Botox^® Cosmetic Injections

BOTOX^® Cosmetic is a minimally invasive injectable made from botulinum toxin, which is produced by a bacterium called Clostridium botulinum. BOTOX^® injections represent the most commonly performed type of cosmetic procedure today, with millions of people receiving injections every year.

Although BOTOX^® is mainly associated with treating facial wrinkles, this is a highly versatile procedure that can be beneficial for many other types of conditions. It is used in small doses to improve the appearance of wrinkles and address other types of cosmetic or medical concerns.

To understand how BOTOX^® works, you first need to know the different types of facial wrinkles. Many of the most common wrinkles are linked to our repetitive facial expressions. Each time we move our face during facial expressions—to communicate emotions such as smiling or frowning—or when we’re talking or even chewing, the skin attached to the muscles is being stretched and squeezed.

As we age, our skin loses some of its strength and elasticity. Eventually, it cannot snap back into place as easily as it once did, and wrinkles become more pronounced. Examples include crow’s feet at the outer corners of the eyes and frown lines between the brows. These wrinkles appear during our facial expressions when we convey emotions such as happiness, sadness, anger, fear, joy, and worry.

On the other hand, some wrinkles result from a loss of volume and elasticity in the skin, the force of gravity, or other causes. These wrinkles are always visible on the face and are known as static wrinkles. These cannot effectively be treated with BOTOX^® or other wrinkle relaxers.

Botulinum toxin, which is the active ingredient in BOTOX^®, has an effect on the nerves and causes muscles to stay at rest, making it effective for treating dynamic wrinkles. BOTOX^® is injected directly into certain muscles and blocks the release of a chemical messenger or neurotransmitter called acetylcholine. By temporarily forcing certain facial muscles to remain at rest and preventing them from moving for a limited time, dynamic wrinkles remain less visible.

BOTOX^® is primarily used for wrinkles on the upper third of the, face such as the forehead and around the eye area. The injectable is FDA-approved for moderate to severe frown lines, forehead lines, and crow’s feet.

BOTOX^® was originally used in the 1970s as a treatment for certain medical conditions like strabismus (crossed eyes), but researchers and doctors noticed that it also had the effect of softening wrinkles on the glabella, which is the area above the nose and between the eyebrows. In 2002, it was approved by the FDA for cosmetic use in the treatment of frown lines, also known as glabellar lines or “elevens” between the eyebrows.

BOTOX^® can be an excellent choice for patients over the age of 18 who want to address specific concerns, such as frown lines, forehead wrinkles, and crow’s feet. It is not recommended for patients who are pregnant, are nursing, have certain medical conditions that affect the muscles, or are allergic to ingredients contained in BOTOX^®. It’s important to maintain a positive outlook and realistic expectations for how your skin can be improved. BOTOX^® won’t change the basic bone structure of your face, but it can make the skin appear smoother and more youthful.

At Cosmetic Surgery Institute, our goal is to help you look and feel beautiful—however you define it. For some people, this may translate to a very subtle enhancement; for others, a more dramatic change is desired. Our dedicated nurse specialist will listen carefully to your concerns in order to craft results that align with your personal concept of beauty.

We believe that the results of any injections are only as good as the provider, and our nurse Adrienne is a talented and experienced injector. Men and women searching for BOTOX^® Cosmetic or dermal filler injections from as far as the East Coast travel to Cosmetic Surgery Institute in the Los Angeles area to seek out her services. Adrienne frequently holds training clinics in our office, where practitioners from all over California come to learn her techniques.
To view real results from some our patients, visit our photo gallery.

Prior to your injection session, you may be asked to avoid alcohol and anti-inflammatory medication for one to two weeks. This helps to reduce bruising. If a topical anesthetic is requested, your injector will first apply the ointment to the treatment area. Then, using a very fine needle, small amounts of BOTOX^® will be injected into the appropriate location. The procedure typically takes only a few minutes, and discomfort is minimal.

