BOTOX® and Dysport™:
|BOTOX® is effective in improving the appearance of a gingival smile by relaxing the muscles that cause excess gums to show.|
How do they work?
It has long been observed that when a patient has a stroke that paralyzes one-half of their face, they lose the wrinkles on that same side of their face. For the treatment of wrinkles, a very dilute solution of BOTOX® is injected just under the skin into the overactive muscles producing the wrinkles. This blocks the impulses from the nerves to those muscles and produces a temporary muscle weakening, allowing the skin to regenerate and eliminate the lines.
When the muscles are kept under the influence of these products, they become shrunken (atrophic) and the effect starts to become more long lasting. The first botulinum toxin treatment may last two to four months, but if the next treatment is given before the BOTOX® effect has significantly worn off, the second treatment will often last three to five months. With the third treatment, if given before the effects of the previous treatment have worn off, the effect tends to become even longer lasting. We've had patients come in saying "I had BOTOX® given a year ago, somewhere else, and it didn't work." A statement like this reflects a misunderstanding of the use of BOTOX®. We tell patients that to get optimal results they need to think of BOTOX® and Dysport™ as a series of treatments, not just a one-time or short-term therapy.
Frowning before BOTOX®
Frowning after BOTOX®
BOTOX® and Dysport™ are used primarily to correct lines on the upper one-half of the face, particularly the frown lines, the forehead lines, and the crow's feet. These lines can add years to your appearance and can project a false impression of anger, concern or depression. These products can also be used to improve fine and deeper lines in the upper lip, the "downward smile" (the downward drooping of the corners of the mouth that occurs with aging), to improve the "gingival smile" (excessive gum show on smiling) and the creases and folds in the neck. BOTOX® and Dysport™ have also been used to decrease the roll of muscle just below the lower lid margin and accentuated by smiling in some individuals. They can also be helpful treating webbing of the neck and the transverse neck creases. Unfortunately neither BOTOX® nor Dysport™ can be used to correct lines that are not caused by muscle contraction, but in some of these instances Restylane and other fillers may be of help. Frequently, fillers and botulinum toxin are administered during the same visit.
Botulinum toxin acts to improve lines or creases by weakening the muscle that folds the skin. It is this repeated folding and unfolding that causes the creases. When the muscle activity stops, the fold rapidly becomes less prominent because the skin tends to flatten out in the absence of muscle activity. However, the line in the skin remains initially. Fillers fill the fold, elevating it, but that does not stop the muscle activity. Frequently botulinum toxin and fillers will be used together in a single location, to produce more rapid initial improvement. If the BOTOX® or Dysport™ treatments are kept up, the filler will last a very long time.
Are there people who should not use BOTOX®?
People who are pregnant, breast feeding, have rare neurological disorders, or who are allergic to albumin should not be treated with BOTOX® or Dysport™.
Frowning before BOTOX®
Frowning after BOTOX®
What results can you expect from BOTOX® or Dysport™?
Within two to fourteen days, you should begin to see decreased movement of the muscles injected. Dysport™ tends to have a more rapid onset of action than does BOTOX®. Over the next one to two weeks, you should see a further reduction and possibly a complete absence of movement of the treated muscles. We will frequently see patients back after two to three weeks to evaluate the effectiveness of the treatment. If there is still some muscle movement we may inject additional botulinum toxin. As the treated facial muscles remain weakened, the skin gradually remodels itself and the lines are first reduced and then frequently eliminated. The effects of BOTOX® generally last about three months, although thick, strong muscles may need to be treated more frequently initially. It has been reported that about 30% of patients treated with Dysport™ have a response lasting 4 months or more. With repeated treatments, as the muscles become weaker, the effect of the treatment may last longer. This depends on keeping the muscles inactive. If the effect of the product is allowed to wear off, the muscles regain their strength, the folds and creases redevelop, and the muscles do not shrink in size. The botulinum toxin effect lasts on average three to six months, although on occasion it may be longer or shorter. For best long term results these products must be re-injected as it begins to wear off. It is essential to keep the muscles in a weakened state so that the lines do not reform.
What about safety and side effects?
Dermatologists and ophthalmologists have been using BOTOX® since 1980 and Dysport™ since 1991 . They have an excellent record of efficacy and safety and were first used in infants to correct overactive eye muscles. Although there have been recent news articles about the safety of boyulinum toxin, significant problems have occurred only in children with cerebral palsey who were receiving large doses into their neck muscles to treat spasticity (hyperactivity of the muscles). It is our belief that BOTOX® and Dysport™ are exceptionally safe and effective, and can help prevent you from projecting emotions that you're not feeling. We had one woman patient who said that much of the communication in her marriage involved her husband repeatedly asking her "Why are you angry?" Despite her repeated denials, it took botulinum toxin therapy for them to be able to move on to other topics of conversation.
