If you have considered undergoing a cosmetic procedure to improve the appearance of aging skin, you probably know that sorting through the seemingly endless treatment choices can be overwhelming.
Non-surgical injectable therapies, such as dermal fillers and wrinkle relaxing agents, have increased in popularity in recent years. At first glance it may seem that all injectable treatments achieve results in a similar way. However, these non-invasive options can be quite distinct. Unlike dermal fillers, which plump the skin, wrinkle relaxers halt the formation of lines by temporarily paralyzing the facial muscles. As a result, creases and expression lines are smoothed out, giving a more youthful finish. The appropriate use of wrinkle relaxers is an art; a precise balance between movement and wrinkle reduction should be achieved from the treatment. When this balance is present, patients will avoid the artificial frozen look, and just appear more refreshed.
Today, wrinkle-relaxing procedures are considered a safe and favored option for people with the etched-in wrinkles associated with everyday facial movement.
About BOTOX®, Dysport® & Xeomin
At his New York office, Dr. Westreich uses the three leading wrinkle relaxing treatments, BOTOX® Cosmetic, Xeomin®, and Dysport® to reduce the appearance of dynamic lines, specifically:
- Crow’s feet or smile lines
- Furrowed brow (the 11s)
- Horizontal creases in the forehead
- Banded creases in the neck
- Low eyebrows
- Other movement associated lines, such as chin dimpling, lines at the sides of the nose, under-eye bulges, and downturned mouth corners.
BOTOX® Cosmetic, Xeomin®, and Dysport® treatments contain botulinum toxin type A, the active agent that prompts muscular relaxation. Although the mechanism of action is similar, subtle differences in clinical effect may occur. Dr. Westreich will choose the wrinkle relaxer most appropriate for the patient, based on his aesthetic goals, patient preference or sensitivities, and other criteria. All treatments are highly effective and can provide similar results.
- BOTOX® was originally developed for therapeutic uses–such as migraine relief and the control of eyelid spasms. BOTOX® Cosmetic has since secured a place for cosmetic use. Today, BOTOX® Cosmetic is one of the most widely used cosmetic treatments offered. After treatment, patients can see improvements within 3-4 days of the treatment and, in general, can enjoy the benefits of a single treatment for approximately 3-4 months, sometimes longer.
- Dysport® is a related but newer wrinkle relaxing product than BOTOX® Cosmetic. In some patients, Dysport® may be better tolerated and give marginally faster results than BOTOX® Cosmetic. Like BOTOX® Cosmetic, Dysport® can last for 3-4 months.
- Xeomin® is another product, which has been available for use in the last few years. It’s clinical effect and onset is similar to BOTOX® Cosmetic and Dysport®.
During treatment, Dr. Westreich will inject the wrinkle relaxer into the muscle tissue with a very fine needle. To control the outcome, he administers the substance in small doses, precisely calibrating what is needed to induce the muscles to relax. The injections produce little discomfort and can be done in a short office visit. Because the wrinkle relaxing procedures are non-invasive, no downtime is required.
Dr. Westreich specializes in achieving a naturally softer appearance through subtle use of wrinkle relaxers. Using his original Smoothtox procedure, Dr. Westreich makes injections into selective areas of the muscle, resulting in a more targeted and refined outcome. His technique ensures that the muscles are not overly treated, thus preventing the unwanted frozen look. During your consultation, Dr. Westreich will evaluate your skin and determine if wrinkle relaxers can help you recapture a smoother, more refreshed face.
The Difference Between a MedSpa and a Facial Plastic Surgeon Office
When considering BOTOX injections, it may seem tempting to cut costs by receiving the injections at a medical spa rather than at a plastic surgeon’s office. After all, these spas can be convenient, offer other beautifying services such as facials and massage, and they often run specials or discount deals, offering BOTOX at a much lower cost than an accredited plastic surgeon. However, though medical assistants at a medical spa may be licensed to apply BOTOX, patients are generally much happier with the results from a proper application by an accredited plastic surgeon.
