As the most common non-surgical cosmetic procedure in the United States, Botox is used to treat wrinkles, uncontrolled blinking, facial creases and amblyopia (or lazy eye). Botox injections also treat patients who suffer from excessive underarm sweating by calming the muscle that activates sweat glands. It has also been shown to reduce self-reported depression and chronic headaches.
Here at Raval Facial Aesthetics and ENT, we use both Botox and Dysport, a similar product from a different manufacturer. Dermal fillers we use include Restylane, Restylane Silk, Restylane Lyft, Juvéderm, and Voluma. All of these can help reduce the appearance of fine lines and wrinkles, although certain products work better for deeper folds and some are formulated specifically for the lips or cheeks.
The Science: How Botox Works
Botulinum toxin is a neurotoxic protein produced by the bacterium Clostridium botulinum. Selective muscle denervation describes the action of the toxin. Under normal conditions, a nerve sends a signal to the muscle to make it contract. The nerve meets the muscle at the neuromuscular junction that releases a chemical component, acetylcholine. The release of acetylcholine causes several chemical reactions that result in muscle contraction. Botulinum toxin works by blocking the acetylcholine receptors on the muscle side of the junction, meaning that when acetylcholine is released, it will not bind to the muscle, and thus the muscle will not contract. The muscle is essentially paralyzed, though not as a result of nerve damage.
Botox and Wrinkles
The injection of Botox into a muscle that causes wrinkles when it contracts results in its paralysis, thus reducing the appearance of the wrinkles. The effects are more pronounced for dynamic wrinkles that only appear when the muscle contracts. It works to relax the contraction of muscles by blocking nerve impulses so that the wrinkles soften and relax. Botulinum toxin does not get rid of wrinkles, it only helps soften them and reduce their appearance.
As with any procedure, your safety and your results depend on the person performing the procedure. Skill that comes from quality training and experience is your first line of defense against potentially negative side-effects or permanent nerve damage. Dr. Jeffrey Raval and our medical aestheticians are well-skilled in the treatments we offer, and our office meets the highest standards when it comes to safety and sanitation, as well as comfort.
When Will You See The New You?
Restylane injections produce virtually immediate results. You may start to see results from a Botox injection within 48 hours, though for most patients visible results start to appear in 3 or 4 days. It can take up to 2 weeks to see the full effect of any injections, once your muscles have relaxed.
Not surprisingly, results are noticeable sooner with fine lines such as early crow’s feet, than for deep wrinkles and folds on the forehead or between the nose and mouth. There is no set time frame, because everyone’s facial structure and skin are a bit different.
How Long Will Your New Look Last?
Botox and fillers do not permanently change your face. They are all biodegradable, meaning they are slowly absorbed by your body so the effects are not permanent. Most treatments last 3 or 4 months, though Restylane and Juvéderm typically last 4 to 6 months. Voluma can last for up to 2 years. Just as it takes a little longer to see results when your target is deep folds or wrinkles, results may not last as long for these deeper lines. Fortunately, you can repeat Botox and dermal filler treatments as the results begin to diminish. Over time, because the injected muscles are flexing less, they begin to atrophy, meaning most patients are able to extend the time between “refresher” treatments.
Does Denver Altitude Have an Impact on Botox Results?
Anyone who has spent much time in the Denver area knows that our high altitude has a distinct effect on certain things. For example, visitors and new residents sometimes find that our thin air makes it harder to breathe until you’ve acclimated. So it’s only natural to wonder if our altitude might have an impact on skin improvement treatments such as Botox.
The good news is that high altitude has no bearing on whether you’re a good candidate for Botox injections and it does not impact results. However, Denver’s altitude can definitely affect your skin’s appearance. High altitude means more of the sun’s damaging ultraviolet rays are able to penetrate, shining directly on exposed skin. Those invisible UV rays are always there, whether it’s sunny or not, no matter the season.
If you’re going to invest in skin enhancement procedures, such as Botox injections, you’ll want to do everything you can to achieve the best possible, longest-lasting results. That means protecting your skin from the sun and wind with some simple solutions:
- Wear a hat that shades your face from the sun
- Always apply sunscreen with SPF 30 or higher before you go outdoors. Be sure the product guards against both UVA and UVB light.
- Moisturize: sun, cold and wind all dry the skin, making it more susceptible to wrinkling and giving it a dry, chapped or reddened appearance.