BOTOX® and Dysport™ and do not affect the nerves transmitting sensation, so there is no numbness associated with their administration.
There have been no long-term side effects, allergic reactions or health hazards related to cosmetic botulinum toxin use thus far. Some patients have been getting these treatments for more than 10 years, with no serious problems. Side effects may include nausea, headache or mild flu-like symptoms, usually with doses above those used for cosmetic purposes. If you should stop botulinum toxin treatments, your appearance will gradually revert to the appearance you would have had if you had never been treated.
How long will it take to recover?
One of the many advantages of BOTOX® and Dysport™ treatments is that there is no down time. Although occasional bruising may occur, the treatment produces no other immediately noticeable effect and you may immediately apply make-up and go about your usual activities. No local anesthetic or sedative is required, so you will be able to continue with all of your usual activities immediately after your treatment. You will even be able to drive yourself home after a treatment. These treatments take only a few minutes.
Does it hurt?
These treatments are short and gentle. Because of the extra care and equipment we use, almost every patient who has been treated elsewhere has confirmed that our California BOTOX® and Dysport™ injections are significantly less painful than any of their previous treatments. A minimal amount of discomfort may be experienced when the needle is inserted and a few drops of the material are injected into the muscles which need relaxation. The discomfort lasts only a few seconds, and new patients very frequently exclaim that the pain was much less than they had anticipated.
What should I do after my BOTOX® treatment?
You should exercise the treated muscles for two hours following your treatment. This will allow the best possible uptake of the product by the treated muscles during normal facial movements. Do not rub or touch the areas that were treated for two hours following your procedure. Rubbing and pressing the injected areas could spread the material out of the treated muscles and into non-targeted muscles. If your injected material moves out of the muscles where it has been placed, there could be less effect on those muscles, and unwanted temporary relaxation of nearby facial muscles. After two hours, there are no restrictions.
Who performs the treatments?
Dr. Bock will personally administer your BOTOX® or Dysport™.
How much do these treatments cost?
Dysport™ and BOTOX® cost the same per area treated. Many cosmetic treatments were once considered a luxury item only for those who had a high disposable income; BOTOX® and Dysport™, however, are very affordable even for those with modest incomes. Some people will need to budget for these treatments just as they would for buying items such as shoes, make-up and having their hair styled. Our charge for BOTOX® in California is $12 per unit, with further discounts on followup visits. This price is competitive with other facilities in the area, and is less expensive than most -- even though in many other facilities, BOTOX® is not injected by a physician. We will tell you when to return for your next BOTOX® treatment, and if you keep that appointment you get a 10% discount on your treatment. Because of the larger volumes required, we charge $9 per unit for the use of BOTOX® (or the equivalent amount of Dysport™) for excessive sweating of the hands, feet and armpits.
The cost of your consultation is credited toward the cost of your first cosmetic procedure or treatment.
How many units of BOTOX® will my treatment require?
Typical treatments are as follows (note that Dysport™ units are equivalent to about 1/3 of a BOTOX® unit, in terms of effectiveness):
If you are interested in BOTOX® or Dysport™ treatments, what is the next step?
The next step is to call California Skin & Laser Center at 800-500-5842 and to schedule an evaluation. At that time Dr. Bock will advise you whether you are a candidate for this procedure, and what other possibilities exist for improving your appearance.
Why should I choose California Skin & Laser Center for my BOTOX® and Dysport™ treatments?
At California Skin & Laser Center, we want you to have an excellent outcome and to feel that your needs and concerns have been promptly addressed in a caring and sensitive fashion. We strive diligently to ensure your satisfaction, your comfort, your privacy, and your safety. All treatments are supervised or performed by a board-certified dermatologist with many years of successful experience in a large variety of cosmetic procedures. Many treatment modalities are available, and we can recommend the one or two that are most likely to meet your needs; we're here to meet your needs and help you realize your aspirations. At our clinic in Stockton, CA, we serve communities throughout San Joaquin County and the Central Valley, including Lodi, Sacramento, Tracy, Manteca, Modesto, Galt, and Valley Springs; many of our patients also come from the San Francisco Bay Area.