How Botox and Fillers Can Freshen Up Your Look without Surgery

 When those telltale signs of aging are making you feel self-conscious about your appearance, talk to us about Botox and fillers in Seattle that can freshen up your look with no downtime. Botox continues to be a popular injectable for targeting deep wrinkles along the forehead and fine lines around the eyes. We have a range of injectable fillers for patients that want to fill out facial lines and creases, and achieve a more youthful look without surgery. Dr. Jonov can put together a customized treatment plan to freshen up your looks without having to go under the knife. Continue Reading

Upper Lip Plumping Featured on The Doctors

Refining the appearance of the upper lip is a delicate business, and sometimes a single procedure just doesn’t do the trick. Recently, some plastic surgeons have been using a two-part procedure to enhance the appearance of the upper lip a Botox injection to mask fine lines, followed by injections of hyaluronic acid fillers to add volume. This technique was recently featured on an episode of ABCâ??s The Doctors.

(Please note: the video below shows a woman having her lips injected with dermal fillers. Although the procedure is painless, it might be a bit unsettling to people with a phobia of needles.)

I’ve always had thin lips, says Mary. I’ve tried different kinds of lipsticks and liners and things that might allegedly plump your lips but it’s not really worked. I don’t do enough for myself and it would be really fun to have some girly lips. The solution for Mary is what Dr. Ordon calls the upper lip overhaul. Unlike similar procedures previously performed on the show, this is a twofold procedure with one half having been performed in advance. Botox has been injected near Mary’s upper lip to resolve the fine lines that appeared there. The second step involves adding volume with dermal fillers along the border of the lip, where the lip has thinned as a result of the aging process. Typically, with the aging process, you see those lips thin, because we lose volume in the structures around the mouth, says Dr. Ordon. Botox and hyaluronic acid fillers both last roughly 3-6 months, so that patients can have the results of the dual procedure refreshed simultaneously.

There’s something else that I noticed in the video, which often goes unnoticed, but bears mentioning. You can see how subtle the results of the procedure are  Dr. Chopra deftly avoids the over-plumped look that is the hallmark of bad cosmetic surgery in Hollywood nowadays. That’s because Dr. Chopra knows exactly how far to go, and when to stop.

Back in April, the ASAPS website had an interesting post about the importance of shape, as well as size, when performing lip augmentation. Plastic surgeons need to be careful about how much volume to add, since too much volume can result in trout pout overdone lips that make you appear fishy. Your lips have a natural proportion that must be respected. According to one Detroit plastic surgeon quoted in the article, the lower lip should be one and a half times the size of the upper lip. That’s the proportion of Mary’s lips that you can see in the video.

A Botox Procedure for Poker Face?

Cosmetic procedures for men been on the rise lately, so why not a Botox procedure aimed at the traditionally male-dominated world of poker? That seems to be the reasoning behind a New York doctor offering Pokertox to help poker players retain their solemn expressions during games. However, it seems that even the poker players themselves think that Pokertox is a lousy idea.

How would it work? It’s quite simple. With this procedure, the surgeon would use Botox and facial fillers (like Juvederm) to enhance a gambler’s poker face. To succeed in poker, it is important to be able to hide facial emotions, since unconscious signals known as tells can reveal information about the player’s hand. Botox is a cosmetic treatment that works by inhibiting targeted facial muscles.

While it is normally used to allow other muscles to stretch away the appearance of wrinkles, Dr. Jack Berdy believes that Botox can also be used to reduce the appearance of unconscious tics. Unfortunately for Dr. Berdy, the response from poker players has been less than positive. Josh Hale, who competed on the World Poker Tour, told the Huffington Post that the game has moved on from bluffs, and is more analytical these days. Players might look at physical tells, but they are relying more on betting patterns and bet sizing.

Besides the changing nature of the game, says expert player Jay Melancon, you also have to think of the costs versus returns. You’d have to play in very high-stakes games to make it worth it, and if you have a tell that is that obvious, you shouldn’t be playing in those games. As well, the ubiquitous hoodies and sunglasses at poker tournaments make these subtle tics often impossible to distinguish.

As a marketing gimmick, Pokertox is certainly attention-grabbing. However, as a cosmetic procedure, I wouldn’t bet my money on it.

Photo credit: Wikimedia Commons, Pokeravond

Does Botox Affect Our Ability to Empathize?

does Botox affect our ability to empathize?While a new study finds that Botox injections may inhibit your ability to read othersâ?? facial emotions, the researcher did admit that it’s a fairly subtle effect.

Published in Social Psychological and Personality Science, the study found that people who had Botox injections were significantly less accurate at reading othersâ?? emotions in photos compared to those who had Restylane injections.

Study researcher David R. Neal, PhD, a psychology professor at the University of Southern California, said, If you have a poker face because your facial muscles are paralyzed, you can’t read others emotions as well. But he also pointed out that â??People are not becoming automatons. Itâ??s just a matter of weighing whether the aesthetic and self-esteem boost outweighs any subtle impact on your ability to perceive others emotions.â?

