August 17, 2011

How Can I Fix Droopy Eyelid After Botox?

Experiencing a droopy eyelid following a BOTOX® treatment is not normal!  If you experience serious ptosis after receiving BOTOX, meaning one eye is 2 mm to 3 mm lower than the other eye, it’s important for you to be assessed by an oculoplastic surgeon.  If your ptosis is severe, and you have confidence in your treating physician, there is no harm in letting that doctor assess you.  However, while things can happen, this degree of ptosis is very unusual.  If you have any concerns about your doctor, it is highly recommended that you consider getting a second opinion.

Iopidine Ophthalmic Drops May Help

Oculoplastic surgeons are trained to assess and follow upper eyelid ptosis.  They are familiar and have experience treating upper eyelid ptosis.   A prescription for Iopidine (aproclonidine ophthalmic solution) can be helpful in this circumstances.  This medication is a glaucoma medicine that can elevate the eyelid a couple of millimeters. The drops can also be used to assess the severity of the ptosis and predict the likely time frame for the resolution of ptosis.  Dr. Steinsapir recommends trying the drop twice a day for a week.  If the drop is working to open the eye, then it is likely that the ptosis will resolve in 4-6 weeks.

What if the Drops Don’t Work?

If the drops do not cause a change in the position of your upper eyelid, you have a more profound BOTOX-induced upper eyelid weakness.  In these cases, the ptosis can last up to three to four months―in very rare cases, this might last even longer.  If the drops are not working, don’t keep using them.  Instead, try the drops approximately every fifth day or so.  Use them twice a day when they work.  The drops in no way speed up the final resolution of the upper eyelid ptosis and only appear to be effective when the BOTOX effect is mild.

How Can I Avoid This Kind of Problem?

The incidence of upper eyelid ptosis in the hands of an experienced injector is very, very small.  Less experienced injector are more likely to perform a treatment that causes ptosis.  It’s important to carefully research a doctor or nurse’s credentials and their track record for successful injections.  Looking at one series of eight patients, for example, presented to Dr. Steinsapir in Los Angeles, only one of them had their actual dose of BOTOX recorded in his medical chart.  Years ago, when doctors were still trying to understand the best method of BOTOX treatments, upper eyelid ptosis was reported in as many as 5 percent of cases. The incidence of upper eyelid ptosis in the hands of experienced injectors is much less than 1percent. For example, Dr. Steinsapir has treated only three mild cases of ptosis in his last 3,500 treatments.

About Dr. Steinsapir

Dr. Steinsapir trained alongside the inventor of BOTOX and has performed thousands of BOTOX treatments in Los Angeles since 1988 and recently patented his Microdroplet BOTOX technique. He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in BOTOX, which can be a vital part of your minimally invasive treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment.  No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success.  Only you and your treating physician or surgeon can determine if a treatment is right for you.

 

July 26, 2011

How does BOTOX and the new product Xeomin compare?

Xeomin® is a Botulinum Toxin A, made by Merz Pharmaceuticals that contains the same active ingredient found in BOTOX® and Dysport®.  Unlike BOTOX however, Xeomin does not need to be refrigerated before reconstitution.  Xeomin isn’t currently approved for cosmetic uses but it is comparable to to BOTOX and Dysport.

Uses for Xeomin

Xeomin is approved by the US FDA for the treatment of adults with cervical dystonia, severe neck spasms, or blepharospasm, advanced eyelid spasms.   It is not approved for the treatment of wrinkles and crows feet in the United States, but it is used throughout Europe and Canada for this purpose.

Merz, the company that developed Xeomin, reports that clinical studies for cosmetic applications are underway.  Doctors are able to use this product in what is referred to as “off-label” manner, meaning that your doctor can prescribe Xeomin at doses and for procedures other than those recommended by the FDA, however in these situations, you are using the product at your own risk.  It is possible to obtain treatment for cosmetic indications with Xeomin.  Just note that such uses have not been tested rigorously and may pose higher risk than being treated with drugs that are formally approved for treating cosmetic issues such as BOTOX® and Dysport®.  Based on studies so far and the use of Xeomin in Europe – where it is available for cosmetic purposes – doctors anticipate that Xeomin will work very much like BOTOX for cosmetic applications.

