Botox (also called botulinum toxin injections) is a liquid neurotoxin injected directly into the muscle to treat frown lines, smile and squint lines, nasal crunch lines, and horizontal forehead wrinkles. By relaxing the muscles of the face, these lines become less obvious. We are creating a more youthful, vibrant appearance.
Botox has been used to treat patients worldwide for medical and cosmetic reasons.
Botox is injected into the muscles of the face. The liquid is absorbed into the muscles near the injection site. Within two weeks it creates a temporary localized paralysis that lasts approximately 3 months.
BOTOX is most frequently used to treat:
-Severe Frown Lines
-Crow’s Feet (lines around the eyes)
-Horizontal forehead lines
-Chronic migraine symptoms
-Severe Forehead Lines
-Realaxing “Peach Pit” chin
-Nasal scrunch or squint lines
-Lines on the neck
Generally, it is used in small amounts in the lines around the mouth. This helps to relax the vertical lines around the lips. Dermal fillers can be used in those areas as well to remove unwanted wrinkles.
The effects of Botox generally last three months. Clinical trials have shown that pregnant women, people with autoimmune diseases, bruise easily, and those with muscle or nerve conditions are not good candidates for botox application. It is important to fully inform your dentist of all your medical conditions and all medicines you are taking.
Can any dentist inject Botox?
No. A dentist must be appropriately qualified and certified. Marielaina Perrone DDS is certified by the American Academy Of Facial Esthetics (AAFE) to administer Botox. As part of regular dental school education, dentists go through extensive training around facial anatomy, which puts them in a unique position to administer Botox.
It’s essential that you only work with properly qualified dentists who are qualified and certified to administer Botox to ensure that you do not suffer any avoidable complications due to incorrect botox use and administration, such as drooping eyelids and muscle weakness.
How To Prepare Before a Botox Injection?
Botox comes from the manufacturer as a crystalline substance, which has to be reconstituted with saline. Your dentist will add varying amounts of liquid when reconstituting it. Although there is no right or wrong amount of liquid to add, most botox injectors add about 1.25 ml per 50 unit vial of botox is the standard.
Some botox injectors will add quite a bit more. This added dilution can lead patients to think they are getting more Botox when they get the same or less amount of Botox. The total dose of botox, not the volume of liquid, leads to the desired cosmetic effects.
Therefore, it is vital to choose your botox injector wisely. Some provide Botox at a specific dollar amount per unit, but they may dilute the Botox, thus not providing the agreed-upon amount. This dilution is like going to a concert and receiving a watered-down drink, but the costs are much higher for Botox.
What Happens During the Botox Procedure?
The patient is placed in a somewhat raised position in the dental chair, and the areas to be injected are cleansed with a makeup remover wipe and a sterile alcohol pad. Dr. Perrone will apply a topical anesthetic called Comfortox BLT (contains benzocaine, lidocaine, tetracaine). The Botox injections are applied to the desired areas (for example to treat frown lines).
Typical Botox application patterns include about five botox injections between and above the eyebrow area and then another eight botox injections across the forehead, along with four botox injections on the sides of the eyes. Dr. Perrone can inject more sites, depending on the type of wrinkles and the desired effect for the patient.
Dr. Perrone will commonly apply botox to the masseter muscles to relieve clenching, TMJ pain and narrow the face. It is pretty common for pressure to be applied if an area seems to be bleeding after the botox injection.
Immediately following the application of botox, we apply arnica gel. This gel will help prevent bruising and swelling following application. Patients are instructed to do the following after treatment:
-not work out or do anything that will cause them to sweat
-stay out of direct sunlight
-no showering that evening
-gentle ice on the face
-no manipulation of the face to move the Botox application
-no laying on face for the evening
What Happens Following the Botox Injections?
After the botox injections, the patient will usually lay upright or semi-upright in the dental chair for about two to five minutes. This is to ensure the patient feels good after the application of botox. Important for the patient to avoid taking over the counter medicines like aspirin, ibuprofen, or naproxen before or after the botox procedure. Taking any of these medicines can lead to increased risk of bruising.
Next Steps on Botox
Botox injection results will be evident within three to seven days, with full effect in 2 weeks. You can take photographs before the procedure. This will allow patients to check their results themselves rather than relying on memory.
Before having the botox injections done, the patient must realize that Botox does not erase wrinkle lines but relax them. This means for the patient that deeper lines will become somewhat less deep, and superficial lines will virtually disappear.
It may be beneficial for the patient to have an additional cosmetic procedure, such as dermal filler substances (Juvederm dermal fillers) to flatten out the deep crevices that are now relaxed. Dr. Perrone recommends waiting two weeks following Botox application before having dermal fillers applied.
This will give you time to evaluate areas that need additional help for optimal results. The crease area between the eyes and around the lips is ideal for Botox use in conjunction with Volbella dermal filler as these fixed wrinkles do not always respond to Botox alone.
Side Effects of Botox
Side effects include:
-eyebrow or eyelid droops or lift
-a temporary headache
-uneven facial expression
-rare flu-like symptoms.
Many of the side effects for Botox are seen when:
-injected by an unskilled practitioner
-area of injection not cleaned properly
Even though they are rare if you have any serious symptoms, contact your dentist as soon as possible.
With Botox, there are good cosmetic effects and possibly unappealing side effects. When botox is applied correctly, your dentist should customize it for each person’s face. The practitioner must consider the facial muscles used the most, a person’s job, facial features, and personal desires and preferences.