In the study, women who had their facial folds treated with Restylane were able to read others’ emotional states with about 77% accuracy, while those who had Botox had 70% accuracy.

Why would Botox have this effect and not other fillers? According to Neal, evidence suggests that people use mimicry to register and label the emotional states of others, so something that limits one’s ability to reproduce another person’s expression of emotions, such as Botox which has a paralyzing effect on facial muscles in the immediate vicinity of the injection site â?? would likely impair oneâ??s ability to register or label those emotions.

Andrew Jacono, MD, a facial plastic surgeon in New York City who reviewed the study, said that the findings likely only apply to those who use excessive amounts of Botox.

When Botox is overdone, it doesnâ??t look right and people arenâ??t perceived in the right way, Jacono said. â??The goal is to try to make sure when you get Botox, it is done in a subtle way so you can look better and maintain your ability to emote and read others.

New Uses for Botox on the Horizon

Images via Botox's before and after toolBotox and Dysport are famous as wrinkle fillers, but research for other uses for these injectables is also underway.

CBS Interactive Business Network reports that Medicis, maker of Dysport, is working with a company called Revance to create a wipe-on, wipe-off version of botulinum toxin to treat facial wrinkles and excessive sweating.

Meanwhile Botox’s maker Allergan is researching the drug for use as a painkiller and as a treatment for juvenile cerebral palsy and enlarged prostate.

Allergan also continues to focus on Botoxâ??s success as a wrinkle filler with a new website that allows users to upload their own photos and then create photos of what they might look like after Botox (images in this post are from the before and after tool). The injectable was also approved as a preventive treatment for chronic migraine in October 2010.

The CBS report says sales of Allerganâ??s Botox began recovering last year after declining during the recession, and recent statistics from the American Society of Plastic Surgeons showed that non-surgical cosmetic procedures were up 5 percent in 2010 from 2009.

Dysport, which was released by Medicis in 2009, has also seen sales success. The company’s non-acne skin products were up 31 percent in 2010, and most of that increase is attributed to Dysport.

Learn more about Botox at Seattle Plastic Surgery.

Botox Improves Quality of Life, Self-Esteem, Study Finds

woman smilingBotox is effective for smoothing facial wrinkles and helping patients look their best. But are its affects more than skin deep? According to a new study published in Dermatologic Surgery journal, Botox may also improve quality of life and self-esteem.

Plastic surgeon Dr. Steven H. Dayan conducted the study that had 100 participant treated with either Botox or a saline placebo for facial wrinkles between the eyebrows, on the forehead and around the eyes.

Participants were surveyed on their quality of life before the injections and two weeks and three months after the injections.

Findings showed that Botox injections result in improvements in quality of life and self-esteem. Those treated with Botox showed statistically significant improvements in answers to quality of life questions pertaining to many aspects, including:

  • Physical health
  • Mood
  • Overall life satisfaction
  • Body satisfaction
  • Self-worth
  • Appearance
  • Attractiveness
  • Sense of well-being

Increases in overall self-esteem and appearance-, social- and performance-related self-esteem were also observed in those treated with Botox.

The study also found that patients who received Botox for the first time demonstrated a greater improvement in quality of life and self-esteem when compared to participants who had previously received Botox.

“The findings in this study ask us to think much differently about Botox treatments,” says Dr. Dayan. “We have long known the physically enhancing benefits of Botox treatments, but to now have data that indicates Botox also improves one psyche, self-esteem and quality of life is very significant. The question now has to be asked is if getting Botox makes people feel better about themselves, could this translate into them being more productive in their professional lives and happier in their personal lives?”

Learn more about Botox at Seattle Plastic Surgery Center.

Botox Approved to Prevent Chronic Migraines

Botox injectionThe FDA has approved Botox as a preventive treatment for chronic migraine headaches in adults. Migraines’ three times more common in women than men are characterized by intense pulsing or throbbing pain. Chronic migraine patients have a headache more than 14 days of the month.

For chronic migraine, Botox is given about every 12 weeks as multiple injections around the head and neck to try to dull future headache symptoms. Researchers are still trying to determine how Botox works on migraines, but one theory is that it blocks pain signals from reaching nerve endings.

Last year Botox worldwide sales were divided equally between medical and cosmetic uses, reports the New York Times. However, Allergan, the maker of Botox, believes its sales as a medical treatment may soon eclipse its sales as a cosmetic wrinkle treatment. The injectable is also approved to treat uncontrolled blinking; crossed eyes; certain neck muscle spasms; underarm sweating; and muscle spasticity in the hands and elbows.

In other Botox news, British scientists report that they’ve developed a way to refine the anti-wrinkle treatment to improve its use for treating Parkinson’s, cerebral palsy and chronic migraine. The researchers produced a refined Botox-like molecule, which they said would be practical for clinical use but would not have unwanted toxic effects.

“It will now be possible to produce Botox-based medicines in a safer and more economical way,” said Bazbek Davletov, who led the study at Medical Research Council’s Laboratory of Molecular Biology.

Davletov said the new refining technique could allow scientists to produce new forms of Botox with wider practical medicinal uses, for example as a long-term painkiller.

