The Good and The Bad Of Botox

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!

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