What is Botox?
Botox injections are still the number one cosmetic procedure in the U.S. with millions of treatments performed annually. Botox safely relaxes those muscles that create unwanted dynamic wrinkles and lines in the face (lines seen with expression). If treated early, Botox can prevent these dynamic lines from progressing to static lines and wrinkles (seen at rest without expression) which will then also need to be filled. Believe it or not, most people are unaware of some the many benefits of Botox injections including its uplifting, anti-gravity effect on the face and neck.
It seems like everyone is offering “Botox” treatments these days. You can find discounted treatments in your hair salon, spa, doctor, and dentists’ office. Results however can’t compare to that obtained by a highly skilled injector. We have all seen examples of bad and fake Botox results in the media and Hollywood. Obtaining long lasting natural results requires both artistry and attention to details. In addition, not all Botox products are real or the same. Treatments using real Botox by an advanced injector can be eye opening — both figuratively and literally. There is a reason why Dr. Rubinstein is ranked in the top 1% of injectors nationally and is one of the most sought after clinical trainer on advanced Botox injection techniques. He has trained hundreds of dermatologists and plastics surgeons.
Below is a list of many of the conditions Botox can treat. Most Botox injectors tend to focus primarily on the lines of the upper face (more basic treatments) and are not familiar with many of the more advanced injection techniques.
Botox Wrinkle Treatments (Beginner)
- Frown (eleven) lines (Procerus and Corrugator muscles)
- Horizontal lines in the forehead (Frontalis muscle)
- Crow’s feet (Orbicularis Oculi muscles)
Although the upper face is not as advanced of a treatment area, inexperienced injectors will commonly cause the brows to over arch (“Spock brows”) or to drop causing hooding of the upper eye lids. Ptosis, which is the inability to fully open the eyelid, can also occur. Partial results will create persistent frowning. Over treat and you risk the frozen, expressionless look.
Botox Lifting and Contouring Treatments (Advanced)
- Lip wrinkles (Orbicularis Oris muscle)
- Under eye wrinkling (micro droplets in the Orbicularis Oculi muscles). This can also help open the eyes making them appear larger.
- Chin dimpling –orange peel appearance (Mentalis muscle)
- Jaw line shaping (Masseter muscle)
- Lip lift (Depressor Anguli Oris muscle)
- Eye and brow lift (brow depressor muscles)
- Nose drooping (Depressor Septi muscle)
- Nostril flaring (Nasalis muscle)
- Neck banding (Platysma muscle)
- Neck lines (Platysma muscle)
- Gummy smile (Levator Labi muscles)
- Excessive sweating
Q&A Botox Injections
What is the cost of Botox treatments and why do some doctors charge by the unit vs. the area?
Dr. Rubinstein finds that it is in the patient’s best interest to charge by area rather than by unit. Many of his patients have four or five sites injected including the more advanced treatment areas. Having multiple areas treated doesn’t mean it will produce a frozen-like effect. He also finds that using more units, for example, in the frown lines and crow’s feet increases the duration of effect. Doctors who charge by the unit tend to under treat in an effort to bring down the cost for their patients who think they are getting a good deal when in reality they are seeing less results which don’t last as long. Botox Cosmetic is still the gold standard and is therefore more expensive than Dysport and Xeomin which are also FDA approved and commonly used. Make sure your doctor is using Botox Cosmetic if they are advertising lower priced “Botox injections” and not another product. Both optimal and Maintenance of your results will increase the efficacy and duration of future results — longer duration means lower cost over time. You will also receive additional savings in your subsequent treatments because Dr. Rubinstein’s practice participates with Brilliant Distinctions, an Allergan (maker of Botox Cosmetic) discount program. You also will earn points within his practice — 5% on all services and surgeries that can be applied towards your future treatments.
Is Botox safe?
The risk of complications are very low when real Botox is both dosed and injected properly. The use of illegal fake Botox is rampant usually resulting in suboptimal results. Severe complications from fake Botox including death have been reported. Botox Cosmetic, (manufactured by Allergan) continues to be the gold standard in the United States and has been used safely in millions of patients over the past 25 years.
What are some potential Botox risks?
The most common side effect is mild bruising. This is can be prevented by avoiding the medications listed for you on our “Meds to Avoid list.” Dr. Rubinstein also uses a very small 31 gauge needle which is less likely to cause bruising. Eye lid droop, also known as ptosis, is rare in the hands of an experienced injector. This can be treated with Visine eye drops. Flu like symptoms and headaches are also rarely reported.
What to expect during your Botox injections?
There is minimal to no discomfort. Dr. Rubinstein minimizes discomfort by using the smallest available needles for the injections. Botox is packaged freeze dried and needs to be dissolved in saline (sterile salt water). Dr. Rubinstein uses a special type of saline that takes the sting out of the injection. Applying ice to the area just before the injection further minimizes any discomfort. Although numbing cream is not necessary, applying numbing cream 30 minutes prior to the injection (ordered through Dr. Rubinstein’s office) makes the injection pain free.
What to expect after your Botox injections
Typically, there is minimal to no bruising. There is no pain after the injections are completed. You will begin to see results after three days with final results by the tenth day. Results last on average four months. The first few treatments, it may last closer to three months but with subsequent treatments, it will last longer and longer. A recent study showed that after two years, Botox can last up to four to six months. This can only be accomplished when higher unit dosages are used in each area. Less units per treatment area equals less short term cost, therefore shorter duration/reduced results. Whereas, more frequent treatments can give you greater long term cost and longer lasting results.
Are there any restrictions after Botox injections?
Do not exercise, bend down (touching your toes), or massage the injection sites the day of the treatment. Dr. Rubinstein doesn’t believe that you have to sit upright for six hours. Normal activity can be resumed immediately.
Is a follow up visit required after Botox treatments?
A two week post injection follow up is encouraged after your first treatment with Dr. Rubinstein. This can be done in person as well as by sending a brief video from your mobile device with you making different facial expressions including smiling, frowning, lifting your eye brows, pursing your lips, tensing your neck, and trying to show your teeth. Dr. Rubinstein can determine if there is a need for a dose adjustment (higher or lower) after your first treatment. An additional benefit of being charged by area and not by unit is that there is no additional fee for a touch up at the two week mark.
Can I prolong the duration of my Botox results?
Your first treatment typically will last on average three months. Subsequent injections will last longer averaging four months especially if a higher amount of units are used in very expressive areas. There tends to be a prolonged effect over time especially if subsequent injections are performed prior to complete loss of the effects. Injecting Botox too frequently can have the opposite effect potentially resulting in your body producing antibodies against the Botox resulting in a diminished effect. Some studies have shown that zinc deficiency can decrease the duration of effect. A zinc supplement, called Zytase, can be taken 4 days before treatment. No prescription is needed and it can be purchased online.
Am I too young for Botox?
At times, Botox can be very helpful for some twenty somethings and certainly those in their early thirties who are already beginning to show fine lines, and can prevent the development of wrinkles. This is more typically, for fairer skinned individuals (lighter-skinned Caucasians).
Am I too old for Botox?
Botox provides the benefit of looking better immediately when you frown, smile, etc. If lines have already become etched into your skin, Botox can help prevent them from getting worse if not slightly improve them over time with consistent usage. Another therapy to smooth out lines such as dermal fillers with or without laser skin resurfacing can be used to eliminate these types of wrinkles. After the etched-in wrinkles are improved, Botox can then help to prevent the wrinkles from becoming etched in again.