Are there any reasons why I should avoid BOTOX or Dysport?

BOTOX is a nonsurgical cosmetic treatment that has been proven to be both effective and medically safe.  Millions of people enjoyed treatment with BOTOX and Dysport, another botulinum toxin A product, last year to improve their cosmetic concerns.

Microdroplet BOTOX Before and After

Microdroplet BOTOX Before and After

However, this does not mean that BOTOX is the right choice for everyone, and this is a decision your doctor can help you make.  The short answer to “Is there any reason to avoid BOTOX?” is that it is extremely unlikely that you will experience any complications from BOTOX, and given the temporary nature of the treatment, you needn’t worry that your looks will be changed permanently; on the other hand, side effects can occur even if you are treated by a highly qualified injector.  It is also reasonable to expect that side effects will be more likely when treatment is performed by relatively inexperienced injector.

Are BOTOX and Dysport safe and effective?—absolutely.  But like every medication, these drugs need to be used in an expert fashion, which includes knowing when treatment is not appropriate.

New Black Box Warning for BOTOX

The FDA has recently required the manufacturer of BOTOX, Allergan, Inc. and the distributor of Dysport, Medicis, Inc. to include a special health warning regard the use of these drugs, which both contain botulinum toxin A as the active ingredient.  Experience with these drugs since they were approved has demonstrated these drugs to be very safe and effective when used in the small doses needed for cosmetic treatment.

These drugs are also used for medical purposes in much higher doses.  At these higher doses, there have been serious side effects leading to the new FDA warning regarding systemic or so-called spreading effects.  Specifically, larger doses of either of these drugs can cause systemic side effects including a generalized weakness, medically referred to as asthenia, double vision, blurred vision, eyelid droopiness, difficulty swallowing, difficulty breathing, difficulty speaking, and urinary incontinence.  Note that droopiness of the eyelid and double or blurred vision is possible, though fortunately rare, if cosmetic treatments spread to other parts of the face.  Breathing and swallowing difficulties can be life threatening and have contributed to death in already very sick individuals in the treatment of medical conditions.  It is thought that very high doses of these drugs used to treat certain medical conditions in small children present the greatest risks.  Individuals with life threatening heart conditions should also be treated with caution.

No definitive systemic side effects have been reported for the doses typically used for cosmetic purposes or for treating excessive sweating in the armpit area.  However, certain precautions seem reasonable even for cosmetic use.

If you have had any prior episodes of any of the systemic side effects described above, you should advise your doctor and not accept additional treatment with any botulinum toxin agents unless it is for medical purposes and your treating physician and you agree that the potential treatment benefits out weigh the adverse side effects.  If you are not sure, discuss your prior reactions with your doctor.  Although, quite rare, if you have a known allergic response or hypersensitivity to any botulinum toxin preparations it is advisable to avoid these treatments in the future.

It is your responsibility to be completely honest with your doctor about your medical history and anything that may affect your treatment.  BOTOX has a great track record for safety in both clinical studies and in practice, helping to relax select facial muscles at the eyebrow and restore a more youthful appearance.  While systemic side effects of these drugs probably occur even for cosmetic treatments, these effects must be very rare or mild.  But for this reason, there are a few instances when BOTOX should be avoided.

If you are pregnant or breastfeeding, you should not be treated with BOTOX or Dysport.  There is a very small study of women who were treated with BOTOX while pregnant with no problems, but this is not enough evidence to state that BOTOX and Dysport are safe during pregnancy or while breastfeeding.  What should you do if you discover you were pregnant when you received BOTOX?  Don’t panic. While this practice is not recommended, this single study suggests that the exposure may be safe enough that there may be no reason for action.  However, it is recommended that you see your gynecologist/obstetrician for personalized care recommendations. For the same reasons, reputable physicians will not treat you for cosmetic reasons if you are known to be pregnant or breastfeeding.  Treatment with these agents for medical reasons is determined on a case-by-case basis.

If you have a known neuromuscular disease, you should generally avoid cosmetic BOTOX and Dysport treatment.  These are unusual and debilitating health conditions like myasthenia gravis, Lambert-Eaton syndrome, and peripheral motor neuropathic conditions like amyotrophic lateral sclerosis.  If you have an existing difficulties breathing or swallowing, it is important to make your doctor aware of these issues.  Because BOTOX and Dysport treatment could make these conditions worse, it is generally advisable to avoid treatment under these circumstances due to the potential spreading effect of these treatments in higher doses.  Again, no definitive problems have been reported for the smaller doses used for cosmetic treatment, but caution is warranted with these types of medical conditions.

