A newsletter from David J. Levens, MD, FACS
Board-certified plastic surgeon
Please contact me for a free consultation with Dr. Levens.
Case Study: BOTOX®/Fillers
Mercedes, 44, of Parkland, wanted a rejuvenated look: “I had crow’s feet around my eyes and laugh lines around my mouth,” she says. “I wanted to see what could be done without surgery.”
Dr. Levens injected Botox® around Mercedes eyes to minimize the appearance of crow’s feet by reducing contractions of the underlying muscles. He injected the filler Restylane® to reduce the appearance of laugh lines. He also injected Restylane® below Mercedes’ cheek bones to compensate for lack of volume in that area which increases with age.
“Having the look of higher cheekbones was a great bonus,” Mercedes says. “I’m very happy with the results. The difference isn’t dramatic, but it’s quite noticeable to me. It was definitely worth having this done.”
The Procedures
Botox® is an excellent treatment for “frown lines” between the eyebrows, “crows feet” beside the eyes, and horizontal lines across the forehead. These lines and wrinkles are caused by repeated contraction of the muscles of facial expression. It is very difficult to change these facial expression habits. Aging and sun exposure can make expression wrinkles even more prominent.
“Botox® works by weakening specific muscles of facial expression so that the contractions cannot continue to occur,” Dr. Levens says. “Without the repeated contraction, the lines and wrinkles fade dramatically though complete eradication cannot be guaranteed. Botox® is injected with a tiny needle directly into the affected areas. There is usually a mild stinging, which lasts only a second or two. Treatment only takes only a few seconds for each area.
The patient can return to work or social activity immediately since there is virtually no evidence that a treatment has been performed. On the rare occasions when a tiny bruise forms, it may be completely covered with make-up, and will fade rapidly. The positive effects may be noticed as soon as 4 days after treatment but maximum benefit may not occur for 2 weeks.
The effects of Botox® are not permanent. Muscle function returns about 4 months after the first treatment, and the procedure must be repeated to continue its benefit. Studies have shown that repeating the treatment as soon as unwanted muscle movement returns will often extend the effective period of each treatment. Some patients only require treatment every 5-6 months. Most say the slight inconvenience of repeating Botox® treatment is far outweighed by its effectiveness, ease of treatment, lack of “down time”, and avoidance of surgery and anesthesia.
Complications are virtually non-existent. In extremely rare reported cases, the muscle that elevates the eyelid is weakened, creating a temporary mild eyelid droop which fades as the Botox® wears off.
Restylane®. This is one of an ever-growing number of injectable wrinkle fillers on the market which are used to fill in crow’s feet and laugh lines, including fairly deep groves. They can be used to plump up sunken cheeks, giving the face a fuller, more youthful look, and create the impression that the facial skin has been “lifted”. They require little or no “down time”, do not require more than topical anesthesia, do not involve the risks associated with surgical procedures, and produce a very natural outcome. Depending on the material used, the results last from 4-12 months.