Are frown lines making you look angry?

Consider Botox® Cosmetic

Botox is a quick, easy, non-surgical way to ease wrinkles caused by repetitive muscle action, such as:

• “Frown lines” between your eyebrows
• Crow's feet
• Forehead lines

Botox Cosmetic is the most popular non-surgical cosmetic treatment in the US, according to the American Society for Aesthetic Plastic Surgery. In 2007, American women and men received 2,775,176 Botox treatments.

What is Botox and how does it work?

Botox Cosmetic is an injectable treatment made from a purified protein, botulinim toxin type A. When injected into the muscles that cause facial wrinkles, Botox works by blocking the release of acetylcholine, a body chemical that signals muscles to contract. Result: A more rested, refreshed look.

How can Dr. Rappaport tell where you need Botox?

Dr. Rappaport will test your ability to move certain muscles in your face. This will help him understand the location, size and use of the muscles that have created facial wrinkles—and determine where to administer Botox injections for best results.

How long does a Botox treatment take?

A Botox treatment is a simple lunchtime procedure. The treatment normally takes about 10 minutes, and you should be able to go right back to work or your normal activities afterward.

How soon are results of Botox visible?

It normally takes 24 to 72 hours to see the effects of a
Botox treatment.

How long do Botox treatments last?

Botox Cosmetic treatments can last up to four months, although results may vary. The FDA recommends that the procedure be performed no more often than once every three months.

Does Botox have any side-effects?

The most common side-effects following Botox treatments include mild, local injection-site discomfort, swelling, redness or bruising. These typically last only a short time after a treatment.

Drooping of the upper eyelid, should it occur as a result of the injection, is temporary and reversible.

Other side-effects can occur, but are extremely rare. For more details, see the patient safety information from Botox's manufacturer, Allergan, Inc.

Who should not have Botox treatments?

You should not use Botox Cosmetic if you:

• Have an infection at the proposed injection site(s)
• Are pregnant or think you might be pregnant
• Have a known hypersensitivity to any ingredient in the formulation

Dr. Rappaport answers questions about Botox Cosmetic

What's the most common use for Botox Cosmetic?

“The most popular area for Botox treatments is the area between the eyebrows, to smooth out the ‘frown lines‘ that form there from repeated muscle action. It's also very effective in treating crow's feet around the eyes.”

Can Botox do more than treat wrinkles?

“Yes. I can also use Botox to enhance your appearance by non-surgically reshaping facial features. For example, if you have flat eyebrows, I can strategically place Botox to offset the pull of one muscle, allowing for your brows to elevate.

“Or if you have a downturn at the corners of your mouth, I can strategically place Botox to relax the muscles that may cause that downturn. This will allow your mouth to take on a more pleasing appearance.”

Do you administer Botox injections yourself?

“Yes. I do all the injections of Botox and facial fillers in my practice. There's a real difference when you have your injectables done by a skilled physician. My knowledge of anatomy and appreciation of aesthetics allow me to give you a very natural look.

“You want some personality on your face, not the ‘frozen’ or ‘plastic’ look you might see when a person is treated by a less-skilled injector.”

What are some finer points of your Botox technique?

“The distinction is not so much the quantity of Botox I use, but where it's injected. You don't want to get migration of Botox from the injected area to adjacent areas that may affect the ability to open the upper eyelids.

“Sometimes, particularly when I'm trying to sculpt with Botox, less is more. I'll ask the patient to come back in a week and take a look. Then we might inject an additional amount if needed—particularly if it's the first time a patient has had Botox—to get the desired effect. Some people may have greater muscle pull on one side than the other, and I can adjust the quantity of Botox I administer.”

Do men get Botox treatments, too?

“Yes—even I do. Many people who seek Botox treatments do it to avoid an ‘angry’ or ‘worried’ appearance. That's what led me to get Botox treatments. When I'm evaluating a patient, my natural facial expression is one of concern. But that look is sometimes misinterpreted as ‘What's wrong?’ To avoid that, I have a little bit of Botox injected so I don't have that worried appearance.

“I'm not looking to change the shape of my face, and wrinkles on men are usually more acceptable than they are on women. But in certain circumstances where facial expression belies the intent, Botox can be very useful. I don't want my facial expression of concern to be misconstrued as worry, when it's actually just a reflection of the intensity of what I'm doing.

“My father had very heavy brows and was always frowning, so I treated him with Botox as well. My mother loved it! People who have heavy brows and heavy muscles and look like they're in constant consternation do well with Botox.”