Botulinum toxin products contain a tiny amount of human albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases. A theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD) also is considered extremely remote. No cases of transmission of viral diseases or CJD have ever been identified for albumin.

BOTOX and Dysport can be potentiated by aminoglycosides, a type of potent antibiotic, or other medications that interfere with neuromuscular transmission including curare-like nondepolarizing blockers, lincosamides, polymyxins, quinidine, magnesium sulfate, anticholinesterases, and succinylcholine chloride.  If you are using any of these drugs, the effect of the toxin may be potentiated and caution is advised.  For this reason, it is important that you fully discuss with your doctor all medication that you may be using.

If you develop any unusual symptoms (including difficulty with swallowing, speaking, or breathing), or if any existing symptom worsens, notify your doctor at once.  If the symptoms seem serious, call 911 for emergency help and notify your treating doctor when this is convenient.  If you do experience loss of strength, muscle weakness, or impaired vision avoid driving a car or engaging in other potentially hazardous activities and seek medical care.

Very few people reading this and getting BOTOX or Dysport will have any of these issues.  However, if these warnings do apply to you, be honest with your doctor and seek alternatives to these products.

How Individualized Treatment Plans Make All the Difference

The key to effective BOTOX treatment and other cosmetic treatment in Los Angeles is to find a doctor who specializes in the help you need and has experience, education, recommendations, and results to prove that he or she is skilled and the best qualified.  If you are worried because you have heard of unsatisfactory results like the “BOTOX freeze,” you are likely hearing about a few examples of people either going to unqualified practitioners (they may not even be doctors; for example assistants and “physician extenders”).   Just because one of your favorite actors or actresses show up with a frozen forehead, don’t assume that this is a desirable treatment result.  There are great alternative to this type of treatment result.

Seek Help from Qualified Cosmetic Botulinum Toxin Specialist

Only a private consultation with a physician who is fully qualified to administer BOTOX and Dysport will be able to help you understand your best course of action.  BOTOX is a minimally invasive, safe, and effective treatment that helps millions of people each year restore balance to their face.  Dr. Steinsapir is multi-fellowship trained in both cosmetic surgery and oculoplastic surgery, and with many years of practical experience.  He is a Clinical Associate Professor at UCLA and has the practical know-how needed to understand complex facial dynamics and establish unique treatment plans that work.  Please contact us today to find out if you are a good candidate for BOTOX or Dysport treatment.

BOTOX in Los Angeles: For Definitive Treatment, Choose Dr. Steinsapir

You’ve done your research and you’re ready to take the next step toward restoring balance and youth to your face.  You have decided it’s time to consult with a doctor about BOTOX.  Great!  By now you’ve hopefully learned some important facts about BOTOX, and now it’s time to find an experienced doctor who is a good match for your needs and with whom you feel comfortable.  On your search we invite you to consider Dr. Steinsapir and his extensive credentials which, when combined with his experience, his patent-pending Microdroplet™ BOTOX, and his genuine concern for those he treats, make him one of the best BOTOX doctors available.

Los Angeles BOTOX Before and After Photo

Los Angeles BOTOX Before and After Photo

Dr. Steinsapir invented Microdroplet BOTOX, his patent-pending answer to improve a great procedure by producing better outcomes and preventing the facial “freeze.”  Dr. Steinsapir has been performing BOTOX treatment in Los Angeles since 1988, and to date he has performed thousands of minimally invasive BOTOX injections.  He has had the training, time, and experience necessary to perfect his technique and improve upon the standard procedure with his ground-breaking developments; in fact, Dr. Steinsapir trained alongside the inventor of BOTOX himself and has been recognized as a Los Angeles BOTOX leader for many years.

Dr. Steinsapir received medical training at the UCLA School of Medicine and Ophthalmology Residency at the University of Chicago. Dr. Steinsapir completed separate fellowships in both cosmetic and eyelid plastic surgery, and his specialization in facial cosmetic procedures in Los Angeles means that he understands the complexities of the human face more than most generalists (who are excellent and qualified professionals for many needs).  In addition to his private practice on Wilshire Boulevard in Brentwood, he is a Clinical Associate Professor of Ophthalmology at the Jules Stein Eye Institute at the David Geffen School of Medicine at UCLA.

Dr. Steinsapir views BOTOX as an important, effective treatment that is a minimally invasive solution for those who do not wish to have surgery and want their recovery time to be fast. Dr. Steinsapir is one of the most experienced BOTOX doctors having treated patients with BOTOX since 1988.  Cosmetic BOTOX treatments started in 1992.  Unfortunately many treatments are flawed and induce a frozen look.  By listening carefully to what people liked about their treatments and what they did not like, Dr. Steinsapir developed an entirely new approach to treatment with BOTOX.  Microdroplet BOTOX leads to better facial results by releasing the eyebrow depressors to balance the position of the eyebrows and soften the pinch often seen at the brow.  This approach is able to smooth forehead lines without causing BOTOX paralysis.  Instead, your results are completely natural.