- Hydrate: your entire body needs plenty of moisture to stay healthy and keep your skin in good condition. Drink plenty of water to stay hydrated.
- Use only top-quality skin care products that contain essential, proven ingredients.
- If you’ve received a Botox treatment, maintain your best results by scheduling renewal treatments every 3 to 6 months.
Botox Procedure Side Effects
With a board-certified injector, Botox treatments are one of the safest youth-enhancement options you will find. Negative side effects are very uncommon, but for a small group of patients, temporary bleeding and mild bruising can occur. Here at RMLA, we use extremely fine needles to inject Botox and dermal fillers, so our patients rarely experience bruising or bleeding. If that’s going to happen, it will happen immediately and we use an ice pack to reduce swelling and simple pressure to stop injection site bleeding. We add a touch of lidocaine to the filler, which thins it slightly. This reduces post-injection numbness as well as the chance of bruising, and it provides smoother long-term results.
Less common, but possible side effects are an asymmetric appearance from one brow to the other or drooping of the upper eyelid. Even the most common Botox side effects can be avoided by choosing a highly trained Injector. Using a thinner needle for injection as well as formulating a compact injection solution are both ways to avoid common side effects.
Frequently Asked Questions About Botox
Below are some commonly-asked post-injection questions and what we recommend here at Rocky Mountain Laser Aesthetics.
Do I have to move the muscles the Botox was injected into?
No. Here at RMLA, we use a very high concentration of Botox, which means the volume injected is much smaller. That minimizes any potential movement.
Can I lay down after Botox?
Yes. Some sources will suggest you should remain upright for several hours or elevate your head for the first couple of nights, so the Botox or filler can “settle” and remain in place. The truth is, studies have shown that you can do whatever you want without causing any adverse effects.
Can I apply makeup, wash my face, or apply any creams after Botox and fillers?
Sure. We often refer to Botox and filler injections as “lunch hour” treatments because there is no downtime. Appointments are very short, and afterward you can reapply your makeup and head back to work. We do recommend that you not over-massage your face for the first hour or two. Using gentle strokes will help keep creams or makeup from penetrating the injection site(s).
Can I get a massage or a facial after Botox?
It’s best not to massage your face too much right away so if you’d like to get a facial too, just schedule that before your injections.
And a massage? It’s perfectly OK to lay down after Botox or filler injections and there is no risk that your treatment results will be “scrunched” by the massage table facial ring.
Can I exercise after Botox or fillers?
Yep. Botox and fillers are entirely lifestyle-friendly. You can safely do whatever you want.
What if there is a bump from Botox or fillers?
Occasionally, patients may see a visible bump or feel firmness where Botox or the gel filler has been injected. This is not “misplaced” product that needs to be “massaged into place.” Rather, it is most likely a deeper bruise that will go away on its own in a few days.
Combining Botox with Other Treatments
Botox and dermal fillers compliment many other skin rejuvenation procedures because they work in different ways. You can combine Botox with treatments such as:
- Dermal fillers
- Chemical peels
- Laser and Intense Pulse Light (IPL)
- PRP or PRFM
- Certain skin care products
At RMLA, we know you want improvement, but strictly natural-looking results. We also know that time is a precious commodity for most of us these days. Happily, most minimally-invasive skin treatments take only a few minutes, and often there is little or no downtime required afterward.
To make things even more convenient, you can get Botox on the same day – during the same appointment – as laser skin treatments, chemical peels, etc. Dermal fillers and Vitrase (a product that dissolves filler) can also be combined nicely with other skin treatments, but they cannot be administered on the same day.
Proper Treatment Order is Crucial: Get a Consultation
Along with administering treatments in proper order during each appointment, we will recommend the safest and most effective schedule of repeat sessions as well. Because they work incrementally, Botox and most other skin treatments require multiple applications to achieve the best possible results. Let us help you create a strategic plan to address all of your concerns – short term and long-term so you get maximum results, most efficiently and affordably.
A one-on-one visit is the best first step toward skin improvement. It gives us a chance to discuss in detail your aesthetic goals and concerns, examine your skin first-hand, and then recommend the best procedure(s) and timing to achieve the results you want. Botox is a popular and safe treatment option for reducing the appearance of wrinkles and fine lines. Schedule a consultation today if you’re ready for younger looking skin.