What Is BOTOX® Cosmetic?

BOTOX® Cosmetic injections for the treatment of facial wrinkles is one of the most common procedures performed at the Dermlounge and Richmond Aesthetic Surgery in Short Pump. In fact, BOTOX® Cosmetic injection is the most common cosmetic procedure performed worldwide. BOTOX® Cosmetic is administered with a series of very small injections and has essentially no downtime and very few, rare side effects. BOTOX® Cosmetic is used most commonly in patients ages 24 to 70 years old to treat of a number of conditions, and is widely used by both men and women.

BOTOX® Cosmetic injections are commonly used to rejuvenate the face, but also have been used to treat excessive underarm sweating.

What Causes Facial Aging?

Facial aging is determined by many factors including environment, sun exposure, lifestyle choices, and genetics. Environmental factors including smoking and pollution can lead to premature aging of the skin causing wrinkles and problems with skin texture and color. Individuals who spend a significant amount of time in the sun usually have deeper wrinkles than those who wear a high SPF sunscreen or avoid the sun consistently. Long-term sun exposure will cause both fine and deep facial wrinkles, irregular pigmentation of the skin, and loss of skin texture and elasticity. Genetics is the one factor that is not controllable, and many people notice that their skin ages similarly to their parents’.

During your initial consultation, board-certified plastic surgeon Neil J. Zemmel will perform a complete medical history and focus on your desires for facial rejuvenation. A physical examination of the face and neck will be performed assessing:

  • The position of the eyebrows and forehead
  • The presence of frown lines or forehead creases
  • The shape and position of your upper and lower eyelids
  • The presence of wrinkles (crow’s feet) around the eyes
  • The presence of a tear-trough around the lower eyelid
  • The shape and position of the cheek
  • The occurrence of marionette lines and parentheses lines around the mouth
  • Skin and muscle laxity of the neck
  • Asymmetry of the face, especially the forehead and brow area
  • The overall quality of your skin
Our team will formulate a custom treatment plan that addresses your facial aesthetic concerns and will give you a safe and beautiful result.

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How Does BOTOX® Cosmetic Work?

BOTOX® Cosmetic gives a refreshed, rejuvenated look by weakening certain small muscles of facial expression. Certain facial muscles cause wrinkling or pleating of the overlying skin after many years of movement and contraction. By weakening these muscles, the wrinkles become less prominent and will smooth out in time.

BOTOX® Cosmetic works by preventing the release of the neurotransmitter acetylcholine at the targeted muscle to temporarily stop muscle contraction. This effect is called chemodenervation and usually lasts three to six months depending on the area treated and the experience of the patient.

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Types of Facial Wrinkles

There are two types of wrinkles present on the face: dynamic and static.

  • Dynamic wrinkles are present when a person is making facial expressions, such as raising the eyebrows or frowning. These wrinkled occur with repeated contraction of the facial muscle that cause pleating of the skin. Once these muscles are weakened the overlying pleats improve dramatically. Dynamic wrinkles such as as crow’s feet, frown lines, and forehead creases are very easily treated with BOTOX® Cosmetic.
  • Static wrinkles are wrinkles are present all the time even when no movement is occurring. Static wrinkles are caused by the effects of gravity and loss of facial volume. The most common static wrinkles encountered are marionette lines and parentheses around the mouth (the nasolabial fold). Because these wrinkles are caused by loss of volume, the best treatment is to add volume to these areas with a filler such as JUVÉDERM®.

Most Common Wrinkles Treated with BOTOX® Cosmetic

The most common wrinkles treated with BOTOX® Cosmetic are the horizontal lines of the forehead, the vertical frown lines in between the eyebrows, and the crow’s feet around the eyes. Other areas treated are the vertical lines around the mouth (lipstick lines) from smoking or drinking from a straw, as well as the horizontal “bunny” lines across the bridge of the nose. BOTOX® Cosmetic can also be used to treat chin dimpling, platysmal bands of the neck, as well enlarged masseter muscles, which cause a larger jaw line in women.

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What Can I Expect During My BOTOX® Cosmetic Treatment?

The first visit includes your comprehensive consultation with Dr. Zemmel, and BOTOX® Cosmetic treatment if desired. The most important part of this visit is to discuss the concerns you have with your skin and your personal goals with BOTOX® Cosmetic treatment. This allows us to prepare a plan of treatment specialized to your needs because no two patients are alike. Next, the area to be treated will be cooled with an ice pack to reduce your discomfort. The actual injections are virtually painless as we use the smallest needles possible for each treatment. You can expect between 3-5 injections in each treated area. The entire consultation including the injections takes approximately 30 minutes.

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What Can I Expect in My BOTOX® Cosmetic Recovery?

The most common side effect that occurs is very mild redness along the injection sites that usually dissipates within 30 minutes of the procedure. Less commonly, some patients may experience a pinpoint bruise from the needle puncture that will take approximately 2-3 days to heal. The effects of BOTOX® Cosmetic begin between 2-5 days after treatment. After your first treatment, you will see the maximum effects at approximately four to eight weeks. During this period the wrinkled skin will begin to remodel, smooth out, and redrape. BOTOX® Cosmetic does not affect skin sensation, only muscle contraction. This means you will be able to feel all of the areas treated but you will not be able to fully contract the muscles. These results last approximately three to six months depending on the individual.