Consult with a Caring Physician

Your treatment with BOTOX in the Los Angeles or Beverly Hills area will likely be a great experience if you take the time to find the best cosmetic surgeon for your needs and personality.  Dr. Steinsapir is a friendly, approachable physician whose real concern for your wellbeing is matched by his experience in BOTOX specialization. Call us today to learn more about how BOTOX with Dr. Steinsapir can make a difference in your life.

Should I have lip filler or BOTOX for my lip lines?

Those who have very thin lips, asymmetrical lips, or irregularities in their lips such as lip lines, bumps, or wrinkles can benefit from lip treatment.  There are safe, effective options available for those seeking improvement in the lips.  Your treatment will depend upon the nature of the problem, but usually Restylane works the best.

What about BOTOX?

We have found that BOTOX in the lips is usually not ideal.  This is because BOTOX relaxes overactive muscles, which makes it great for areas like the forehead where muscles are often too tense, but not in the lips.  There are many important muscles around the mouth that don’t respond optimally to BOTOX.  Since hyper-contracted muscles around the lips are usually not a concern, it doesn’t make sense to use a muscle relaxant in this area.  There are a few people with “gummy smiles” who may benefit from having their lip elevators relaxed in this area, but generally this is not the issue we see very often.

Expression of emotion is very important in the face.  This means that BOTOX treatment is great for some things – for example, if you have forehead wrinkles that make you look continually angry, BOTOX can restore your relaxed face to a position of emotional neutrality, giving you a clean palette from which to express yourself.  This also means that BOTOX should not be placed into an area that is already aptly expressing emotion.  Most people have properly functioning muscles around the lips, which is why we usually recommend using a filler for lip lines treatment.

Lip lines BOTOX may not be the preferred option in most cases, but there are many other benefits of BOTOX application.  BOTOX is a precise treatment that can be applied exactly where it is needed and only there, so you don’t have to worry about BOTOX paralysis or a treatment in your cheeks migrating to your lips.  If you’ve already received BOTOX lip injections and would prefer an alternative to BOTOX, you don’t need to worry because the effects will wear off in time.  As long as you see an experienced physician for your cosmetic facial treatment, you can anticipate many BOTOX benefits as experienced injectors will individualize treatment for what is best for you.

Great Lip Filler Options

The lips can usually be treated in minimally invasive ways without using lip plastic surgery, although surgical procedures are useful in some situations.  One nonsurgical procedure that works great is Restylane lip enhancement.  From our experience, our opinion is that Radiesse and Perlane aren’t the optimal lip products, as Restylane is more forgiving and effective.

Restylane is ideal because it creates great results while maintaining the flexibility that more permanent treatments don’t give you.  Restylane is now available as Restylane-L, which contains a numbing medicine for increase lip treatment comfort. If you have any issue with Restylane in lips, your doctor can easily modify, lessen, or erase the treatment by injecting the enzyme hyaluronidase.  This is a safe and simple outpatient procedure.  Flexibility is essential in lip treatment because of the delicate nature of the lips’ skin and contour.  Restylane usually does the job well the first time, but in case it doesn’t, you can relax knowing that Restylane will not cause any irreversible problems.

Improving existing lip problems

Sadly, some have lips that are not pretty due to prior work by well meaning physicians, surgeons, and, yes, lay injectors. These lips may have been damaged by silicone oil, fat transfer, and mystery fillers, or just plain funky surgery and lip edge implants.  Well, help is available for these forlorn lips.  Many can be vastly improved with artistic application of Restylane to fill in and correct what is missing. Lips that have been damaged by accident or an unfortunate treatment experience can find help in Restylane.

Who can treat my lips?

Think of a meeting with a potential cosmetic surgeon like an interview.  Assess the experience and qualifications of each individual doctor, make sure it is a currently licensed physician or surgeon, and don’t forget to assess your own comfort level too.  The stuff you hear should make sense, and you should feel confident about the treatment options you discuss together.  We’re not telling you to interrogate the doctors you meet, but to make sure you communicate well, have all your questions answered, and feel good about the doctor’s ability to help you.  Like any good interviewer, be open to return questions and speak with honesty and frankness.

