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Botox Myths and Facts

There are many misconceptions and myths about Botox. Here we clear the air to explain what Botox is, what it does, and how it works.

Myth: Botox is not safe.


Botox before and afterThe safety record of Botox is well established. Botox has been used for over 20 years for a variety of treatments with minimal side effects. Botox is amongst the safest treatments for treating facial wrinkles.

Myth:  There are creams that work better than Botox.


Topical creams work on the surface of the face. Botox works on the muscles under the skin which cause the deeper wrinkles to form. Once the muscles relax, the skin overlying it can smooth out. When used in combination with A E Skin products such as the Brightening Cream, better results are seen because treatment is directed at both the superficial and deep wrinkles.

Myth: Botox is only for the rich and famous.


According to the Aesthetic Surgery Education Research Foundation Botox Cosmetic Use Survey of 1048 patients (2005) the most common users of Botox are working mothers aged 40-55; and those with an annual household income of less than $ 100,000 are more likely to use Botox than those with an annual household income of more than $ 150,000. And with the Allergan Brilliant Distinctions Program, patients are able to save on every Botoxtreatment.

Myth: Botox is only for old people.


A common misconception is that Botox is only for those who are in their 60's or 70's. On the contrary, we have a lot of patients in their 20's who receive Botox. This is either for prevention or for those who have expressive faces. I find that the younger one is when one starts receiving Botox treatments the more signs of aging will be delayed. In other words, Botox can be used to prevent wrinkles from either appearing in the first place or from getting deeper over time.

Myth: Botox isn't for men.


A common misconception is that Botox is only for women. On the contrary, similar to women, many men are concerned about their appearance and want to look their best. In the past several years Botox and other cosmetic treatments such as fillers and laser rejuvenation have become more and more popular in the male population. It is also important to understand that men have different facial features than women and a masculine appearance is desired. Therefore, an expert injector should understand the anatomic differences between the genders and know how to use the product to produce desired results. One example is the position and shape of the eyebrow. While the ideal eyebrow for women is high with an arch, men have lower set brows that are more horizontal. It is critical that the product is placed in the correct positions on the face to avoid feminizing the eyebrows.

Myth: It is safe to have a Botox treatment during pregnancy or when breast feeding.


Although Botox is one of the safest treatments offered, there are some situations where it is not appropriate. The safety and efficacy of Botox treatments have not been determined in women who are pregnant, trying to become pregnant, or breast feeding. There is also no evidence that Botox crosses the placental barrier, but such studies have not been published. While some physicians are comfortable treating women who are pregnant, trying to become pregnant, or breast feeding, in the absence of data we err on the side of caution and recommend that my patients avoid Botox and other such cosmetic treatments until they are no longer breast feeding.

Myth: Botox can only be used in the upper face.


Although Botox is most frequently used in the upper face, it can also be used in various areas in the lower face. The nasalis muscle on the bridge of the nose is responsible for the bunny lines that are sometimes seen there when one frowns or smiles. Botox can be placed in the orbicularisoris muscle around the lips to provide a pout to the lips and reduce the appearance of vertical lines around the lips sometimes called smoker’s lines (although they are seen in people who do not smoke as well). Botox can be placed in the depressor angulioris (DAO) muscle to elevate downturned corners of the mouth which sometimes produce a sad face appearance. Botox can be placed in the mentalis muscle on the chin to address a cobblestone appearance or dimpling on the chin. Botox can be placed in the masseter muscle in the lower face to contour the lower face and address pain associated with TMJ. Botox can be placed in the levator labiisuperiorisalequaenasii (LLSAN) muscle located just beside the nose on either side to address what is called the gummy smile. The gummy smile is seen in some people whose upper lip elevates so high when they smile that the upper gums are seen in addition to their upper teeth. Botox can be placed in a vestigial muscle (seen in some people) called the depressor septi nasii to prevent the tip of the nose from moving downward when smiling. Botox can be placed just under the jawline in what is called the Nefertiti lift to relax the platysma muscle which pulls down on the lower face, thereby improving jawline definition. When placed lower in the neck Botox can address vertical neck bands.

Myth: Botox will leave me with a frozen face.


Many people are concerned about how their appearance will change after a Botox treatment. This is understandable given the amount of both positive and negative publicity there has been around Botox and other cosmetic treatments. Although results are visible, treatment with Botox does not make you look like you had work done. The muscles causing the frown lines are relaxed, so you can still have expressions, just without the wrinkles. When done properly, Botox will provide a natural appearance that makes a person look more youthful and rested. With the increase in popularity of Botox treatments many offices now provide such treatments. It is important to find an office where the injector has experience and expertise in Botox injections. Look for experience, before and after photographs, and testimonials.

Myth: If I stop using Botox, my face will look different than before.


A common misconception is that if Botox treatments are discontinued the wrinkles will look worse than they did prior to starting the treatments. When Botox treatments are discontinued the treated muscles are no longer relaxed and they are able to contract normally as they did prior to starting the Botox treatments. When this occurs, the wrinkles will begin to reappear and will look as they did prior to Botox treatments. This usually takes three to four months.

Myth: Botox treatments are painful.


One of the most common questions regarding Botox is whether the treatment is painful. We use a painless technique to maximize our patients comfort during the treatment. This starts by reconstituting the Botox with preserved saline, which contains benzyl alcohol, to decrease the discomfort with the injection. We use a tiny needle, similar to the size of the needle used for TB test on the forearm. During the Botox treatment, we provide a relaxing environment by playing a calming video with gentle music. We provide stress balls to our patients to hold during their Botox treatment. We apply cold air on the area which serves to numb the skin. We also use the Beauty Bar, which is a vibration device which distracts the patient from the injection of Botox itself. Finally, with experience, we have developed a technique to inject to minimize pain. This includes pinching the area, pushing the skin into the needle (as opposed to pushing the needle into the skin), using a slight rotation, and using gentle pressure. Most patients are surprised at how comfortable the Botox treatment is.

Painless Botox Treatment Demonstration

Myth: Botox can cause Botulilsm.


Botox was originally obtained from the bacterium Clostridium botulinum, the bacteria that causes botulism. These bacteria can be found in certain foods that are not properly preserved. When it is ingested the bacteria multiplies and spreads through the bloodstream releasing a protein called botulinum toxin, the active ingredient in Botox. As the bacteria multiply more and more of the toxin is released. The botulinum toxin attaches to the nerves on large muscles such as those responsible for breathing or those in the limbs. This makes it difficult to breath and perform activities such as walking. The live bacteria are required to multiply and continue releasing large amounts of the toxin. In the absence of the bacteria, as when Botox is used for cosmetic purposes, more toxin is not produced. Also, the number of units used for cosmetic Botox treatments is miniscule compared to the amount required to produce effects such as difficulty breathing. Finally, the minute amount of Botox used in cosmetic treatments is not enough to pass into the bloodstream and spread to other muscles, as evidenced by the lack of systemic side effects.

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

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