Subtle Botox

By Brian Arslanian, MD

Botox has dozens and dozens of uses in medicine and cosmetics. From relief of TMJ pain, to sweaty palms, or how about getting rid of migraines, and then there is helping kids with cerebral palsy with muscle contractures and spasms, and overactive bladder…..and there was a recent study that found Botox around the heart after bypass surgery prevented an irregular heart beat after surgery and decreased complications….WHOA!

But the most obvious, and most headlines, goes to wrinkle prevention. It seems like everyone is getting Botox nowadays, and you are the odd one out if you haven’t started by your 30th birthday. The most common areas that are treated are the Crows Feet, eleven lines, and the forehead. I would say this makes up about 80-90% of all Botox injections for wrinkles. One of the major reasons for this is that the results are pretty dramatic and patient satisfaction is high. So what about that other 10-20% of injections….where are those going?

That brings me to the gist of this article….. “Subtle Botox” is what I like to call it. As I have gained more and more experience over the years, I have found that Botox can do all sorts of things to make you look more youthful and beautiful. The catch is that these treatments are sometimes not as dramatic as the “classic three” I mentioned above, but in the right patients they can be just enough to give you a fantastic result. So lets get started!

Beautiful Big Eyes!

Are you sick of having little squinty eyes when you smile? Or maybe you have started Latisse and your lashes look amazing, but you just need that extra pop. If done by an experienced injector, a small amount of Botox can be injected into the lower eyelid in combination with an outer eyebrow injection to help relax the muscles causing those squinty eyes.

Before and After Photos

No More Gummy Smile!

A gummy smile is one in which the upper lip raises up more than it should and exposes the gum line above the teeth. Ideally, the upper lip should cover up a few millimeters of the teeth and show little to no gum line. An experienced injector can place one small injection above the lip and next to the nostrils to weaken the muscle enough to drop the lip into a much more aesthetically pleasing position.

My Chinny Chin Chin!

As we get older the muscle in the chin, the mentalis, tends to have a harder time relaxing. For this reason, the muscle stays tense and via its attachments to the skin, cause this “cobblestoning” appearance, which is not very attractive. A few well placed injections of Botox into the muscle can relax the muscle and give you a more youthful, rested look to your chin.

Nefertiti Neck Lift

Aging causes the the muscles and tissues of the face to slowly start falling due to gravity. This eventually will start causing the jowls of the face. Eventually the only correction will be a facelift, but before we get to that point there are some alternatives. The so called “Nefertiti Neck Lift” involves placing Botox into neck muscle, the platysma, along the jaw line. By weakening the platysma muscle, which normally is helping pull down the tissue of the face, the muscles of the face can then do better job of pulling the tissues back onto the face. This can help to resolve the jowls and better define the jaw line.

Many thin women also start to develop the platysmal bands usually in the middle and sometimes off to the sides. Again, this is usually treated with a neck lift and sewing the muscles together. But a temporary fix is to treat the bands with Botox to relax them and give the neck a smooth, youthful appearance without the cost and recovery of major surgery.

Bunny Lines no more

When we laugh really hard or smile, some of us have an exaggerated response from the nasalis muscles on either side of the nose. These muscles can bunch up the skin on the sides of the nose and give us that “bunny nose” appearance. A few units of Botox placed into each muscle can soften these lines to give you a more natural look next time you are at the comedy club laughing hysterically.

So the next time you are considering going to one of these “fast food” Botox parlors that are basically giving Botox away, just consider all the applications you are probably missing out on by going to someone without the experience and artistic background to give you something more than “McBotox” Injections.

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