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Botox FAQ

How common is eye droop?

Eye droop or lid droop is actually not very common. The medicine has to leak in to affect the muscles of the upper lid. Brow droop however is much more common.

Are there any potential permanent side effects with neuromodulators?

I will never say never. But, one of the amazing things about neuromodulators and also the worst thing about neuromodulators is that it’s temporary. It always wears off whether you like the effect or not.

I can’t use Botox anymore, what can I do?

It would depend on why you can’t use it. Can you switch up neuromodulators? Do we have to do it differently? Do you have to accept the fact that you can’t get rid of all of your wrinkles or do you want to consider surgery like a brow lift or getting your eyes done?
It would depend on why you can’t use it. Can you switch up neuromodulators? Do we have to do it differently? Do you have to accept the fact that you can’t get rid of all of your wrinkles or do you want to consider surgery like a brow lift or getting your eyes done?

How common is Botox resistance?

It’s actually very rare to have antibodies to a neuromodulator. Usually it’s seen for medical purposes using much higher doses. It doesn’t mean that your response to neuromodulators doesn’t change as you age.

Is anyone too old for Botox?

This has nothing to do with age, it has to do with what we’re treating. If a patient walks into my office in their sixties and has extremely deep lines, they can’t have the expectation that it’s going to work for them. That is to be true at various different ages.

How long should a neuromodulator treatment last?

I think the more important question isn’t how long it lasts but how often you need it to be treated to look good because some patients’ version of a wear off is another patient’s version of it lasting a long time.

How much Botox is too much?

Any amount that makes you look fake, any amount that changes an appropriate natural anatomy. On a medical scale, you really need to use enormous doses for toxicity.

What is the best age to start Botox?

When you’re starting to get wrinkles affected by hyperextension of the use of muscle. For some people that’s 25, for other people that’s 45.

Which brand of neuromodulators do you like best?

I like all of them best.

On the masseter muscle, how long do the results of neuromodulators last?

The most popular use of neuromodulators now is for grinding muscles. Not just for the functional aspect, but for aesthetic widening that women sometimes find unpleasant. I usually tell people about 3-4 months before re-treatment.

What are your thoughts on a Botox cat eye and nose Botox for the tip and flaring nostrils?

There are a lot of subtle uses for neuromodulators. The tip of the nose can be raised a little bit, you’re not really going to get a cat eye. You can use it for flaring nostrils, it works great. There are lots of subtle treatments but for the right patient.

Do you recommend neuromodulators for the chin?

I like it in the chin, but again only if someone needs it and that muscle is causing dimpling.

What is the best place to place a neuromodulator or Botox if you want a brow lift?

The two spots where the depressors are (he pointed to his face in the video). Anything put in the forehead will bring you down not up.

Does one brand of neuromodulators last longer than another?

It depends on how you use it, the age, where you use it, etc. It’s not a great question because it has a complicated answer.

Is it okay to get Botox and fillers before Fraxel?

I do on a daily basis because you’re numb and you’ve been sitting for an hour. Some people have concerns that it may cause a diffusion effect on the injectables.

Do you recommend neuromodulators for the chin?

I like it in the chin, but again only if someone needs it and that muscle is causing dimpling.

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