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Exceptional Dentistry Las Vegas and Henderson NV Since 1999.

Dental Implants, Teeth Whitening, Porcelain Veneers, &
Botox Cosmetic.

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Cosmetic surgery is an extremely popular specialty of medicine that has been growing quite rapidly for decades. Youth is associated with vitality and beauty. For many of us, aging is not an easy thing to do and we seek out help to keep us looking and feeling younger and more vibrant. When seeking out cosmetic surgery, many often overlook the role our teeth play in our appearance. As we age, our teeth become darker, get worn down, and may even change alignment. This can create not only cosmetic issues but functional ones as well. These functional issues can lead to Temperomandibular Joint (TMJ) issues, headaches, and muscle pain.

How Can My Dentist Make Me Look Younger?

As our teeth wear over time, it can result in a shorter looking face, longer looking teeth, and darker teeth. The resulting appearance may make some of appear to age prematurely. The breakdown can be caused by tooth erosion (high acid wear), attrition (flattening and fracturing due to grinding and oral habits), and abrasion (overly aggresive brushing), recession (loss of gum tissue making teeth appear longer) . The length and shape of our faces and teeth, as well as the position of the jaw are determined by the teeth, skeletal bones, and a person’s bite. So, when a person’s teeth wear down it will give the appearance of a shorter face. Pain and discomfort are often associated with wearing down of teeth and gums, as they become more sensitive, prone to increased fractures, and to development of TMJ and headache pain.

Your dentist can give you the ability to change all of this, allowing the patient to look more youthful while correcting dental issues.  The patients oral hygiene must be good and the mouth should be in a healthy state before any work can be completed.  This should include control of periodontal disease, removal of any loose teeth, addressing gum loss issues, ascertaining desired whiteness, and correcting dangerous oral habits, .  Great care must be taken while returning someone to their proper tooth height (vertical dimension) as it can create even more TMJ and headache issues if not done properly.

Some of the procedures involved in making you look younger include:

Porcelain Crowns. These crowns will give the cosmetic appearance most patients are seeking but also give the strength and stability to open one’s bite .  One type of strong porcelain which is used where teeth grinding has been a problem is a Bruxzir crown. When placed properly, a patient will begin to see an immediate improvement in their bite and in the cosmetic appearance in the skin around the face as wrinkles will lessen.

Porcelain Veneers. A staple of cosmetic dentistry but used in conjunction with porcelain crowns to lengthen and restore the length of front teeth. Porcelain veneers are less invasive and more conservative than porcelain crowns. For teeth that do not require a full coverage crown, porcelain veneers can adequately lengthen and reshape, and change the color of your smile.

Orthodontics. Limited or full orthodontics may be necessary to remove any bite issues that can cause undue stress or trauma to the teeth before new restorations are placed.

Dental Bonding. Used to restore any teeth that have been damaged by tooth decay, staining or slight wear. Dental bonding is a cosmetically pleasing option that will look very natural when completed.

Crown Lengthening. A surgical process to expose more tooth structure so that there is enough room to properly place a crown. This is often necessary in severe grinding cases.

Gum and Bone Grafting and Recontouring. Lost bone and gum tissue can often times be grafted to help regrow them. They can also be reshaped surgically to be healthier, easier to work with, and more cosmetically appealing.

Teeth Whitening. Many of our worn teeth are also dark and discolored. The color you desire to reach may require a dental whitening process, or simply a whiter color bonding restoration or a whiter colored porcelain restoration.


Cosmetic dentistry will change not only how your teeth function but how you feel about yourself. Many dentists often overlook the relationship between our teeth and our bite. If the bite is not in alignment, your teeth and face will never look and feel their best.

Botox is a liquid neurotoxin injected into the muscle used to treat frown lines, squint and smile lines, nasal crunch lines, and horizontal forehead wrinkles. ByBotox Marielaina Perrone DDS relaxing the underlying muscles, these lines become less deep and show less. Creating a more youthful appearance.

Botox has been used to treat millions of patients all over the world for medical and cosmetic reasons since its FDA approval in 2002. The liquid Botox is produced in a laboratory by a bacterium called “Clostridium botulinum”. It has been purified under very strict controlled laboratory conditions. 

