Botox | Cosmetic Injectable
Botox is a naturally-occurring protein made by the bacteria Clostridium Botulinum. It is manufactured and purified by Allergan Pharmaceuticals and has been used for cosmetic procedures since 2002. Because Botox is a relatively large molecule, it cannot be absorbed through the skin like many creams and other beauty products. It must be injected by a physician/heath care professional with knowledge of anatomy, as well as appropriate depth and dose.
How does Botox work? Acetylcholine is a neurotransmitter responsible for communicating the desire for muscular contraction from the nerve to the muscle. Botox works by preventing the release of Acetylcholine. Thus, the signal to contract is never communicated and the muscle remains in resting form.
Botox has been studied and proven to be effective in the treatment of hundreds of overactive muscle disorders. It was first used therapeutically in the 1960s when an ophthalmologist discovered he could selectively target certain muscles of the eye and treat infants with strabismus (commonly referred to cross-eyed). It has since gained popularity in treating disorders of the esophagus, the bladder, and almost all skeletal muscles of the head, neck, torso, back and extremities.
Because acetylcholine is additionally the neurotransmitter responsible for sweat gland innervation, Botox can be used to treat excessive sweating, known as hyperhidrosis.
It can also be used in the treatment of migraine headaches.
Cosmetic procedures, however, are by far the most common use of Botox today. In fact, Botox is the most common cosmetic procedure.
The procedure is typically performed in a medical office. The patient tells the physician their areas of concern – typically the frontalis, the corugator supercilii, and the orbicularis oculi, which are more commonly referred to as forehead wrinkles, frown lines, and crows feet, respectively. A small amount of Botox is then injected at specific sites within these muscles.
Results typically take approximately three to five days to appear and last for approximately three to five months. The longer a patient has been receiving Botox injections, the less Botox they require. This is because the treated muscles decrease in size from inactivity and small muscles require less Botox than large muscles.
Botox is so effective because it is the only wrinkle treatment that targets the underlying cause of wrinkles — the muscle.
It all starts with a nerve telling a muscle to contract. This causes the overlying skin to scrunch up. With time and repeated contractions, the skin begins to thin at certain points and a wrinkle is born.
Think of the skin as a piece of paper. By folding the paper along the same crease over and over, you are deepening/reinforcing that fold and weakening the paper.
Now imagine if all of a sudden you cannot fold the piece of paper. Instead, you flatten it out and place it between two large books. With time the fold fades. That is the same mechanism by which Botox is able to prevent/decrease the wrinkles of the face. The big distinction in the analogy, however, is that skin is a living organ that is able to regenerate. So with time and good skin care, wrinkles virtually disappear.
Botox’s competition include topical creams, which simply do not address the source of the wrinkle, and plastic surgery, which is very invasive, painful and requires general anesthesia. This is why Botox has earned the reputation as the best anti-wrinkle treatment available and why 6.1 million people had cosmetic Botox in 2014, up 8 percent from 2013.
Sites of Injections
- Nasalis – the Nasalis muscle covers the bridge of the nose. Contraction of the Nasalis leads to elevation of the nose and the appearance of ‘bunny lines’. Botox can prevent this contraction and erase the bunny lines.
- Levator Labii Superioris Alaeque Nasi and Levator Labii Superioris – have you ever noticed when some people smile you see a lot of their upper gums? This is called a ‘gummy smile’. It is defined as a smile that shows more than 2 millimeters of upper gums and is the result of hyperactive levator labii superioris alaeque nasi and levator labii superioris. A little bit of Botox in the right anatomical area can soften the smile and keep the gums hidden behind the upper lip.
- Depressor Anguli Oris – the Depressor Anguli Oris is a muscle responsible for pulling down the corners of our mouth. As we age the corners of our mouths tend to drop and can give some patients the appearance of a permanent frown. Botox can help reverse this by paralyzing one of the muscles responsible for it. The results are a slight upturn of the corners of our lips and a softened appearance of the lower face.
- Mentalis – close your mouth and blow out inflating your cheeks. You may notice some dimpling of the chin. Some patients have these small dimples throughout their chin even when not making this face. They are the result of a muscle called the Mentalis and you guessed it, Botox can decrease their appearance.
We strive to be fair and upfront about our pricing. Unlike other Botox clinics, we promise no hidden fees. Consultation is free of charge meaning regardless if you decide to get Botox or not, you will not be charged for your visit. Transparency has always been our policy and you will only be charged for the Botox we inject.
Botox is $14.00/unit. You have our promise to always be fair and to always inject the amount agreed upon pre-treatment. The number of units is determined by the number of muscles injected, amount necessary for specific muscles, and relative size of an individual patient’s muscles. We usually recommend our patient buys their 100U bottles from us. This is to prevent cross-contamination.
Typical number of units are:
- Frontalis (forehead wrinkles) – Women: 8-12 units; Men: 10-14 units
- The Corrugator Supercilii (frown lines) – Women: 18-22 units; Men: 20-30 units
- The Orbicularis Oculi (crows feet) – Women: 16- 20 units; Men 18-24 units
- Masseter (grinding) – 50 units
There is no maximum or minimum number of units per patient.
Does getting Botox hurt?
All procedures at Clear Dental use 30-gauge needles. They are commonly referred to as insulin needles and are the smallest hallow bore needles available. That being said, you are getting an injection in the face, which is a sensitive area. Everyone’s pain tolerance is different and most patients experience some pain. Some injections are near painless and some hurt quite a bit, but the pain is very short-lived and there is minimal to no pain afterwards.
I heard Botox is a toxin. Is getting cosmetic Botox dangerous?
Like everything in medicine, toxicity is a matter of dosing and the amount of Botox injected for cosmetic procedures is thousands of times too small for any major adverse effects. In fact, no one has ever died as a result of receiving cosmetic Botox. That’s pretty impressive seeing as 6.1 million Americans received cosmetic Botox last year alone. Botulism, a form of food poisoning that results from eating a massive amount of un-purified protein, has been an extremely deadly disease throughout history. Today, however, as long as you don’t can your own vegetables, this will not happen to you.
How long after the procedure does it take to see results?
Most Botox patients see results on post-procedure day three and full results on post-procedure day five to seven.
How long does the Botox last?
First-time Botox patients typically see results that last between three-to-four months. Patients who have been receiving Botox for a number of years typically have longer-lasting results.
What will happen if I get Botox one time but do not continue to get it on a regular basis?
If you do not continue to get it on a regular basis, the effects will wear off and wrinkles will reappear. You will NOT get more wrinkles than you previously had. This is a common misconception.
Will it be obvious that I’ve had a cosmetic procedure?
At Clear Dental, we aim to give patients the “you look better, but I don’t know why” look. Because Botox simply decreases muscle activity and does not stretch skin, rest assured you will not get the “blown away” look associated with more invasive cosmetic procedures.
Is there anyone who should not get Botox?
Yes. People who cannot get Botox include anyone who has:
* Had an allergic reaction to any of the ingredients in Botox
* A skin infection at the planned injection site
I’m pregnant. Can I still get Botox?
Although it’s unlikely there will be any adverse side effects to your baby, Clear Dental recommends not undergoing the procedure if you are pregnant or trying to get pregnant.