Botox

This highly purified and very safe substance has the very specific and predictable mechanism of action of deactivating ANY muscle function at, or sometimes near, where it is injected. Therefore, it can cure or reduce any wrinkles that are due to muscle activity. The effects are not permanent, and last three to five months depending on the patient, muscle, and activity. It can be administered in the office in a matter of minutes, and you can return to work and full activity virtually immediately. Long-term use has a tendency to lessen the frequency and amount of Botox needed to obtain a given result due to several mechanisms of action. There are no bad long-term side effects.

Botox only deactivates muscles and treats the wrinkles related to the muscle activity. It does not fill in deep furrow lines and creases. In these cases it may be necessary to utilize a combination treatment of Botox to deactivate the muscle and then an injectable to fill in the furrow or crease.

Dr. Romano likes to think of the indications for Botox falling into two broad categories as outlined below. Functional use refers to injecting Botox into a muscle with the sole endpoint of deactivating the muscle and the wrinkles due to the muscle. Cosmetic use refers to injecting certain muscles in certain amounts and in certain areas to provide a specific or more balanced aesthetic result. Most offices only provide the first. Dr. Romano’s office provides both.

This cosmetic usage, and understanding the balance of muscle activity and its effect on the skin and surface, is where he employs Botox beyond its usual capacity—in a very artistic way.

Functional Uses of Botox:

  • Frown lines between the eyebrows. This works best if the lines are not deep.
  • Crow’s feet
  • Transverse lines of the forehead
  • Heavy vertical muscle bands in the neck
  • Complex irregularities of the chin
  • Smoker’s lines of the lips

Cosmetic Uses of Botox:

  • Create symmetry in uneven eyebrows
  • Raise the tail of the eyebrows
  • Raise the inner corner of the eyebrows
  • Elevate the corners of the mouth
  • Decrease the muscle bulk at the corners of the jawline (typical in Asians)
  • Even up sagging lower eyelids
  • Even up sagging upper eyelids
  • Even up facial features from Bell’s palsy or other facial nerve problems

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