Botox versus Xeomin

There is no scientific evidence to suggest that Xeomin will be better than BOTOX, or less effective.  If you are treated with Xeomin, the dose your doctors uses may be the same or slightly different than the dose used for BOTOX.   These products are not bioequivalent and for this reason, treatment may vary.

Like any product introduced into the market as a competitor to existing brands, the use of Xeomin, once it is approved by the US FDA for cosmetic use, will be based largely on personal preference.  But as with any Botulinum Toxin A injection, it’s important to remember that only an experienced cosmetic surgeon should perform the procedure.  Just as BOTOX and Dysport cannot be administered by an esthetician, an unsupervised nurse, or anyone other than a licensed professional, Xeomin is no different.  Do not assume that because it is new and has different dosing and storage requirements than BOTOX, that it can be administered by anyone.

About Dr. Steinsapir

Dr. Steinsapir trained alongside the inventor of BOTOX and has performed thousands of BOTOX treatments in Los Angeles since 1988 and recently patented his Microdroplet BOTOX technique. He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in BOTOX, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment.  No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success.  Only you and your treating physician or surgeon can determine if a treatment is right for you.

July 15, 2011

What should I expect with my BOTOX treatment?

There are a lot of different rumors out there about what you can expect from BOTOX®,  Dysport®, or other botulinum toxin A injections; rumors about harmful side effects, who is qualified to perform the injections, and long recovery periods.  The truth is, BOTOX injections have an amazing track record for safety and  require little to no down time.  The results last from 4 to 6 months before you may feel the need to freshen your appearance.  Receiving BOTOX relaxes your facial muscles to remove crows feet, lines in your forehead, and that angry pinch at the eyebrow that robs you of a more youthful, relaxed, and friendly appearance. There is no substitute for having a leading authority in cosmetic surgery personally perform your service.

Where is surgery commonly performed?

BOTOX injections are an office-based service. You may see estheticians and unqualified individuals like medical assistants offering injections illegally in spas and salons under the justification that they have a “medical director.”   There are no states that permit this arrangement.  Unless a doctor is present and performs the service, this type of situation is the illegal practice of medicine.  Don’t let an unqualified individual perform your BOTOX or Dysport service.

Only a licensed medical doctor or a nurse under the direct supervision of a licensed medical doctor can inject BOTOX.  The exact details of the required qualifications vary by State so it’s important to research the individual you wish to perform the injection to ensure he or she is qualified.  However, just because your doctor or nurse is minimally qualified to perform the injection does not necessarily indicate he or she is the ideal choice for the procedure. As with many other medical procedures, the best results require a certain level of qualification, skill and experience; these concerns are perhaps even more important when considering modifications to your physical appearance.

What is the typical recovery course and physical restrictions?

BOTOX injections may cause a little bruising from the treatment and you may notice redness in your skin for an hour or two. Many people find that they can return to work immediately after treatment.  Others find that they like to apply a little ice to the injection points before facing work again.

Although you can return to your usual routine following treatment and may feel physically ready to take on the world, Dr. Steinsapir strongly advises you refrain from exercising and engaging in strenuous physical activity for at least 24 hours.

What are some common complications after a cosmetic botulinum toxin treatment and how are they addressed?

Many prospective patients worry about side effects or potential dangers of Botox® injections.  In the case of BOTOX® and Dysport®, the FDA issued a “Black Box Warning” in 2009 because there was concern regarding a rare but potentially fatal complication when they are used to treat very small children with cerebral palsy.  The dose used for these medical treatments can be 10 or more times higher that what is used for cosmetic purposes.  More information regarding these issues can be found here.