You can return to your day right away after your treatment. Some people may experience slight bruising, redness, or puffiness at the injection site. These side effects are minor and should dissipate over the next few days.

During this time, muscle activity in the treated area will decrease, causing the skin to appear smoother and more youthful. This effect should last for approximately four months, and the treatment can be repeated.

It’s important to remember that BOTOX^® doesn’t work as soon as it’s injected, so don’t panic if you aren’t seeing your desired results right away. It will usually take a few days for you to begin to see the effects of BOTOX^®, and the final results will show within 10 to 14 days. The reason for this delay is that it can take time for the messages to be cut off after the product binds at a connection point between the nerves and muscles.

Patients will tend to see faster results when the injectable is used for finer lines, so it may take a longer time to see the full results for deeper or more etched-in wrinkles. The effect will vary depending on the concentration of the product and the way it’s injected.

BOTOX^® is a temporary treatment, so you can have “maintenance” treatments after it wears off if you want to preserve your results. Higher doses of BOTOX^® will typically have a longer lifespan. If you are hoping to make the most of your investment, there are several ways to help preserve the effects for as long as possible. It’s recommended that patients wear sunscreen daily, practice sun safety in general, and avoid smoking. Maintain healthy skin with a good skincare routine that includes products such as retinol, hyaluronic acid, peptides, and antioxidants. Also, be consistent with maintenance injections.

To reduce facial aging, BOTOX^® Cosmetic is frequently injected between the brows (to address frown lines), around the eyes (to address crow’s feet), and on the forehead (to address horizontal forehead lines). It is not recommended for under-eye bags or puffiness, or for the correction of “laugh lines” in the outer corners of the mouth and cheeks (also known as nasolabial folds). For these concerns, a dermal filler such as JUVEDERM^® is a better option. This is because contour changes and laugh lines develop mainly due to volume loss. BOTOX^® does not add volume to the skin, but temporarily reduces a targeted muscle’s ability to contract properly. By keeping the muscle at rest, related wrinkles are less likely to be visible.

BOTOX^® can also be used to reduce excessive sweating on the palms, under the arms, or on the soles of the feet. Some people may also benefit from injections near the temples to reduce migraine headaches.

When used together, BOTOX^® and fillers can provide substantial improvements in facial rejuvenation. Many of our patients combine these treatments in a “liquid facelift” procedure for the temporary reduction of signs of facial aging—including skin laxity—without surgery.

Because Cosmetic Surgery Institute uses a very fine needle for BOTOX^® injections, there is very little discomfort associated with the treatment. Most of our patients report a pain-free procedure. No anesthesia is needed, and mild discomfort is easily addressed with over-the-counter pain medication. Some patients may request a topical anesthetic if necessary.

An expressionless appearance is typically the result of poor injection techniques, such as when the product is injected into the wrong muscle, injected unevenly, or over-injected. This risk can be greatly reduced by choosing a qualified and experienced injector.

Although treatments will make you look less expressive, you should still maintain natural looking facial expressions. It’s often better to start slow and have more subtle treatments if you’re new to the product. Our nurse at Cosmetic Surgery Institute, Adrienne, is a highly trained and skilled BOTOX^® provider whose trusted injection techniques are sought out by professionals across California. She will discuss with you the appropriate number and placement of injections to ensure the most natural results.

The results of BOTOX^® injections are often enhanced with injectable treatments such as JUVEDERM, Restylane^®, or RADIESSE^®. Many people also use it to better maintain the results of their facelift or in conjunction with laser treatments for more complete results.

Cosmetic Surgery Institute also offers Dysport^® and Xeomin^®, which are injectables that work the same way as BOTOX^®, but have unique characteristics that set them apart. Collectively, the three muscle relaxers are known as “neuromodulators.” Your injector can help you to determine which specific injectable would work best for you at your consultation.

For additional videos on specific procedures and the practice, please visit our video page.