The Surgeon Minute

It Still Doesn’t Get Better Than Botox

It Still Doesn’t Get Better Than Botox

Whether you are male or female, in your 20’s trying to prevent wrinkles, or in your 70’s trying to reverse wrinkles, Botox is a popular, dependable non-surgical anti-aging treatment option.  

Botox is so universally beneficial, Boston-based board certified plastic surgeon Dr. Brooke Seckel refers to it affectionately as, “Mother’s Milk.” Why? Because, he explains, “Botox is safe, benefits just about everybody, and, the younger you are when you start, the more beneficial it will be for you.”

Botox Treats & Prevents Wrinkles

In order to understand how Botox works, it is important to understand a little bit about how wrinkles form. There are two types of wrinkles: dynamic and static. When facial muscles are active, dynamic lines appear temporarily. When you frown, for example, dynamic wrinkles will appear in the skin between your eyebrows. Squint, and dynamic wrinkles appear at the corners of your eyes.

Botox - dynamic vs. static wrinkles.

Strong facial muscles create visible changes in the skin above the muscles. Botox works by relaxing the muscles of the face. “Botox weakens the muscles that cause our frown lines and our crow’s feet,” explains Dr. Seckel. “If you don’t do Botox, those lines become permanent, static lines.”

In our younger years, when we stop frowning and squinting, dynamic wrinkles vanish when facial muscles relax. Somewhere in our 20’s or 30’s, our skin quality begins to go downhill. Aging, sun damaged skin loses collagen and elasticity. It also loses the ability to bounce back from dynamic wrinkles.

As a result, these repetitive dynamic wrinkles become etched in the face as static wrinkles. Then, even when we’re not actively frowning or squinting, frown lines and crow’s feet are still visible. No one likes to look like they are angry all the time, but static frown lines have that affect.

“If you have Botox when you’re younger, before you form those static lines, hopefully you never form them,” explains Seckel.

Botox Is Temporary

On average, the effects of Botox injections last three to four months. As the muscle relaxing properties of Botox wear off, dynamic wrinkles will begin to re-appear. With Botox, maintenance is key to long term wrinkle prevention.

Is Botox Painful?

Nobody likes to get poked with needles, but the good news is the needles used to inject Botox are extremely thin. In addition to tiny needles, there are several steps that can be taken to minimize discomfort felt during injection.

“Botox should not be painful,” says Seckel, who uses both a topical numbing cream and a cold titanium roller to ensure the injections do not hurt. “The topical cream works on the skin and the cold works on the deeper nerve fibers in the muscles.”

Less painful Botox injections.

When a patient first arrives for Botox treatment, the topical anesthetic is applied and takes about 15-20 minutes to properly numb the skin. After the skin is numb, the cold roller is used just prior to injection to numb the nerves below the skin.

Will I Bruise?

There are thousands of tiny blood vessels in the area surrounding the eyelids and the eyes. When Botox is injected, it can be very difficult to miss these vessels entirely, meaning bruising is always possible.

Cooling the area prior to treatment does more than just numb the skin, it also helps to constrict the blood vessels, making bruising less likely. Immediately following the injection, Seckel applies pressure and a cold pack to further reduce the risk of bruising.

A Better Way to Botox

Dr. Seckel is board certified in plastic surgery and neurology; his in-depth understanding of muscles, nerves and facial anatomy have led him to take a unique approach to Botox injections.

Allergan, the makers of Botox, recommend in training materials that injectors use five main spots of injection in the forehead in order to treat the frown lines. Dr. Seckel, on the other hand, prefers to use only one, sometimes two injection sites to maximize proper placement of the drug into the muscle.

Botox maker - Allergan.

“If you inject the way most people do, sometimes you’re not even hitting the muscle,” says Seckel. “You get a better, longer lasting result with Botox if you make sure you have the Botox intra-muscular, inside the muscle.”

To locate the ideal injection site he asks the patients to frown. “I look at the point of maximum contraction. That tells me where the motor end plate is – that’s where the nerve is coming into the muscle,” he explains.  “I slide into the muscle, inject as I pull out, and do the same thing to the other side.”

By limiting injection sites and targeting the proper muscle, Seckel is also minimizing the risk of sagging eyelid, a condition that can occur when Botox is injected outside of the proper muscle and migrates to other muscles, causing eyelids to droop or sag.

Botox by and large continues to be a miracle compound that can produce incredible results. The results are dependent on the injector, so make sure yours is an expert.

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