“Dose is very important in the safety of all drugs, not just BOTOX® and Dysport®” says Dr. Steinsapir a leading authority, teacher, and much sought after BOTOX® injector.  Even the safety of aspirin, which is present in almost every American household, is dependent on dose: two aspirins helps your headache feel better, but 20 aspirins are poisonous..

Many unwanted results like the BOTOX forehead freeze, droopy eyebrows, the appearance of the eyes being smaller, and the “bat-face” caused by muscle recruitment in areas of the face that have not been treated, are the result of physicians injecting BOTOX incorrectly.  Carefully researching your chosen physicians credentials and experience can greatly reduce the risk of one of these side effects.

An innovative alternative

Dr. Steinsapir has invented Microdroplet™ BOTOX® to address the need to retain authentic facial expression and natural eyebrow placement. Unlike standard BOTOX® procedures, Microdroplet™ BOTOX® creates brow lift without forehead paralysis. If you have had BOTOX® treatments in the past but were not satisfied, Microdroplet™ BOTOX® may give you the results you need by working with greater precision with your facial muscles. The care and interest Dr. Steinsapir has shown in inventing this treatment demonstrates his dedication to achieving a beautiful, more youthful appearance without impeding the ability to express emotion.

Using standard injection methods, there is no way to selectively treat the muscles that pull the eyebrows down.  Instead these methods tend to freeze the forehead.  Perhaps you have experienced these types of results yourself or have seen them in your favorite actresses: The forehead can’t move and the eyebrows drop like stones.  What looks good is a gently lifted eyebrow, no crows feet lines or brow pinch, and a forehead with reduced lines that is still able to move.  Imagine a BOTOX® treatment that allows you to have natural expressions!

About Dr. Steinsapir

Dr. Steinsapir trained alongside the inventor of BOTOX and has performed thousands of BOTOX treatments in Los Angeles since 1988 and recently patented his Microdroplet BOTOX technique. He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in BOTOX, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment.  No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success.  Only you and your treating physician or surgeon can determine if a treatment is right for you.

July 7, 2011

What’s the Best Eye Wrinkle Treatment?

Eye wrinkles are treatable, but not unavoidable.  There is no cure for aging and therefore, no cure for wrinkles, especially around the eyes―our most expressive feature.    However, you can take preventative measures to delay and even reduce the appearance of wrinkles.  There’s no magic cure, but using sunscreen on a daily basis and wearing sunglasses are an excellent way to limit the effect of sun damage and squinting, which are thought to play important roles in the development of periocular wrinkles. It is generally thought that smoking also damages the delicate elastin in the skin speeding the development and severity of facial wrinkles.   Once these wrinkles do appear you will need more than a skin moisturizer to help improve these lines.

Fillers and Muscle-relaxers

Treatments like BOTOX®, Dysport®, and Restylane® are popular because they are noninvasive treatments that can smooth wrinkles, relax tense muscles, and fill in hollow areas.  These injections are not permanent and will wear off.  Touch-up or maintenance treatment is repeated as necessary.  This is typically twice a year for the botox service and commonly a year for the filler service.

BOTOX and Dysport are naturally-occurring protein that prevents treatment muscles of facial expression from contracting, and Restylane is made from a naturally occurring sugar-gel that is found in the body.  Both of these products are eventually organically broken down and expelled from your body completely primarily in the form of water and CO2.  You’ll notice as this happens that your wrinkles will slowly return.  They may stand out to you after many months of looking much better.  When should you be retreated?  Dr. Steinsapir does not believe that your next treatment needs to occur more frequently than once a year.

Can BOTOX and Restylane prevent problems?

We know that BOTOX and Dysport 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 and Dysport, the skin is no longer constantly creased.  While there are no clinical studies suggesting that ongoing treatment with these agents prevent wrinkles from forming, it does make sense that less skin creasing should help preserve skin integrity and reduce the formation of lines and wrinkles.

