As one of the first doctors to use Botox® for cosmetic applications in the early 1990s, Dr. Amiya Prasad believes in personal customization and conservative application that suits his natural-looking aesthetic style. As always, Dr. Prasad makes sure to clearly explain to all his patients the factors needed to be understood, before giving his expert recommendation to the patient’s current facial issue.
He begins with scientific facts, which is comprised of genetics, health issues, and the huge influence of environmental factors. For patients, this type of approach sets them at ease, for what they perceive as their imperfections is seen by Dr. Prasad as their unique characteristic beauty that can be enhanced with a skilled and experienced touch.
More often than not, patients assume that aggressive treatments like surgery are the way to maintain or regain their intrinsic youth and beauty. However, Dr. Prasad, when fully aware of the patient’s problem, will only recommend the most beneficial option—which may or may not include surgery. In the case of wrinkles on the facial area, Botox® is often the better or only option when compared to surgery.
Botox is a liquid injected into the patient’s facial muscles. The main focus of this treatment is to zero in on muscles that make repetitive contractions or movements, like those in the forehead (occipitofrontalis muscles that encompass the entire width of forehead), those that cause vertical wrinkles between eyebrows and the nose (corrugator supercili muscles,) and those that cause wrinkles on the nose (procerus muscle.)
It was discovered centuries ago as part of a bacterium found in ham and sausage. It is a fact that this bacterium, which German scientist Van Emengem named Bacillusbotolinium (derived from the Latin word botolus meaning “sausage”) causes paralysis, extreme twitching, and even death, to name a few.
Botolinum toxic type A, also known as Botox® Cosmetic, is a safer derivative of this bacterium, used to minimize wrinkles through the careful and exact paralysis of facial muscles.
What does Botox do?
Botulinum toxin most commonly known by the popular brand name
Botox is well known in the aesthetic field yet at the same time there was a lot of confusion about what Botox can do for example patients have asked me if Botox is an alternative to surgery or can it completely make deep lines completely disappear
I’ll help you understand what botulinum toxin like Botox can do for your appearance and how I use it in my practice
I’m Dr. Amiya Prasad I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon I’ve been in practice in New York City and Long Island for over 25 years as an oculoplastic surgeon my specialty was amongst the first doctors to use Botox for issues like facial muscle spasms so I’ve been treating patients with botulinum toxin since 1993 once FDA approval for cosmetic use occurred in 2002 the popularity of Botox skyrocketed to where it is today
So exactly what is Botox or other brands of botulinum toxins such as Dysport Xeomin and Jeuveau they’re all categorized as neurotoxins and have different chemical structures which fall under the category of botulinum toxin a neurotoxin like botulinum toxin
When injected into muscles inhibits or limits muscle movement temporarily by blocking signals from nerves to the muscle it takes about three days for botulinum toxin to take effect with the peak effect being in about two weeks
These effects can last for three to six months it’s important to understand that what is injected is a liquid that affects muscle movement this is in contrast to a filler such as hyaluronic acid which is not a neurotoxin but it’s rather a gel used to enhance some volume wherever it’s placed hyaluronic acid fillers have the unique advantage in that they can be dissolved with an enzyme called hyaluronidase should the need arise botulinum toxin cannot be reversed you have to allow for a few months to transpire before the effects wear off with this particular constraint in mind
In my practice I started with more conservative dosing and have my patients come back in two weeks to evaluate their appearance if additional botulinum toxin is needed
I strategically place more at that time I make note of this for future treatments one principle behind the use of botulinum toxin is to reduce the activity of certain muscles which actively contribute to the formation of deep lines for example an area that can be treated with botulinum toxin are the crow’s feet lines located at the outer aspects of the eyes these lines result from contraction of a muscle called the orbicularis oculi muscle by inhibiting movement of this muscle there isn’t as much creasing in the skin which can cause the deep wrinkles to be primarily formed since the eyes are so important to your appearance my patients often ask about crow’s feet lines wrinkles and discolorations which remain visibly significant after botulinum toxin treatment