Botox is injected into the small facial muscles, it stays in that area and does not travel to other areas of the body. The effects gradually wear off naturally over a 3-6 month period.  “Botox” is a brand name made by a company called Allergan. There are other forms of Botox now being produced by other companies. None have the history of effectiveness and safety yet that Botox and Allergan do.  

BOTOX is most frequently used for:

Gummy smiles

-Frown Lines 

-Lines around the eyes (commonly called crow’s feet)

-Horizontal forehead lines

-Nasal scrunch or squint lines

-Lines on neck

It is also used in small amounts in a number of other areas on the face. This depends on the way an individuals muscles of facial expression work. It can raise the outer part of the eyebrow if it is sagging, lift the corners of the mouth, make the lip appear longer to cover gummy smiles, and help to smooth out dimpled chins. Generally it is not used in the lines around the mouth, usually because it might be difficult to speak and eat. Dermal fillers can be used in those areas to remove unwanted wrinkles.

Marielaina Perrone DDS Before and After Botox

Before and After Botox Treatment

The effects of Botox generally lasts anywhere from 3-6 months. After a few treatments, it takes less and less volume of the Botox to maintain muscle relaxation. Botox should not be given to pregnant women, nursing mothers, or patients with neuromuscular diseases like myasthenia gravis, AML (Lou Gehrig’s), or motor neuropathy.  Patients with allergies to human albumin (different than an egg allergy) should not use Botox. It is not recommended in pregnancy or nursing because it has not been tested properly to ensure there is no harm to the child.

Side Effects of Botox

Side effects include bruising, eyebrow or eyelid droops,  a temporary headache, and rare flu-like symptoms have been reported. Many of the side effects that are listed for Botox are seen when large amounts are injected for medical purposes as opposed to the small amounts used for cosmetic purposes. Very rare allergic reactions have been reported.

Some of the cosmetic side effects include:

The frozen forehead – This is sometimes referred to as the “Oscar-Night Freeze.” This is when the face does not move at all. The person ends up looking like a robot. In the beginning, when working with frown lines, the corrugator muscle (the muscle that operates when people frown) may need to be completely relaxed, for a while. Once the frown line dissipates, though, it makes sense to adjust the Botox dose to allow for a little movement so that the expression looks natural. It can be easy to lose sight of the ultimate goal which is no wrinkles, not no movement.

One or both eyebrows pop up too much – This occurs when one or both eyebrows are elevated so much that the arch or the last third of the eyebrow sits up too high, giving a constant look of surprise. In addition, odd wrinkles can occur over the lateral brow. Usually this can be prevented or fixed easily with aBotox Marielaina Perrone DDS few strategically placed drops, if it happens.

Eyelid drooping – This is actually quite rare. Usually, it is the eyebrow that has dropped which in turn makes the eyelid feel heavy. If your eyelid is truly drooping after your Botox treatment, call your doctor. There are prescription drops that will temporarily help elevate the eyelid until the effects of the Botox are gone.

“My brow feels really heavy.” – This is the result of overuse of Botoxing the forehead, specifically the frontalis muscle, which goes all the way across the forehead and is used to raise the eyebrows. If too much Botox is used it relaxes the forehead too much, which results in a heavy feeling in the forehead area. When the forehead falls, so do the eyebrows. Since some of us raise our eyebrows to make the eyes feel more open when there is excess eyelid skin (called hooding), then dropping the eyebrows makes the eyelids look worse—or more hooded. This is where an experienced doctor comes into play. They need to evaluate correctly the amount the patient uses that specific muscle. 

Botox Conclusion

With Botox, there are good and possibly unappealing side effects. Proper Botox treatment is individually customized for each person’s face. The practitioner must take into account factors such as the facial muscles used the most, facial balance, a person’s job, and personal preferences and desires.

“Great Botox” application requires steady hands, the eye of an artist, and the innate ability to get it right.

“Good Botox” is where you get the standard four or five shots into your frown lines and you go on your way. It works perfectly well, but there’s not much customization. And the range of looks that these injectors can accomplish is limited. But if you have only some frown lines, a good Botox treatment can work perfectly fine for you.

“Ugly Botox” unfortunately this happens all too often. It is that completely unnatural frozen look.

The bottom line is, Botox treatment is not a cookie-cutter one size fits all procedure. In the right, it can create a marvelously natural look that makes you more refreshed and relaxed looking. In my opinion, the ultimate of Botox application is no wrinkles, not no movement!