Having BOTOX at a MedSpa
Medical spas offer treatments that qualify as “medical procedures.” This means that the law mandates that these medical procedures are performed or supervised by a doctor. The problem with medical spas is that the definition of “supervision” can vary widely from state to state. Patients at these medispas can be receiving treatment from a medical assistant being paid a low, hourly wage, with little to no training or experience, and the “supervising doctor” can be miles away, with no availability to help in case something goes wrong.
Allergen is the only FDA-approved maker of BOTOX in the U.S., and their vials stay at a steady price of $505 per vial. These do not get discounted, so how can medical spas offer much cheaper prices to their patients? Using inexperienced medical assistants instead of well-paid doctors is one way that medical spas can offer cheaper rates to their clients. Another way is by utilizing very shady practices. Allergen’s vials come in a powder, which is to be diluted with specific ratios of sterilized water. Underhanded medical spas can often dilute this powder with much more water, reducing its efficacy and essentially charging its patients for water, not the active ingredients in BOTOX.
Having BOTOX Treatment by an NYC Facial Plastic Surgeon
The nature of BOTOX as an injection also requires experience and an understanding of facial anatomy to yield the best, most natural-looking results. A facial plastic surgeon such as Dr. Westreich who has dedicated years to studying facial anatomy and understanding how best to achieve the natural, youthful looks his patients desire, will be able to produce much better results than a low-paid, inexperienced medical assistant. Moreover, improperly or inexpertly applied BOTOX can not only cause that tight, “done” look many patients want to avoid, but it can also prevent the eyelid from opening, or cause a droopy eyebrow. Dr. Westreich developed a gentle technique that allows his patients to maintain certain muscle movements and preserve facial expressions – read more about it here.
While low-cost BOTOX deals at a medical spa can be tempting, is it worth the gamble? A properly supervised and applied BOTOX procedure can help you rejuvenate your face, while an improperly applied BOTOX procedure can leave you feeling much worse. If you are in the NYC area, come in for a consultation with top New York facial plastic surgeon, Dr. Westreich.
How Long Does BOTOX Last?
Like many other cosmetic procedures, BOTOX in NYC is not permanent and will last for about three to four months. After that period, the targeted muscles will lose their paralytic effect and will once again begin to constrict. Further injections will be required to maintain the wrinkle-free, youthful appearance. If you are planning on having BOTOX administered to you, it is essential that you consider the cost of having the procedure performed more than once every year.
With that said, it is also important to point out that continuous use of BOTOX can weaken the muscles which cause wrinkles. This may seem like a negative characteristic of BOTOX, but in fact, this is something which can help you maintain your smooth and clear skin for several more months. Doctors have evidence to believe that long-term benefits of BOTOX include longer retention of treatment’s results and better skin texture.
Moreover, static wrinkles can also lose their constricting effects for longer periods. These are thin wrinkles which appear in certain locations like the forehead even when the face is relaxed. Over long periods of dosing with BOTOX, the muscles behind static wrinkles can become inactive leading you to get rid of the creases.
Lastly, many patients will change their habitual pattern of facial expressions, many of which contributed to the wrinkles in the first place. For example, some people move their eyebrows a lot when they talk or frown when they are concentrating. After several rounds of BOTOX, that subconscious behavior tends to stop, causing a decrease in the forehead and frown lines, even when BOTOX is not active.
However, to obtain these long-term benefits, it is crucial that you do not wait too long after the first injection’s effect wears off. In fact, it is actually better to have further injections as soon as you notice the previous treatment losing its strength and wrinkles are starting to appear once again.
Meticulous records of each patient’s treatment strategy are kept so that treatments can be reproduced or modified over time, based on their experience with the previous treatment(s). New patients will usually have a conservative initial treatment and are invited to return (free of charge) 2 weeks later for evaluation of their result and, potentially, the addition of more wrinkle injections. We often tell patients “you can add but you can’t subtract BOTOX for 4 months.” This way, the treatment is individualized for each person’s specific anatomy and aesthetic goals but kept at the lowest possible dosing required for results.
The result is often less BOTOX or dysport used. For example, if a patient wants forehead, frown, and crow’s feet injections, typical patterns will require the use of 40-50 units of BOTOX. Smoothtox technique typically requires only 25-30 units to treat the upper face. Since Dr. Westreich prices the treatment by the amount injected, this typically results in a dramatically lower cost for patients.