This is because the wrinkles and discolorations are the result of deficiencies in the skin quality resulting from causes such as aging sun exposure and smoking my approach to these problems is to customize a strategy to improve the backbone of the skin called the dermis and the surface of the skin called the epidermis for example I use platelet-rich plasma or PRP which is derived from your own blood for benefits of the healing and growth factors that stimulate collagen production and improve your skin’s blood supply
I use different lasers to resurface the skin which refreshes the epidermis as well as radiofrequency technology to help tighten the skin another area where deep lines can be improved by reducing muscle activity is the number 11 lines located between the eyes and on top of the nose these are also called frown lines or glabellar lines which is more of a medical term
These lines have a particularly significant effect on how people perceive you very often people with deep glabellar lines appear to look like they’re upset or angry by injecting botulinum toxin into the procerus and corrugator muscles muscle activity is reduced and these vertical creases become less visible horizontal forehead lines also form due to repetitive use of the frontalis muscle which is responsible for raising the eyebrows
These lines often accompany glabella or frown lines the frontalis muscle lifts the brows and the corrugator and procerus muscles move the brows in and downward since these are opposing muscles the key to satisfactory result is to reduce the horizontal forehead lines while preventing the brows from dropping too far downwards in addition to the reduction of lines formed by muscle activity botulinum toxin can be used for enhancement of different areas of the face by balancing muscle activity with muscle relaxation for example I use botulinum toxin for a procedure called a non-surgical brow lift
I achieved this by relaxing the muscles that pull the brows downward which are referred to as brow depressors these brow depressor muscles include the corrugator procerus and orbicularis oculi muscles by relaxing the brow depressor muscles that pull down the brows with botulinum toxin the muscles that lift the eyebrows in the forehead called the frontalis muscle work unopposed thereby raising the eyebrows botulinum toxin can be used to enhance the appearance around the mouth and lips vertical lip lines above the upper lip also called smoker lines are associated with the activity of a muscle called the orbicularis oris muscle this muscle is used when puckering kissing and in activities like drinking from a straw the depth and appearance of vertical lip lines can be improved
When the lips are puckered by using botulinum toxin to limit the activity of the orbicularis Oris muscle for vertical lip lines that are present when the lips are not in motion a laser procedure can be used to resurface and tighten the skin and improve the appearance of those static lines the downward position of the outer corners of the mouth often seen with the facial aging can be improved by relaxing muscles which pull the outer corners downward called the depressor anguli oris muscles when I treat these muscles with botulinum toxin the muscles pulling the outer corners of the mouth downward work unopposed and so they lift the outer corners of the mouth resulting in a lift that creates a more pleasant expression the upper lip can sometimes almost disappear with smiling
I can strategically place botulinum toxin and make the upper lip more visible when smiling I refer to this procedure as a lip flip some people feel that too much of their gums are seen when they’re smiling
This can be partially due to excess activity of the muscles that lift the lips this is often referred to as a gummy smile I treat the muscle group that lifts the lips to levator labii and the levator labii superioris alaque nasi muscles and I do that with botulinum toxin so the lips don’t elevate as much when smiling and making the gums therefore less exposed a facial imbalance due to the widening of the is associated with thickening of a muscle called the masseter muscle
The masseter muscle is used for chewing and moving the jaw an enlarged masseter muscle occurs frequently with teeth clenching or teeth grinding I inject the masseter muscles with botulinum toxin to reduce the muscle activity that contributes to this enlargement of the masseter muscle over time with consistent treatment the muscle size diminishes and the facial balance is improved multiple small dimples in the chin which is often referred to as an orange peel skin or cobblestone
It can also be treated with botulinum toxin this dimpling is caused by the mentalis muscle often seen with aging the bone loss also contributes to this hyperactivity and greater visibility of the mentalis muscle action on the skin’s surface by reducing the activity of the mentalis muscle with botulinum toxin and the skin dimpling or cobblestone appearance improves