Dr. Zemmel will see you in follow up 2 weeks after your initial treatment to ensure your new look is satisfactory. Although rare, any touch ups or corrections will be made at this time. We recommend repeated BOTOX® Cosmetic treatments every 3 to 5 months. This will ensure that the muscles do not return to full strength causing complete return of the wrinkles.

BOTOX® Cosmetic Before & After Pictures


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How Long Does BOTOX® Cosmetic Last?

The final results of BOTOX® Cosmetic may take 1-2 weeks to develop, though patients may notice improvements sooner. As the contracted muscles of the face begin to release, the wrinkles on the surface of the skin can appear less prominent for a smoother, more youthful-looking complexion. The results of BOTOX® Cosmetic typically last 3-5 months, though individual results vary from patient to patient.

How Often Should I Get BOTOX® Injections?

Maintaining your results with BOTOX® Cosmetic can be easily accomplished by scheduling routine touch-up appointments. Since results often begin wearing off at 3 months, many patients can benefit from 4 injection treatments per year. Even if your BOTOX® Cosmetic hasn’t completely worn off, Dr. Zemmel can adjust the amount of product to be used to ensure you maintain a youthful yet still natural-looking appearance. Some patients who regularly receive BOTOX® Cosmetic treatments may notice their results begin to last longer over time.

Are There Any BOTOX® Cosmetic Side Effects?

BOTOX® Cosmetic is FDA-approved for the treatment of facial wrinkles, including moderate to severe horizontal forehead lines, crow’s feet, and the vertical lines between the eyebrows (glabellar lines). Although there is no downtime associated with BOTOX® Cosmetic, some patients may experience mild discomfort, redness, or bruising at the injection site immediately after treatment. These side effects typically resolve very quickly. In rare cases, side effects may include headache, dry mouth, dry eyes, blurred vision, drooping of one or both eyelids (3%), or swelling of the eyelids. If you are experiencing any serious side effects of BOTOX® Cosmetic, please contact our office or your primary care physician immediately.

How Much Does BOTOX® Cosmetic Cost?

Dr. Zemmel customizes each BOTOX® Cosmetic treatment to suit the patient’s individual needs. As a result, there is no set price for treatment with BOTOX® Cosmetic. Variables that can impact the total cost include the severity of the facial wrinkles, the number of treatment areas, and the amount of BOTOX® Cosmetic needed to achieve the patient’s goals. During your preliminary consultation, Dr. Zemmel will examine your face, discuss your cosmetic concerns, and tell you the cost of your custom-tailed treatment plan. Our patients at the Dermlounge and Richmond Aesthetic Surgery often take advantage of our VIP Program for discounts on BOTOX® Cosmetic. Flexible financing options are also available for patients who could benefit from an installment plan. To learn more about our VIP program or our financing options, please contact a member of our staff today.

BOTOX® for Hyperhidrosis

BOTOX® Cosmetic is also used for hyperhidrosis of the underarms, or excessive sweating. BOTOX® Cosmetic acts to stop the production of sweat from beneath the under arms by inhibiting the function of the eccrine sweat glands responsible for the water component of sweat. The onset of action is rapid usually within 48 hours. Sweating is usually significantly improved or stopped completely for 3 to 6 months.

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Dysport® vs. BOTOX® Cosmetic

Dysport® and BOTOX® Cosmetic are both composed of botulinum toxin A and, therefore, are used to treat similar concerns. Although they can typically be used interchangeably, there are certain differences between the two. Dysport®’s formula has a smaller protein load than BOTOX® Cosmetic. As a result, Dysport® injections begin to work slightly faster than BOTOX® injections. In addition, Dysport® tends to spread farther than BOTOX® Cosmetic, which makes it particularly beneficial for larger areas being treated.

In addition, Dysport® is more diluted than BOTOX® Cosmetic. While Dysport® is less expensive than BOTOX® Cosmetic, more units are typically required to achieve a similar effect. Both Dysport® and BOTOX® injections can provide beautiful anti-aging results when administered by a qualified professional. In most cases, the best injectable for a patient will ultimately be determined based on doctor and patient preference.

Is BOTOX® Cosmetic Safe?

Yes, BOTOX® Cosmetic is considered a safe method of treating a variety of concerns, including fine lines and wrinkles, when performed by an experienced and qualified professional. While initial side effects may occur, such as mild tenderness, bruising, or swelling, the risk of complications is low.

Are There Alternatives to BOTOX® Injections?

As stated above, Dysport® is a popular alternative to BOTOX® Cosmetic that can achieve similar results. Depending on the patient’s specific concerns being addressed, other treatment options may be available to choose from as well. For example, dermal fillers can add volume to certain facial areas to smooth out fine lines and wrinkles. Laser treatments like fractional laser resurfacing are also beneficial for patients wanting to diminish signs of aging. More personalized details about what can benefit you will be discussed with you during the consultation process.

Contact Dermlounge

For more information on BOTOX® Cosmetic, or to schedule a consultation at Dermlounge, please contact us today.