If you are looking for Los Angeles lip injections or other solutions for lip lines, we invite you to a no-risk consultation with Dr. Steinsapir.  Dr. Steinsapir specializes in cosmetic facial treatments and is equipped with top-notch medical offices in Beverly Hills and at UCLA.  His repertoire of experience uniquely qualifies him to perform sensitive, detail-oriented treatments.  Call us today to learn about how lip treatment options can be customized to your unique needs.

Are there any face creams I can use instead of getting surgery?

We hate to bring bad news, but we want to be honest: if you are looking for a facial cream that rivals surgical results, you’re going to be disappointed.  This is not to say that creams or lotions are without some benefit.  It does mean, however, that if you are looking for a natural facelift, BOTOX results, or other dramatic improvements normally achieved through treatment by a cosmetic surgeon, a cream is not going to cut it.

A lot of businesses are profiting from misleading advertising by making claims about “natural alternatives” to cosmetic procedures that only a doctor can provide.  It’s hard not to be interested in a product that promises to give you the same results as surgery at a lower price and through “natural” methods without help from a doctor.  This is in part due to the unfair stigmatization that has been placed on cosmetic procedures, the misunderstanding of words like “natural,” and people who just want to make money.  Unfortunately, this means that a lot of customers end up buying really expensive moisturizers.  You may think you’re getting a deal if you spend “only” $300 on a “revolutionary” something-or-other cream, but you are likely getting no more than a regular, moisturizing lotion sold in a very expensive bottle.

What does this mean for your appearance?  If you aren’t already using a quality moisturizer on your face, your complexion may improve.  However, just because you look better after spending $300 on that jar of cream doesn’t mean that you are getting your money’s worth.  If you started with no moisturizer or a bad one, you will likely see results just as good with a cream you find under $20.  Moisturizers do hydrate the scaly outer most skin layers.   For a few hours this makes the complexion look better but that is all these over the counter products do.  When considering creams versus cosmetic procedures like BOTOX or face lift, ask yourself what kind of a change you need to see.  If you are suffering from flaky, dry skin, a cream may help you out.  If your skin is sagging, your cheeks are hollow, and your features creased with wrinkles, will a cream reverse these effects? Of course not!  It is not realistic to expect a cream to make these kinds of changes even a super expensive one from a fancy department store or boutique.

If you are looking for some kind of structural change, like eliminating wrinkles and hanging skin, filling in hollow areas, or making your eyes look bright and alert, a cream won’t get you far no matter how many buzz words the marketing uses.  This makes sense when you think about the reasons people need facial cosmetic procedures.  The effects of aging, stress, gravity, and sun exposure add up over the years and impair the actual structure of your face.  For example, BOTOX for wrinkles works great because it relaxes overactive muscles that are creating wrinkles.  If these muscles are causing your wrinkles, a cream that is merely absorbed into the outer most layers of your skin will not work.  Those seeking alternatives to facelift through creams would do well to consider how a facelift accomplishes the dramatic improvements we see.  A facelift tightens the deep plane structures of the face and removes extra skin.  Again creams only penetrate the last few cell layers in the outermost part of the skin.

The Cream We Always Recommend

It may not reverse the damages and signs of aging you’ve already incurred, but we know that there is a fantastic cream available that will help prevent the signs of aging: sunscreen!  Over time, our faces show the effects of sun damage through problems in complexion and texture.  Protect your looks and health by finding a sunscreen that smells good and is not greasy.  You will not wake up tomorrow with a new and revitalized face, but in ten years your face will thank you for protecting it.

Making an Informed Decision

We always encourage you to decide for yourself what you’ll do through research, private consultations, and finding a treatment plan that makes sense.  When you evaluate before and after photos, pay special attention the lighting and camera angles to see if the photos are misleading you by changing the photography methods from unflattering to flattering effects that are superficially created by a camera.  Also keep in mind that the images you see are examples of the very best results, rather than typical outcomes.

You can obtain great and natural results through surgeries like facelifts as well as nonsurgical, minimally-invasive treatments like BOTOX, Restylane, Fotofacial, and the chemical peel.  There are a lot of options out there for you to sort through, so be especially careful to look out for signs of a scam.  Effective treatment isn’t cheap, and it doesn’t come in the form of an overpriced magic lotion.  It doesn’t promise more than it can do, and it is honest in its portrayal of results.

Contact us today to schedule your individualized private consultation with Dr. Steinsapir, whom many esteem as one of the best cosmetic surgeons in Los Angeles specializing in facial treatments with natural results.  He can help you find the best solution based on your individual needs and answer your questions openly and honestly.

Will getting BOTOX and Restylane make me look worse when they wear off?