About Dr. Steinsapir

Dr. Steinsapir trained alongside the inventor of BOTOX and has performed thousands of BOTOX treatments in Los Angeles since 1988 and recently patented his Microdroplet BOTOX technique. He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in BOTOX, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment.  No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success.  Only you and your treating physician or surgeon can determine if a treatment is right for you.

June 10, 2011

Should I use Zytaze before getting my next BOTOX treatment?

According to the website, Zytaze® “provides nutritional support to enhance the effectiveness of botulinum toxin injections in the treatment of blepharospasm, hemifacial spasm, or cosmetic procedures.”  The manufactures also claim that Zytaze will extend the effects of your botulinum toxin injections up to 25 percent longer.  Although the science on the website sounds convincing, it’s important to read the fine print on Zytaze.com, which states that the manuscript explaining the statistics is still under review.  So does Zytaze have any benefits? Does it have any negative effects?

The manufacturer’s claims

OCuSOFT, Inc., the manufacturers of Zytaze, state that their product works by improving your body’s ability to absorb zinc.  In order for botulinum toxin injections such as BOTOX®, Dysport®, and Xeomin® to be effective, each molecule of the botulinum toxin must bond with a molecule of zinc.  Phytase, one of two active ingredient in Zytaze, is an enzyme that increases the body’s ability to absorb the zinc, the second active ingredient.  Each prescription comes with 10 pills for a five-day treatment regimen prior to receiving the injections.

Warnings and concerns

A five-day Zytaze prescription can cost around $80 and to save money you may be tempted to purchase generic, over-the-counter Zinc Citrate and Phytase.  However, too much zinc can cause gastrointestinal problems and consuming too much Phytase can cause you to suffer from zinc toxicity, even if you aren’t over-dosing on the zinc itself.  Talk to your doctor before you start taking any of these supplements to ensure you are taking just the right amount.  Before you undergo any procedure, medical or cosmetic, give your doctor a list of all the medications, supplements, and vitamins you’re taking.

The science

Taking Zytaze before undergoing a BOTOX injection may not be helpful if your zinc and Phytase levels are properly balanced.  The study has not been published.  However, clinical data cited in the patent application for the product suggests that investigator studied very few patients in the age range that gets BOTOX cosmetic.  Half of their study patients were over 70 years of age.  Until their study is published in the peer reviewed literature, the claims should be take with a grain of salt.

About Dr. Steinsapir

Dr. Steinsapir trained alongside the inventor of BOTOX and has performed thousands of BOTOX treatments in Los Angeles since 1988 and recently patented his Microdroplet BOTOX technique. He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in BOTOX, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment.  No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success.  Only you and your treating physician or surgeon can determine if a treatment is right for you.

May 22, 2011

How young is too young to receive BOTOX?

In March 2011, Good Morning America aired a story about a pageant mother who regularly injected her 8-year-old daughter with BOTOX®.  As shocking as it is to see a child worrying about wrinkles at such a young age, it’s equally shocking to learn that her mother, an esthetician, was performing the injections herself.  It is illegal for anyone other than a licensed medical doctor or nurse under the direct supervision of a licensed medical doctor to inject BOTOX.  In May 2011, Child Protective Services took the young girl from her mother and while no one likes to see a child removed from their parents’ custody, it’s a relief to hear that this behavior is not normal.  The story has a lot of people asking: How young is too young to use BOTOX?

Food and Drug Administration guidelines

The FDA has approved cosmetic BOTOX and Dysport® for anyone between the ages of 18 and 65 and medically-necessary BOTOXv for children as young as 12. However FDA approvals and recommendations operate as guidelines, not legal mandates.  This means that a physician may use his or her judgment when administering BOTOX, Dysport, or Xeomin®; a physician has the freedom to use it in ways that are not FDA-approved.  Using BOTOX, Dysport, or Xeomin in this manner is referred to as “off-label use” and many drugs are used in this fashion with great benefit to the individual receiving treatment.

