Botox® and neuromodulators

There are several competing neuromodulators, but Botox® is the most well-known. Like the Xerox® machine or the Kleenex®, the brand has practically become synonymous with the product. When they are injected into a muscle, Botox, Dysport®, and Xeomin® all act by temporarily disconnecting the muscle from its nerve. Your muscles become relaxed, and any lines or wrinkles they were causing (such as forehead lines caused when you raise your brows) are smoothed away. Over the course of several months, this effect will wear off as the muscles slowly start working again. Neuromodulators can be very effective in treating fine lines on the forehead, between the eyebrows (the “11s”), and crow’s feet around the eyes.

The muscles of the face are small and tightly packed together. When your doctor injects, say, the area between your brows, it is important that he or she does not accidentally affect the muscles that open your eyelids or move your eyes. This is why it is critical to get injections of Botox or other neuromodulators by a fully trained plastic surgeon, like Dr. Nagarkar, who knows and understands the anatomy of the face.

Dr. Purushottam Nagarkar, University of Texas Southwestern Medical Center, Dallas, Plano and Frisco
Dr. Nagarkar on Botox:

It is important when considering Botox (or another neuromodulator) to differentiate “static” lines from “dynamic” lines. Neuromodulators are a fantastic option for patients with “dynamic” lines – that is, fine facial wrinkles caused by underlying muscles. Static lines on the other hand require another approach – this may be a nonsurgical treatment like fillers or lasers, or surgery such as a blepharoplasty. A facial examination reveals the difference between these two types quite easily.”

Who is a good candidate for Botox:

There are very few reasons why a patient would not be a candidate for Botox. If you are pregnant, have one of a few neurological conditions, or have had a previous adverse reaction to Botox or another neuromodulator, you should not get Botox. If your lines are not “dynamic” but rather are caused by sagging skin or loss of skin elasticity, then Botox may not be the best option for you.

What to expect during your visit:

Getting a Botox injection is a quick and relatively painless process. After your consultation with Dr. Nagarkar, he will develop a plan for the amount of Botox required and the areas that will be injected. Using a tiny needle (the smallest needle in the hospital!), he will inject the pre-planned areas of your face. Because the needle is so small, there is very little discomfort with the injections, and there is no swelling or inflammation afterwards either. You will not need any anesthetic, sedation, or pain medication, and you should be able to return to normal activities immediately after your visit. We only ask that you refrain from any strenuous activity for 24 hours to prevent the injected Botox from spreading to areas where we don’t want it to be – so no barre class that evening!
The entire process only takes 15 to 30 minutes.

What to expect after a Botox injection:

Neuromodulators don’t work instantaneously – to disrupt the nerve-muscle connection takes up to a week. So you may not notice any effect for the first several days. The effects last for 3 to 6 months, depending on the quantity of Botox used, and how often you have had injections before.