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Cosmetic Treatment

Many wrinkles are actually creases that have been worn into the skin by making the same expression thousands of times. These are called “expression lines” or dynamic wrinkles. Typical dynamic wrinkles include frown lines between the eyebrows, crow’s feet around the eyes, and forehead lines. The presence of these wrinkles can add years to our appearance, often making us look angry, tired or worried when we are not.

BOTOX® is a remarkably safe and effective treatment which can help you to control your facial expressions so that you don’t look angry or worried when you aren’t. BOTOX® treatments can help to prevent the unintended display of negative feelings, and in this way help some people to express themselves more accurately.

Dr. Smith is an Allergan Certified BOTOX® Instructor, and teaches other physicians the art and science of BOTOX® treatment. Dr. Smith is one of the largest users of BOTOX® in Canada, and performs well over 100 BOTOX® treatments per month. Dr. Smith has lectured about BOTOX® and demonstrated BOTOX® technique across Canada, in the United States and overseas. Dr. Smith and his staff have all enjoyed the benefits of BOTOX® treatments.

Dr. Smith has contributed to the development and advancement of new uses for BOTOX® -- for example the use of BOTOX® for the treatment medical conditions like painful scars, reflex sympathetic dystrophy (RSDS), Raynaud’s phenomenon, and postherpetic neuralgia.

While you may have earned every one of your worry lines, you don’t have to show them if you don’t want to! If dynamic wrinkles are starting to make you look older or more negative, BOTOX® can help restore the rested, confident appearance you desire.

Please call Toll Free: 1-866-760-1000 if you have questions about BOTOX®,
or to arrange a prompt, confidential consultation and treatment.
No referral is needed for BOTOX® treatment.
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BOTOX® treatments also provide a safe, non-surgical alternative for the reduction of laugh lines, vertical neck lines, and chin creases.

BOTOX® has been used safely and effectively for over twenty-five years in adults and even in small children to treat many medical conditions where overactive muscles require relaxation. Each year hundreds of thousands of patients worldwide receive BOTOX® treatments for a variety of medical conditions, and BOTOX® has also become a leading treatment for reversing some of the visible signs of aging by relaxing the muscles which cause many of our wrinkles. BOTOX® also has become a leading treatment for excessive sweating, and for migraine and tension headaches.

1. What is BOTOX®?
2. How does BOTOX® work?
3. Does BOTOX® work for all kinds of wrinkles and skin folds?
4. What is BOTOX® treatment like?
5. Are there any special instructions for me to follow after treatment?
6. How much do BOTOX® treatments cost?
7. Am I vain?
8. What are the possible side effects?
9. Are there any people who should not use BOTOX®?

What is BOTOX®?

BOTOX® is a medicine made from a highly purified, naturally occurring protein which has the ability to very precisely relax the muscles to which it is applied. This relaxation lasts for a number of months, and then the treated muscles gradually return to their original condition.

BOTOX® does not affect the nerves responsible for sensation, so there is no numbness in the treated areas.

You can stop BOTOX® treatments at any time and be confident that you will gradually return to your pre-treatment appearance. If you have BOTOX® treatments for several years, you may find that the clock will slow down or stop in the treated areas, in particular if you are careful to protect that skin from sun exposure and smoke.

What is the difference between BOTOX® and fillers like Restylane®, Juvéderm® and ArteSense®?

BOTOX® relaxes the muscles which cause many facial lines and unwanted facial expressions.
Fillers fill creases, lips, cheekbones, and also defects like acne scars. Sometimes BOTOX® is used in combination with fillers, for example when treating frown lines on the lower forehead or wrinkles around the lips.

How does BOTOX® Work?

The benefits of BOTOX® on wrinkles come from ability of BOTOX® to selectively and precisely relax the muscles which are causing wrinkles to occur. The skin over the treated muscles gradually becomes smoother and less wrinkled as the muscles relax.

A common use for BOTOX® is to reduce (often by 70-80% or more) the really deep furrows and lines that many people make between their eyebrows when they frown. These lines can make people look quite angry or concerned, even when they are happy.

