Botox (Non Surgical)

As we age more creases appear in our faces for several reasons, including loss of elasticity in the skin.  Many creases are secondary to activity of facial muscles during animation and facial expression such as the forehead due to elevation of the eyebrows, between the eyebrows due to frowning, around the outer aspects of the eyes due to smiling, around the lips due to pursing, and in the area between the nose and corner of the mouth as well as below the corners of the mouth.  .  Along with this there is a general loss of fat volume in the face resulting in further “deflation” of the face.

Surgical procedures to redrape and tighten the excess skin include face and neck lifts.  Other procedures such as chemical and laser peels produce a superficial “burn” to the skin which heals more tightly.  These procedures tighten the “envelope” of the face.  Other surgical techniques involve placement of implants in the face to produce more fullness in areas such as the cheeks, lips and chin.

Patients who are either not good candidates for surgery, or wish a lesser invasive procedure, may be able to obtain improvement with non-surgical procedures that can also be used as a complement to surgery.

There are several non-surgical techniques to fill in areas of depression and restore facial volume.   Injectable fillers such as fat or hyaluronic acid products (e.g. Restylane, Perlane) can be used to fill the “valleys” of facial creases and thereby replace some of the lost volume.  Hyaluronic acid is a natural substance found in many of our tissues such as skin, tendon, muscle, joints, etc.  It is produced in a laboratory (not derived from animal tissue) and injected with fine needles into creases and other sites where there is a relative lack of fullness such as lips, cheeks and other areas.  Restylane and Perlane are the same products except for the size of the hyaluronic acid molecules being larger in Perlane.

The injection may take a few minutes in Dr. Samuel’s office and the effect is immediate but fades over several months.  The longevity of the effect varies with the areas injected and the activity of the facial muscle in the area. Some patients will obtain injections before special events to freshen their appearance.

Other than filling in creases wherever they occur, hyaluronic acid injections can be used to fill in the hollows in the lower eyelids that give the appearance of fatigue, raise and shape the eyebrows, make the cheekbones more prominent, fill the lips to make them appear more voluptuous and highlight the lip margin.  Hollows at the jowl areas can be filled and even touch-ups following various surgical procedures can utilize hyaluronic acid injections.

Another aspect of dealing with dynamic facial creases involves weakening or inactivating the muscle which accentuate the creases.  Rather filling in a crease this technique involves injection of Botox (a very miniscule amount of Botulinum toxin) which temporarily prevents the muscle from contracting.  This will diminish the prominence of wrinkles in areas of active facial expression such as the forehead, frown lines, “crows’ feet”, etc.  The injections take a few minutes and the effect is variable but usually last a few months.

Botox may be used in combination with a filler such as Restylane, thereby filling in the crease and decreasing the muscle activity which produces the crease in the first place.

Patients who seek facial surgery to correct creases will find that if Dr. Samuel feels the benefit of surgery would be too small in comparison to the extent of the surgical procedure, then Dr. Samuel may advise them to consider injections as a temporary measure until they require surgery to achieve adequate improvement.  Dr. Samuel will thoroughly discuss these options with the patient as well as all aspects of the procedures, the expected course and potential consequences.  Unlike with surgery, the consequences of injection treatments (whether fillers or Botox) are temporary.

If you are considering non-surgical procedures such as Botox and/or hyaluronic acid injections to improve facial features then please call Dr. Samuel’s office at 416-630-2715 or e-mail to schedule a consultation appointment.  His staff will be pleased to assist you.

Disclaimer:  The explanations on this procedure are meant to provide only an overview of information on the subject.  This does not constitute ‘informed consent’.  Each case must be assessed   by Dr. Samuel individually.  This will include a proper history, physical examination and discussion of the proposed surgery, post-operative course including the relevant potential complications.  During the consultation and subsequently, the patient will have opportunities to ask questions and clarify any concerns he/she may have relating to any aspect of their care by Dr. Samuel and his staff.

This website is aimed at informing Canadian patients of the services provided by Dr. Samuel.  At no time is it intended for patients who reside outside Canada.

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