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About Botox®

Since its introduction in the 1990s, the uses of Botox have expanded rapidly.   However, at the same time, the number of people injecting Botox have risen exponentially.  

It is essential to clarify who will be injecting your Botox.

While an understanding of the underlying anatomy is required to achieve excellent results, many clinics and spas have technicians with little or no formal training injecting Botox for their patients.

For 2009, Dr. David Shafer wrote a chapter and produced an instructional DVD on Botox injections. Starting with his plastic surgery training at the world famous Mayo Clinic and continuing at the prestigious Manhattan Eye, Ear & Throat Hospital, Dr. Shafer stands on the forefront of facial aesthetics.

It is important for you to know how much Botox is being injected.

Most clinics and spas sell Botox by "area."   However, this allows them to significantly dilute the Botox for a higher profit at the expense of inferior results.  It also increases the chance of cross-contamination between patients.  Additionally, the clinics and spas may store the diluted Botox for long periods which decreases its effect.  

Dr. Shafer injects Botox by unit, so the patient gets exactly what they pay for.  He then keeps an electronic record of your injection to use as a reference for further injections.  Additionally, Dr. Shafer opens a new vial of Botox for every patient.  This eliminates the risk of cross-contamination and ensures that you are always getting "fresh" Botox.

It is important for you to understand the possible complications of Botox.

Botox works by paralyzing the dynamic muscles of the face.  The ideal result achieves a balance between decreasing wrinkles while preserving animation or expression of the face.  Sometimes Botox can leak into unintended muscles.  This can lead to dropping eyebrows or eyelids when injected around the eyes.  It can also lead to oral incompetence when injected around the mouth.  If you do develop drooping of the eyelids, there are medications that may help.  Additionally, Botox always goes away, so if you are not happy with your results, you can be assured that baseline muscle function will return after several months.

Dr. Shafer uses very fine needles with highly concentrated Botox to help avoid these unintended consequences. 

Spend time discussing with your plastic surgeon if Botox is indicated for you.

Some confusion exists between the use of Botox and the use of facial fillers such as Radiesse, Juvederm & Evolence.  Botox decreases muscle contraction which helps reduce dynamic wrinkles - wrinkles caused by movement.  Botox is usually most effective around the eyes and forehead.  Facial fillers help "fill" volume deficits and smooth out static wrinkles - wrinkles caused by volume loss and gravity.  Fillers are generally most useful around the mouth and in the mid face.

Often, a combination of Botox and facial fillers are required to achieve the best results.
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Dr. David Shafer is a Double Board Certified Plastic Surgeon, a Diplomate of the American Board of Plastic Surgery and a Member of the American Society of Plastic Surgeons

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