Often combine this with the placement of long lasting hyaluronic acid filler to add projection to the chin and further smoothen the skin surface botulinum toxin particularly the brand Botox has become a worldwide cultural symbol for the natural integration of medical aesthetic procedures into the daily life of anyone who wants to improve their appearance a consequence of this ubiquity has led to a lot of aggressive retailing and misinformation in particular inappropriately minimizing the risks of botulinum toxin injection consumers are being incentivized to self-diagnose and visit any given botulinum toxin dispenser
Some of the most vulnerable consumers fall into two categories one people who don’t have the means or don’t want to spend the time and money necessary to see a higher level specialist for more comprehensive guidance as to the value of botulinum toxin for their particular concerns and number two people in their 20s who are being overly influenced into undergoing botulinum toxin and other procedures which they really just don’t need both of these groups fall victim to transaction driven lower cost physicians and non-physicians who have financial incentives to sell as much as possible to anyone who walks into their shop
Unlike more established higher level physicians with practices and reputations these people are less concerned about the long-term consequences of what they’re doing to the people who they treat I continuously see patients who come in to see me after spending more money and losing time from work after being improperly treated by these medical retailers botulinum toxin like lasers and fillers is one tool in the toolbox of potential solutions for your aesthetic concerns the art is knowing how to use botulinum toxin optimally as well as when not to use it I help a lot of successful people who come to my practice from around the world for their aesthetic needs one aspect of being successful is that they understand how to leverage their time and resources to maximize certainty in everything they do caveat emptor
I hope you found this information helpful thank you for your question
Botox cannot be a treatment for permanent wrinkles that are not prompted by constant muscular contractions, nor is a surgical procedure advisable to erase wrinkles that are caused by normal facial reactions.
Botox® is also most frequently injected in the glabullar area of one’s face, which in layman’s terms, refers to the muscles that control “frown lines”. Botox is also injected into the muscles of the forehead to lessen crease formation and draw attention to the eyes.
It has also been applied to breasts to control drooping or sagging. Botox® is also know to cure physical ailments such as migraines and spinal diseases.
Through Dr. Amiya Prasad’s very conservative way of performing this non-surgical procedure, Botox® rejuvenates and reduces the visibility of wrinkles, fine lines, and creases around the eyes and face.
Dr. Prasad’s steady hand, perception of individual beauty, and artistic style ensures that his patients do not have a petrified look, but rather, that they look like a fresher version of themselves. Dr. Prasad believes in simply improving, and not tampering with, a patient’s natural beauty and facial structure.
Once Dr. Amiya Prasad decides that Botox® is ideal for one’s facial enhancement, given that the patient also agrees, the treatment can be done right away. The patient may also leave immediately after the treatment.
As always, it is necessary to avoid lying down for four to six hours as the liquid sets into the muscles. Newbies to Botox® rejuvenation may expect some puffiness on the upper half of the face, but this gradually subsides within two to three days.
Ironically, the puffiness may make one simply look a bit different, but not so much to fret or feel they don’t look like themselves.
There have been side effects in patients noted down on other websites, such as eye-twitching, facial drooping, or asymmetry of the facial contour, which can occur within the first 24-48 hours and can be quickly remedied. With Dr. Prasad’s steady hand and long-term successful use of Botox, he assures his patients that these side effects are kept to a minimum.
The wondrous effect of Botox generally lasts for about six months. However, for some, such as beginners to this procedure, they may need to go for another treatment after two months.
The reasons for these differences in effect may be attributed to a patient’s lifestyle, their individual anatomy, and how well they absorb the substance.
Some circumstances that may affect the effectivity of Botox® can include the following:
As the muscles eventually move on from the “acquaintance stage” of Botox® to a more steady relationship, the effects will last longer. There are some recorded cases where the lines may reappear, but not exactly as it looked pre-Botox® treatment.
Some are afraid that life after non-repeats of the Botox procedure will result in faces that will look even worse than before they used it, but this, fortunately, is a fallacy.