Let’s clear up this misconception right away: as the effects of your treatment begin to wear off after several months, your face will slowly regain the looks it had immediately before your treatment, but there is no evidence that Restylane and BOTOX treatments will make you look worse.  The only change is that you looked better for 4 months in the case of BOTOX and over a year in the case of Restylane.  They have very few side effects, which are generally mild anyway.  If you aren’t happy with your results then simply don’t return for re-treatment and you will return to exactly what you used to look like.

before and after Restylane and BOTOX photo

before and after Restylane and BOTOX photo

Are the scary stories I’ve heard true?

A lot of people are apprehensive when it comes to receiving cosmetic treatments.  With all the media scares, rumors about celebrity BOTOX disasters, and misinformation abound, it can be a challenge to sort the truth from the hype.  It can be even more of a challenge to separate an extremely rare risk from typical outcomes.  For example, an unusual story of something that happened one time may technically be an accurate story, but it ventures into dishonesty as soon as it’s misrepresented as a typical event.  In the cases of BOTOX and Restylane, it’s true that in rare cases there can be side effects that are usually mild and not long-lasting, but if you are thinking of a particular public face that just hasn’t been the same in years, then you probably aren’t looking at before and after photos of Restylane and BOTOX, as these treatments wear off over time.  It is treatments like silicone oil, excessive surgery, and simply the ravages of excessive lifestyles that create long term damage to the faces of our celebrities.

People love to talk about dramatic, dangerous situations.  But the truth is, BOTOX and Restylane have an incredibly safe history with results that aren’t permanent.

How will BOTOX and Restylane change my face?

Treatments like BOTOX and Restylane are popular because they are noninvasive treatments that together can smooth wrinkles, relax tense muscles, and fill in hollow areas.  They are remarkably safe and, since they aren’t permanent, create a win-win situation.  If you are happy with your BOTOX or Restylane treatment, touch-up the treatment when need.  If you are not thrilled, let it wear off and move on to something else.  Sometimes we hear patients ask questions like, does BOTOX make wrinkles worse?  Sometimes they express concern about what happens after Restylane injections wear off.

We cannot emphasize enough that BOTOX and Restylane will not permanently alter your looks.  BOTOX is a naturally-occuring muscle relaxant compound, and Restylane is made from a biodegradable sugar-gel that occurs naturally in the body.  Both of these are eventually broken down and expelled from your body completely.  You’ll notice as this happens that your wrinkles will slowly return.  They may stand out to you after months of looking much better, in some cases, fantastic, but if you look at photos of yourself from before treatment, you will see that your problems have not been made worse by treatment.  You are simply getting your old face back.  Will this make you feel like you need more treatment-absolutely because these treatments are truly effective.

In the short run, BOTOX and Restylane will give you a youthful appearance and resolve many problems.  In the long run, BOTOX and Restylane will not affect your looks after you allow their effects to wear off.  A difference between BOTOX and Restylane is that BOTOX treatments are generally needed twice a year, while Restylane is needed once a year.  Most patients opt for retreatment when they see their old problems beginning to return.  This will maintain the natural-looking results gained from treatment.

Can BOTOX and Restylane prevent problems?

We are often asked questions like, can BOTOX prevent wrinkles?  We know that BOTOX does not aggravate wrinkles or make them worse in the long run.  We also know that the face is subject to gravity and general usage as we age, and that wrinkles can be caused by tense muscles.  When these overactive muscles relax, as they do in response to BOTOX, the skin is no longer constantly being creased.  This is similar to a folded piece of cloth; if you take a wrinkle-free piece of cloth and fold it over, then bring it back, you’ll see that it doesn’t “remember” the fold and is not wrinkled.  However, if you fold that same piece of cloth and place it under a book overnight, it will have a set crease when you come back to it.  When BOTOX and Restylane dissipate wrinkles, they are keeping the skin taut so it doesn’t “remember” those problems that BOTOX and Restylane prevent.

The Bottom Line

When Restylane and BOTOX wear off, you will look exactly as you did before treatment, although 6 to 16 months older.  You will not look worse as a result of Restylane or BOTOX wearing off.  If anything, you may have delayed the aging process.  It is understandable why people maintain treatment effects by refreshing their service when the feel it is necessary.

An Individual Treatment Program

Now that you’ve done some research on BOTOX and Restylane treatments, you’re ready to take the next step: research a doctor who can answer the rest of your questions and decide if treatment is right for you.  Dr. Steinsapir specializes in cosmetic facial treatments like Restylane and BOTOX in Beverly Hills and Los Angeles.  Dr. Steinsapir is a leader in facial cosmetic treatments and has innovated advanced treatments like Deepfill Restylane and Microdroplet BOTOX.  Call us today to find out how Dr. Steinsapir can individualize your treatment plan.

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