BOTOX for medical applications

BOTOX and the other clinically available botulinum toxins are often used to treat muscle spasms, cerebral palsy, migraines, excessive sweating, and a number of other medical conditions.  In these situations, physicians will often use BOTOX in an off-label manner and administer it to children younger than 12.  If a physician recommends BOTOX for a young child with one of these medical conditions, the physician has reason to believe that the child’s quality of life will be improved by BOTOX treatments even though medical treatment with these agents for young children is associated with death and life-threatening side effects.

BOTOX for cosmetic applications

The benefits of BOTOX and Dysport on worry-lines in the forehead and around the eyes are undeniable.  However, children have very elastic skin and sub dermal fat to give their faces volume that adults lose as they age.  This elasticity and sub dermal fat is what makes children’s skin so smooth and wrinkle-free.  Receiving cosmetic BOTOX before you’re skin begins to lose these youthful features is not necessary.  So what’s the right age to begin receiving cosmetic BOTOX injections?  That’s a question only you can answer with help from your doctor.  However any reasonable person can understand that injecting an 8 year-old to make her more competitive for a beauty pageant is shockingly inappropriate and abusive.

About Dr. Steinsapir

Dr. Steinsapir trained alongside the inventor of BOTOX and has performed thousands of BOTOX treatments in Los Angeles since 1988 and recently patented his Microdroplet BOTOX technique. He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in BOTOX, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment.  No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success.  Only you and your treating physician or surgeon can determine if a treatment is right for you.

May 20, 2011

I live outside the country, can you recommend someone to perform Microdroplet BOTOX outside the United States?

Microdroplet BOTOX® is a specialized technique developed and patented by Dr. Steinsapir (US Patent US 7,846,457).  Dr. Steinsapir is currently the only physician to offer this service; to enjoy the benefits of this particular treatment, you need to see Dr. Steinsapir as a patient.  Dr. Steinsapir is currently in the process of developing a training program that will make this method of administering BOTOX available everywhere.

Midrodroplet BOTOX process

The Microdroplet BOTOX process controls the depth and distribution of the BOTOX to maximize a natural lift of the eyebrows while preserving natural forehead movement.  This method differs from the way BOTOX is traditionally injected because it prevents unwanted eyebrow pinch and allows you to continue to move your eyebrows naturally.  Microdroplet BOTOX lifts the brow, opening up the eyes to give you a more youthful appearance, but without causing the traditional forehead freeze.

About Dr. Steinsapir

Dr. Steinsapir trained alongside the inventor of BOTOX and has performed thousands of BOTOX treatments in Los Angeles since 1988 and recently patented his Microdroplet BOTOX technique. He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of BOTOX.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success.  Only you and your treating physician or surgeon can determine if a treatment is right for you.

March 22, 2011

How do I avoid the BOTOX® “frozen forehead”?

The frozen forehead, or “BOTOX® freeze,” leaves you with a forehead that is glass smooth, without a line in sight. But the aesthetic costs of this effect are significant; it causes the eyebrows to fall and the eyes look small and closed in, an effect seen in many well-known models and actresses. These types of results are undesirable, but with proper placement of the BOTOX they are also completely avoidable.

Dr. Steinsapir has a solution

Dr. Steinsapir is the inventor of the newly patented Microdroplet™ botulinum toxin (BOTOX, Dysport®, Xeomin®) method.  The Microdroplet method of administering cosmetic botulinum toxin is a breakthrough invention that revolutionizes the way we think about BOTOX treatments. The Microdroplet BOTOX treatment is applied less densely in the ‘worry line’ area to maintain the ability to furrow. The Microdroplet BOTOX treatment along the eyebrows and crow’s feet is very natural and does not interfere with the activity of the forehead. There is absolutely no reason to have a frozen forehead with this new technology.

To achieve natural results without the “forehead freeze” sometimes associated with BOTOX, Microdroplet BOTOX relies on highly controlled placement of tiny microdroplets of botulinum toxin to balance out the give-and-take of the muscles pulling around the eyebrows and causing the all too familiar pinching and frown lines.

