Maximizing Botox for Your Face

By Lance Barazani, M.D., F.A.A.D,

When a Canadian eye doctor happened upon the furrow-erasing effect of Botox, she never looked back: “I haven’t frowned since 1987,” she remarked years later. This is no surprise: When it comes to Botox, she’s hardly alone in her satisfaction.

I’ve been using Botox to help patients resolve their wrinkle woes since the novel ingredient first made its appearance as an anti-ager.

In the beginning, the smoothing power of Botox was an unexpected bonus: The frown-free Canadian ophthalmologist had been using the muscle inhibitor to reduce patients’ eye spasms when a client returned for a follow-up – not for her eyes but to maintain her newly smoothed brow.

In 2002, the Food and Drug Administration approved the injections for cosmetic use in the United States. Since then, Botox has boomed, becoming the country’s go-to non-surgical anti-wrinkle procedure.

In 2018, the numbers climbed to 7.4 million, making Botox far and away the most popular minimally invasive cosmetic treatment, according to the American Society of Plastic Surgeons. Safety, efficacy, and patient satisfaction have added up to increasing demand.

The injections work by introducing tiny amounts of botulism toxin (the scary-sounding scientific name for Botox) to block nerve impulses that trigger muscle movement – and the wrinkles that they cause. These are what we consider “dynamic” wrinkles – wrinkles that form due to repetitive facial movements, like smiling, frowning, and squinting

Right now, for cosmetic use, there are four branded formulas on the market: Botox®, Dysport®, Xeomin® and Jeuveau®. A doctor’s knowledge base for each product’s specifications is crucial.

Plus, ongoing research is shining light on new ways of using Botox,’expanding its potential to address wrinkle zones.

With that in mind, here are my suggestions to make the most of Botox.

5 Tips to Boost Your Botox

1. Choose your doctor carefully:

   The face has more than 40 muscles, and each individual has unique muscle mass, bone structure, and skin characteristics. To make the most of Botox, it’s important to work with someone with expertise who can truly customize your treatment.

2. Remember: Location, location, location:

   Botulinum toxin works by limiting the muscle movements that cause dynamic wrinkles. That’s where we want to target the treatments. On the other hand, photoaging – wrinkles caused by the sun – is a different category. Make sure that you have a clear understanding of what’s causing your wrinkles and the best treatments to address them.

3. Expand your target:

   Botox can address more than forehead wrinkles and crow’s feet. For example, the dynamic wrinkles that develop around our mouths may also be good candidates. But we want to keep in mind that the lower section of the face has complex muscle structure, so it’s important to choose one’s doctor carefully, and perhaps start with a limited dose. More can be added later.

4. Consider a “combo”:

   Integrating treatments can create a complementary boost. When Botox is combined with steps to increase collagen and hyaluronic acid – important supports that keep our skin smooth and firm – the combined approaches can enhance each other.

5. Customize your follow-ups:

   Typically, Botox lasts three to six months. But with ongoing treatments, patients may start to see longer-lasting effects. Staying flexible about follow-ups can help maintain a consistent, natural look.

After almost two decades, Botox is fresher than ever, thanks to advances that keep moving the needle forward.

Lance Barazani, M.D., F.A.A.D., is board-certified in dermatology and specializes in all areas of medical dermatology for adults and children, the prevention and treatment of skin cancer, cosmetic dermatology and laser surgery.  

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. www.advanceddermatologypc.com.