Crow’s feet around the eyes are another common problem can also add years to your appearance, and make you look like you are squinting much of the time. Crow’s feet usually improve nicely when the muscles which cause the crow’s feet are treated with a bit of BOTOX®.

The treated muscles usually start to relax within a day or two, and reach their maximum degree of relaxation within a couple of weeks. About 2-4 months after the first treatment, the effects of the BOTOX® gradually start to wear off. If you liked the effect of your BOTOX® treatment (and almost everyone DOES like it), you will want to return for another treatment when the BOTOX® effect starts to wear off.

If you have a second treatment before the treated muscles have returned to their old bad habits, your second treatment will usually last a few weeks longer. Likewise, if you have your third BOTOX® treatment when you notice that the second treatment is starting to wear off, the third treatment may even longer. Some people who maintain their BOTOX® find after a couple of years that they can go 5-6 months between treatments.

Untreated facial muscles continue to behave in their usual way, so that normal facial expression is unaffected. Because it relaxes the muscles that cause dynamic wrinkles, BOTOX® treatments can also prevent new lines from forming in the areas on your face, forehead and neck which are treated.

Does BOTOX® work for all kinds of wrinkles and skin folds?

Not all facial wrinkles are related only to activity of underlying muscles. These deep creases and skin folds (also known as static wrinkles) are the ones that can still be seen when the skin is lightly stretched with your fingers. Static wrinkles are made worse by sun exposure, by the natural maturing process, and in particular by smoking. Many static wrinkles result from a combination of muscle activity and aging, and can be greatly improved when BOTOX® (to relax the underlying muscles) is used in combination with filling substances like Juvéderm®, Evolence® or ArteSense® .

For people who have had chemical/laser peels and injections of fillers, BOTOX® can prevent or delay the development of new wrinkles and furrows, and so can reduce the long-term need for additional laser resurfacing and for injection of fillings.

In some cases, BOTOX® can be used to delay or eliminate the need for a surgical procedure like a facelift, browlift or necklift; and BOTOX® (by reducing muscle activity which might undo the surgeon’s fine work) can be used to prolong and enhance the effects of those procedures if you have already had them done.

What is BOTOX® treatment like?

BOTOX® treatments are gentle and quick. No sedation or local anesthetic is required, so you will be able to continue with all of your usual activities immediately after your treatment. You can certainly drive yourself home or back to the office.

BOTOX® treatments take only a few minutes, and performed personally by Dr. Smith, using the finest 31 gauge needles to maximize your comfort.

A small amount of discomfort may be felt when the needle is inserted and a few drops of BOTOX® are applied to exactly the muscles which need relaxation. This sensation lasts approximately 5 seconds. Many patients are pleasantly surprised by the lack of discomfort, in particular when they are treated with the very fine and smooth 31 gauge needles.

Occasional patients experience a slight temporary bruising, perhaps the size of their baby fingernail, at an injection site. This can be hidden with cover up, and fades away in a few days.

Are there any special instructions for me to follow after treatment?

1. Exercise the treated muscles during the first hour after your BOTOX® treatment.
   To ensure the best possible uptake of BOTOX® by the treated muscles, Dr. Smith will encourage you to exercise the treated muscles using normal facial movements during the first hour after your BOTOX® treatment.
   
   For example, so that your BOTOX® will work to maximum advantage:
   
   - frown to exercise the muscles above and between the eyebrows which frown lines,
   - raise the eyebrows to exercise the muscles which cause forehead wrinkles, and
   - squint and smile to exercise the muscles which cause crow’s feet.
   
   
2. Do not touch or rub the treated areas until one hour after your BOTOX® treatment.
   It is also important for you to avoid rubbing or pressing on the injected areas for one hour to avoid spreading BOTOX® out of the treated muscles and into non-targeted muscles. If your BOTOX® was moved out of the muscles it is injected into, there might less effect on those muscles, and unwanted temporary relaxation of nearby facial muscles, which could be a nuisance for a week or two. In rare cases (perhaps one case in a hundred), this unwanted relaxation of muscles could cause temporary drooping of an eyelid or slight asymmetry of facial expression. Because the effects of BOTOX® are completely reversible, these rare side effects are temporary, and resolve after a few weeks.
   