The benefits of Microdroplet BOTOX

The result of the precise and balanced placement of your Microdroplet BOTOX treatment is that you can attain natural-looking results that balance your facial features while avoiding the side effects that you see with traditional BOTOX treatments.  While there is a chance with any cosmetic procedure that you will not be completely satisfied with your results, Microdroplet BOTOX can maximize your chances for a natural outcome by relaxing overactive facial muscles and emphasizing features that make a face look more youthful.

Who is a candidate for Microdroplet BOTOX?

Microdroplet BOTOX is recommended for high-profile professionals such as executives, actors, and other individuals who seek an improved aesthetic appearance.  Microdroplet BOTOX preserves natural forehead movement and expression without the all-to-familiar frozen appearance that has become the hallmark of getting treatment with BOTOX using traditional injection methods.  The relaxed and lifted eyebrows with preservation of forehead movement sets this treatment apart from other off-label methods.  Those who wish for a younger look with reduced wrinkles, frown lines, and crows feet will want to checkout Microdroplet BOTOX.

About Dr. Steinsapir

Dr. Steinsapir trained alongside the inventor of BOTOX and has performed thousands of BOTOX treatments in Los Angeles since 1988 and recently patented his Microdroplet BOTOX technique. He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of BOTOX.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success.  Only you and your treating physician or surgeon can determine if a treatment is right for you.

March 19, 2011

Who can inject BOTOX®?

The short answer to the question of who can inject BOTOX® is: any licensed medical doctor or any nurse under the direct supervision of a licensed medical doctor.  The exact details of the required qualifications vary by State so it’s important to research the individual you wish to perform the injection to ensure he or she is qualified.  However, just because your doctor or nurse is minimally qualified to perform the injection does not necessarily indicate he or she is the ideal candidate for the procedure. As with many other medical procedures, ideal results require a certain level of qualification, skill and experience; these concerns are perhaps even more important when considering modifications to your physical appearance.

Nurses

Most States do not allow the independent practice of nurses performing BOTOX injections.  The presence of a “Medical Director,” in name only, is no substitute for a personal examination by a supervising physician on the premises when you are treated by a nurse. It has become common to see nurses injecting clients at beauty salons.  They might also suggest that they are supervised by a “medical director.”  In the State of California for example, registered nurses are only permitted to inject under the immediate supervision of a licensed physician.  The physician needs to have performed an examination and be physically present in the same office where the treatment is taking place.

When seeking a professional for this procedure, talk to the doctor to determine who will perform the procedure, what their qualifications are, if they have undergone specialized training, and how much experience they have performing the injections.  If you don’t feel comfortable with the prospect of the nurse or the doctor performing the injections, it’s time to look for someone new.

Dr. Steinsapir never uses nurses or “physician extenders” to treat you.  He personally performs all treatment himself.  Don’t be fooled into thinking that cosmetic treatments are simple enough to be performed by an assistant under supervision.  Dr. Steinsapir, like all reputable surgeons, makes sure that he is available to answer your questions in person and address your concerns individually, rather than directing you to a receptionist or simply brushing you off.  He can individualize your treatment plan to help you meet your personal goals.  Have treatment at the time of your consultation if it is right for you.

Dentists

Most States do not permit general dentists to inject cosmetic BOTOX.  However, dentists who hold a dual, MD and DMD degree sometimes perform cosmetic BOTOX injections.  These individuals are often highly trained Maxillofacial surgeons with residency training in Maxillofacial surgery.  It is misleading to simply describe these individuals as “dentists.”  Check with the licensing board for your State to learn what is, or is not permitted.  When it doubt, remember, that there is no substitute for experience in performing these treatments.

