative measure used in combating wrinkles that form from making an expression. This is why you will hear providers call them dynamic wrinkle lines or wrinkles of motion. The idea behind Botox is that it temporarily weakens a muscle complex, therefore not allowing you to use that muscle to its full potential. When you are not able to use the maximum potential of that muscle it allows that area to rest. Over time, this will soften your expression lines. In younger patients these expression lines can easily resolve with one or two treatments of Botox. More mature patients have been making these expressions for much longer therefore their dynamic wrinkle lines can actually become etched in scars that are significantly more difficult to treat with Botox. So the key to Botox is starting early and not when those lines become obvious or pronounced at rest. With that being said, it is never too late to start Botox, even more mature patients can see a great benefit from using Botox. Most patients will start Botox in their late 20’s and 30’s. Unfortunately Botox gets bad press when it is “over done”, mostly by patient request, from those that suffer from what we call “wrinkle-rexia”. Bystanders should not know that you have received Botox, only that you look “soft, natural, well rested, and really good for your age”.

Now understanding the importance of starting Botox early, let’s dive a little deeper into the science behind Botox. Botox is a protein derived from the bacterium clostridium botulinum that has qualities of a neurotoxin. Botox decreases muscle activity by blocking overactive nerve impulses that trigger excessive muscle contractions. It was FDA approved in 2002 to use in between the brows but we often use it off-label to soften crow’s feet, forehead lines, and in the lower face to achieve the best outcomes for our patients. The results of Botox last about 3-4 months and can vary between patients and areas of the face. It takes anywhere from 2 days to 2 weeks to see the initial results post injection. The Botox injection procedure is very quick and can easily be done during lunch hour or in between errands. Some practitioners will use ice or numbing cream prior to injection, to minimize discomfort. Common side effects include headache and pinpoint bruising. Other less common side effects are flu like symptoms, droopy eyelid, and heaviness in the brows. All side effects of Botox are transient meaning they go away in a few weeks following the procedure. Most would consider Botox and safe and effective cosmetic procedure.

So the next time you ask yourself “Do I need Botox yet?” I encourage you to reference this post and inform yourself on the benefits of starting Botox early and often to maximize your anti-aging potential.

Nicole Nations, ARNP-C

Nicole Nations, ARNP-C

By: Nicole Nations, ARNP-C, Cosmetic Practitioner at the USF Health Cosmetic and Laser Center

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Making Sense of Botox and Fillers

Published: April 10, 2010

Many of my patients have expressed confusion regarding the role of Botox and fillers for treatment of skin wrinkles.

Specifically, they often don’t realize that these very popular cosmetic procedures serve two very different purposes.

As we age, repetitive muscle movement results in dynamic wrinkles, such as those that occur around the eyes (crow’s feet) and between the eyes (frown lines). Botox, the brand name for OnabotulinumtoxinA, is injected into the muscles responsible for causing these wrinkles. By temporarily paralyzing these tiny facial muscles, the wrinkle is softened, making the face look younger and refreshed. It generally takes two to three weeks before the full benefit is seen. The effects of Botox only last three to four months.
Botox injections will not work for static wrinkles – wrinkles that are present all the time, even when the face is not animated. And Botox won’t eliminate the tiny creases already etched into the skin from many years of repeated movement – a good reason to commence with injections sooner, rather than later.
Botox injections are the most commonly performed nonsurgical cosmetic procedure performed in North America. They have an excellent safety profile. The only significant adverse events have been when large doses (many times that used for treating facial wrinkles) have been used “off label” in non-facial sites.

Newer varieties of botulinum toxins, such as Dysport, are becoming available. Whether these prove to be superior is yet to be determined.

I recommend that you purchase Botox by the unit, not by the area – it is the only way to accurately compare prices. Keep in mind that cost alone should not drive your selection of a provider. Experience and skill are necessary for a successful outcome!

Before Fillers

Before Fillers

Immediately Post Fillers

Immediately Post Fillers

Fillers, in contradistinction, are used primarily to restore volume to the aging face. As we age, our facial skin becomes thinner, fat diminishes, muscles atrophy and bone loss occurs, resulting in a face reminiscent of a deflated balloon. As the skin sags we develop unsightly furrows along the nose (naso-labial folds) and on the chin (marionette lines). These furrows can be safely filled with many different materials, and the results are immediate.

I generally prefer nonpermanent fillers, especially those containing hyaluronic acid (e.g. Restylane, Juvederm), a natural component of normal skin. These fillers last six to nine months, so if you don’t like the results, the skin will eventually return to baseline. Even better, if you hate the results, you can inject hyaluronidase and immediately reverse the effect.

Fillers are also used to enhance the lips, which also lose volume as we age. This is a case where less is more; if they end up being too big, it doesn’t look normal (restoration, not over-inflation, is the rule).

Remember, Botox and fillers are temporary “fixes” that have an excellent safety profile.

Injection is both a science and an art. It is foolhardy to just shop price – a lesson many have learned the hard way. Experience and an artistic eye are paramount to a successful outcome!

Neil Alan Fenske, MD

Neil Alan Fenske is the Professor and Chairman of the University of South Florida Morsani College of Medicine and the Medical Director of the USF HEalth Cosmetic and Laser Center on Davis Islands

http://health.usf.edu/medicine/dermatology/bios/bio_fenske.htm

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