After one hour there are no restrictions at all.

How much do BOTOX® treatments cost?

In Canada, BOTOX Cosmetic™ is not expensive; however there is a cost involved. Many cosmetic treatments were once considered a luxury item only for those who had a high disposable income. BOTOX Cosmetic™ is very affordable even for those with modest incomes, but some people need to budget for it just as they would for buying accessories like shoes and having their hair styled.

Having successful cosmetic treatments for your face is not expensive, it is priceless.

BOTOX® is priced at $10 per unit.
There is no charge for your consultation.
BOTOX® treatments is a tax-deductible medical expense in Canada (similar to dental, orthodontic and cosmetic surgery bills), so save your receipts!

Typical BOTOX® treatments use:

• Glabellar frown lines: (between and just above the eyebrows) 25-40 units of BOTOX®
  
• Upper forehead lines: 15-20 units of BOTOX®
  
• Crow’s feet: (wrinkles and squint lines radiating outwards from the outer corners of the eyes) 20-40 units of BOTOX®
  
• Anterior neck: (to reduce jowls, and to reduce vertical and horizontal lines on the anterior neck) 30 - 40 units of BOTOX®
  

Remember that in Canada any costs for cosmetic treatment that is not covered by a drug plan or health spending account are a tax-deductible medical expense. Americans are generally allowed to use the cost of therapeutic treatments as a tax-deductible medical expense.

Am I vain?

Many people at some time before BOTOX® treatment for wrinkles or excessive sweating have fears and doubts. A common concern is that they are being vain. My experience has been that just about all patients who have BOTOX® treatment, laser hair removal, and other procedures to maintain their appearance and comfort are no more vain than anyone else. What does distinguish these individuals is a desire to get the most out of life, and to look as good as they feel.

Looking after your appearance is not a fault. After all, would you leave your house with broken gutters or peeling paint? Why do less for your body? I think you should feel proud of yourself for having the will and the ability to change something that you find unacceptable. I emphasize that you should only have BOTOX® treatment, laser hair removal, and other treatments if it is for you. It is a big mistake to do these things if it is just for somebody else.

As Dr. Richard Glogau of San Francisco has noted: the same self-esteem that makes our patients successful in their chosen fields, precise in their consultation questions, well groomed and well dressed, and often careful in their diet, exercise, and other aspects of health maintenance lead our patients to seek help for their wrinkles and frown lines.

These individuals are normal healthy people, and the same degree of self-interest that prompts them to exercise, be selective in what they eat and drink, and protect themselves from sun damage leads them to explore the benefits of BOTOX®. Our patients simply want to look their best.

What are the possible side effects?

There have been no long-term side effects, allergic reactions or health hazards related to BOTOX® use thus far. Some patients have been getting BOTOX® treatments on a regular basis for more than 15 years with no problems.

Are there people who should not use BOTOX®?

People who are allergic to albumin should generally not be treated with BOTOX®.

Consultations about treatment with BOTOX® or with BOTOX Therapeutic™ can usually be arranged within two or three weeks simply by calling our special BOTOX® line Toll Free: 1-866-760-1000. Treatment can be done the same day as the consultation, if you wish.

Our staff — many of whom have had BOTOX® treatments themselves — can take the time to discuss your wishes and options, and answer your questions.
No referral is required.

Niagara Falls Dermatology & Skin Care Centre Limited
Kevin Smith, MD, FRCPC Dermatologist
Licensed and inspected by the College of Physicians and Surgeons of Ontario

Fellow of the Royal College of Physicians and Surgeons of Canada
Board Certified in the United States by the American Board of Dermatology
Suite 201, 6453 Morrison Street, Niagara Falls, Ontario

Please call us Toll Free: 1-866-760-1000 if you have any questions, and to arrange for a prompt, confidential consultation and treatment. No referral is needed.