Read the FDA press release on its approval of Botox to treat chronic migraine and the article on refining Botox, Scientists Find Way to Refine Botox for New Uses.

Botox Decreases Pain in Breast Reconstruction Patients

Woman holding chestBotox can reduce post-operative pain in women who get silicone implant breast reconstruction after a mastectomy, according to Dr. Allen Gabriel, who presented his study at the recent International Society of Aesthetic Plastic Surgery Congress.

Dr. Gabriel, a plastic surgeon in Vancouver, Washington, did a 30-patient clinical trial for this off-label use of Botox that demonstrated that botulinum toxin A addresses the sources of severe pain associated with the procedure.

Silicone breast implantation usually involves the positioning of a temporary expander implant between layers of the chest muscle, which is filled with water to create a pocket where a permanent implant will reside. According to Dr. Gabriel, the muscle often contracts and spasms in response to the expansion, causing the patient pain.

Dr. Gabriel, along with his collaborator Dr. G. Patrick Maxwell, theorized that Botox injections could offer relief by temporarily paralyzing the muscle so that fewer spasms occur, resulting in less pain.

“The use of [botulinum] is changing the reputation of expanders as a painful part of breast reconstruction,” Dr. Gabriel said. “Before we started using [botulinum], patients leaned toward autologous reconstruction because of anxiety about expander pain. Now, patients are more inclined to choose expanders.”

The clinical trial assigned 30 breast cancer patients who were all getting a mastectomy with silicone implant breast reconstructionâ??into two groups: one group received Botox injections in the chest muscle and the other received injections of saline solution as a placebo.

The women who received the Botox injections were more comfortable after surgery than those who received placebo, Dr. Gabriel said. He measured patient responses three times during and after the procedure. He also noted that during days 7 to 45 of the recovery period, those that received Botox injections used significantly fewer doses of narcotics and muscle relaxants.

New Botulinum Toxin Approved for Therapeutic Uses

Botox injectionThe FDA approved a new botulinum toxin type A on August 2 for the treatment of adults with cervical dystonia and blepharospasm. XEOMIN is the third product of this kind to be approved in the U.S., after Botox and Dysport.

XEOMIN’s approval is based on the results of two U.S. clinical trials. A study cited in the Journal of Neurological Sciences on the efficacy and safety of XEOMIN concluded that it is a safe and effective treatment for cervical dystonia. It said that XEOMIN showed non-inferiority to Botox when used in the same doses to treat the disorder. Dystonias are neurological movement disorders in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. Cervical dystonia is characterized by twisting of the neck and blepharospasm by excessive eyelid spasms.

XEOMIN is the only botulinum toxin that doesn’t require refrigeration prior to reconstitution. Merz Pharmaceuticals, the maker of XEOMIN, believes this could simplify product distribution and storage and help ensure product integrity at the time of injection.

In early 2010, Merz announced it would be acquiring BioForm Medical, a leader in the dermal filler market with its Radiesse filler. Once the acquisition is complete, Merz and will be renamed Merz Aesthetics.

Despite growing competition, Botox the first botulinum toxin approved by the FDA is showing strong sales. According to Allergan’s latest earnings report, Botox sales rose 7 percent in the quarter to $360.5 million. Allergan said it now believes the drug will post sales of $1.36 billion to $1.39 billion this year, which compares with a forecast in February for $1.33 billion to $1.37 billion.

Company Aims to Make Botox Lotion a Reality

Botox cream before & after photosA specialty bio-pharmaceutical company in California is conducting clinical trials on a Botox product that can be applied to the skin in cream formâ??no needles necessary, according to WCBS-TV in New York City.

Revance Therapeutics says that it will be two years before trials of their product RT001 are complete; then it is up to the FDA to decide whether to approve the drug, which is being tested for use on crow’s feet.

In an interview with WCBS-TV, Dr. David Colbert, a New York City dermatologist, expressed concern about such a product. He says he worries that a Botox lotion would be so popular that black market versions would be sold online without oversight and that the potential muscle paralyzing effects could be dangerous.

I think it’s a brilliant idea, but I’m more concerned about the welfare of people who would use it irresponsibly, he says.

In the early trials patients saw a moderate reduction in wrinkles around their eyes after using it for a month.

Dr. Richard Glogau, a clinical professor of dermatology at the University of California, San Francisco and a primary investigator for the study, said after early trials that Revance needed to rework the formulation so the drug would stay where it was applied and not spread to other parts of the body.

More doctors are beginning to voice their opinions about the product’s potential. Dr. Anthony Youn, a plastic surgeon in Michigan, wrote on his website:”I think a huge application of this topical botulinum toxin is in sweat reduction. Could you imagine an antiperspirant stick with this product that lasts several months with each application and leaves no residue? I’d buy it!

Dermatologist Dr. Fredric Brandt of Miami said, The results are good, but they probably won’t be as dramatic as [Botox] injections.

To view the WCBS-TV segment, go to and search for Botox cream.

(before & after use of RT001 for 28 days; image via WCBS-TV)

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