The right doctor for the job

When seeking a medical professional for BOTOX injections, board certification in one of the four core aesthetic specialties is usually a good place to start: Dermatology, General Plastic Surgery, Facial Plastic Surgery, and Oculoplastic Surgery.  Board certified professionals in one of these four specialties undergo rigorous and extensive training and have a wealth of experience working with BOTOX.  Especially when seeking cosmetic injections in the facial regions, look for someone who understands the importance of adapting treatment for a given face.

Beginning your search with board certified professionals will greatly reduce the number of unqualified professionals you interview.  Look for someone with the skills and experience to provide satisfactory results that make you happy.

About Dr. Steinsapir

Dr. Steinsapir trained alongside the inventor of BOTOX® and has performed thousands of BOTOX® treatments in Los Angeles since 1988.  He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of  Medicine at UCLA.  Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of BOTOX, which can be a vital part of your evidence-based treatment plan.

February 27, 2011

Can I exercise my facial muscle for an improved tone?

Exercise and diet are essential for a healthy lifestyle, but it’s important to recognize their limitations.  Not every condition can be cured by exercise, vitamin supplements or fad diets, especially when the problem is not a result of poor nutrition or inactivity.  We absolutely encourage you to exercise moderately and eat well, but we admit to being skeptical of the arising claim that exercising facial muscles can restore youth and beauty to one’s face.  This is an unproven method, and when one considers that they are likely still using their facial muscles just as much as they were ten years ago, it becomes apparent that their aging looks are unlikely due to facial inactivity.

It’s appealing to believe that we can resolve all of our concerns through exercise, and while research shows that exercise does benefit our health in many ways, it also shows that further medical treatment is required for many conditions.  Just as someone with presbyopia cannot exercise to regain the ability to focus for reading vision, it’s not likely that you’ll be able to reverse the effects of age, time, gravity, and stress by wiggling your face or by having electrical currents stimulate your facial muscle to contract.

There are many types of facial cosmetic surgery and other treatment that can help you obtain the result you need if your doctor determines that you are a suitable candidate.  These range from minimally invasive treatments with little-to-no downtime like BOTOX and undereye Restylane to surgeries like the facelift and plastic eyelid surgery including eyelid reconstruction, which give dramatic yet natural results to individuals with far-reaching concerns.  While it is impossible to know which treatment, if any, is most suitable for you before a private consultation with the best facial cosmetic surgeon for you, you can be confident that there are a wide range of treatments that an expert can custom-tailor to meet your needs.

As a specialist in facial cosmetic treatments, Dr. Steinsapir has treated many individuals who first explored a variety of “natural solutions” for their aesthetic facial concerns.  Frustrated when they saw no results, they eventually consulted with Dr. Steinsapir and opted for proven treatment methods that provide dramatic yet natural results.  This human tendency to pursue unproven treatments is not a fault; it is normal to want to independently resolve a problem using the least invasive and most economical method possible.

Dr. Steinsapir is focused on your personal goals and comfort level.  Dr. Steinsapir always asks you questions about your specific goals, individual situation, and preferences so that he can plan a solution that is aligned what you want, so you can feel comfortable knowing that you are ultimately in control of your treatment plan.  Dr. Steinsapir very much believes in using the least invasive method for accomplishing a particular goal; for example, he does not recommend a forehead lift when a BOTOX treatment for wrinkles will will meet your goals – and he is a leader in his field of minimally invasive solutions.

If you are seeking a proven treatment with an experienced facial plastic surgeon with extensive training in oculofacial plastic surgery, we invite you to a personal consultation with Dr. Steinsapir today.  Dr. Steinsapir is honest, friendly, and can talk to you about customized treatments that give you the results you seek by addressing your specific needs and unique facial features.  Please call us today to schedule a time when you can speak with Dr. Steinsapir.

About Dr. Steinsapir

Dr. Steinsapir is a board certified cosmetic surgeon and oculoplastic surgeon in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Dr. Steinsapir has a private practice and also serves patients at UCLA, where he is an assistant
clinical professor. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of facial cosmetic surgery and eyelid reconstruction, which can be a vital part of your evidence-based treatment plan.

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