Botox Mechanism of Action
To understand the details of exactly how Botox works requires a small amount of basic anatomy and physiology knowledge. Muscles that are used for facial expression (examples of skeletal muscles) contract when there is an innervation by a nerve, meaning that the nerve sends a signal to the muscle telling it to contract. This occurs at a point called the neuromuscular junction, the attachment of the nerve to the muscle. The nerve releases a neurotransmitter called acetylcholine into the space between the nerve and muscle called the synaptic cleft. The acetylcholine then binds to the membrane of the muscle. This binding triggers the muscle to contract. Botox prevents release of acetylcholine from the end of the nerve into the synaptic cleft. This prevents the signal from being passed to the muscle and it prevents the muscle from contracting, thereby relaxing the muscle.
Common Areas of Treatment with Botox
The most common areas of treatment with Botox are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns, and the crow's feet seen around the eyes when one smiles.
Patient Assessment for Botox Treatments
A full assessment for a Botox treatment requires a formal exam in the office where the skin can be viewed in multiple angles and with and without facial expressions. In our office, we take standardized photographs to monitor our patients’ progress. The photographs are taken with a clean face, consistent lighting, consistent background, with jewelry and makeup removed, and with clothing covered. These are taken in five different angles, one straight on, two profile photographs, and two oblique photographs. These five photographs are taken of patients with a neutral expression. Additionally, multiple sets of photographs are taken depending on the area to be treated. For example, if the frown lines are being treated five more photographs are taken in the same positions, but with the patient frowning. This allows for monitoring of the patient’s progress. It helps a person remember what someone looked like prior to a treatment and to observe the improvement from a treatment. It can also be used if correction is necessary as it will show the areas that require additional units of Botox.
Isn’t it time that you understand exactly what your skin type needs to look its best?
While everyone knows to wash their skin everyday, it’s amazing how many people don’t truly understand what their skin needs apart from daily cleansing. The products you use, how you use them and other daily habits can play a large role in the health of your skin. Our Encino, CA, dermatologist, Dr. Alex Eshaghian, is here to share how to properly care for your skin based on its type.
You Have Dry Skin
If your skin feels tight and itchy after you wash it then you could have dry skin. Besides skin that feels dry, tight, flaky or itchy, you may also notice lines around the eyes or mouth.
Skin Care Tips for Dry Skin: You will find that being too rough or aggressive with your skin can actually make dryness and agitation worse. Always be gentle with your skin, especially when washing your face. Opt for a gentle cleanser and avoid hot water (only use lukewarm water). Finish up your skincare regime with a cream-based moisturizer. Also, remember to always apply sunscreen daily.
You Have Oily Skin
You notice that your skin often looks greasy, shiny or oily. As a result, pores may look enlarged and visible. You may also find yourself prone to breakouts.
Skin Care Tips for Oily Skin: While you may be tempted to wash your face multiple times a day, this can actually make oily skin worse. You should only wash your face twice a day (in the morning and at night).
And you may think you can just skip moisturizers altogether, but you shouldn’t. Look for a lightweight moisturizer to apply each day to help keep oil glands from working overtime. Also, remember to always apply sunscreen daily.
You Have Combination Skin
With combination skin you may notice that while certain areas of your face are normal or perhaps even a little dry, your forehead, chin and nose are oily (this area is known as the T-zone). If you have an oily T-zone but the rest of your face seems normal then you could have combination skin.
Skin Care Tips for Combination Skin: This can be a bit more frustrating to tackle since the skincare products you’ll find on the market won’t tailor to both oily and dry/normal skin. You’ll need to consider products for both. If you are unsure of which products to use to tackle combination skin then this is the perfect time to talk to our Encino skin doctor. Also, remember to always apply sunscreen daily.
You Have Normal Skin
Lucky you! This means that no areas of your skin are either oily or dry and pores are small and barely visible.
Skin Care Tips for Normal Skin: One of the best things about having normal skin is that you can pick and choose the kinds of products that will work best for you, while paying attention to any issues that may still arise along the way. Continue to follow a daily regime of washing your face twice a day, using a gentle cleanser and then applying a moisturizer right after. Also, remember to always apply sunscreen daily.
If you have questions about skin care or the dermatological services we offer, then call AE Skin in Encino, CA, today to learn more about the best ways to keep your skin healthy and happy.
We are excited to announce the publication of Dr. Alex’s new book, Everything You Ever Wanted to Know About Botox. This book is written for our patients and their friends who are interested in learning more about Botox. Dr. Alex has performed over 10,000 cosmetic treatments over the past eight years. During this time, he has treated thousands of patients and answered many questions. From this experience, he has compiled a great deal of information for his patients. This book includes all of this information. Below is an excerpt from the first chapter.
Welcome to the world of Botox. This book is written for the layperson who may or may not know what Botox is and what it does, but would like to learn more about it.
Dr. Alex’s book Everything You Ever Wanted to Know About Botox is now available for purchase directly through our online store.
The book contains six chapters:
- Background Information
- How Botox Works and How It is Used
- Risks, Side Effects, and Corrections
- More Information
- Botox Before and After Photographs
Alex Eshaghian, MD, PhD (“Dr. Alex”) was raised in Los Angeles, CA. He attended UCLA for college and graduated Magna Cum Laude with a degree in Biology in 1998. Dr. Alex completed his medical education at the prestigious Vanderbilt University Medical Scientist Training Program in Nashville, TN with scholarships from the National Institutes of Health and the Canby Robinson Society, receiving both MD and PhD degrees. Dr. Alex completed his post-graduate training in the Department of Internal Medicine at the University of New Mexico in Albuquerque, NM. He subsequently trained in cosmetic medicine through independent courses and with distinguished doctors in Los Angeles, CA. Dr. Alex also has had clinical training in dermatology at Vanderbilt University, UC Irvine, USC, UCLA, University of New Mexico, Veteran’s Affairs Hospitals in Nashville, TN, Albuquerque, NM, Long Beach, CA, and Los Angeles, CA, as well as in various private clinics in southern California. He is certified in the injection of Botulinum toxin and dermal fillers as well as in the use of lasers for cosmetic applications and has performed over 10,000 cosmetic treatments. Dr. Alex has received many accolades including Phi Beta Kappa, College Honors, Departmental Honors, Goldenkey International Honour Society, and Mortar Board National Honors Society.
In addition to his clinical training, Dr. Alex has extensive experience in medical research. His interest in research began at UCLA when he worked in a nephrology lab. He then spent four years in a molecular biology lab in the Department of Chemistry and Biochemistry at UCLA. His dissertation in graduate school was in the Department of Cell and Developmental Biology where he studied genetic factors involved in photo-aging of the skin and in non-melanoma skin cancer. He has given oral and poster presentations at numerous conferences including the American Academy of Dermatology, Society for Investigative Dermatology, American Society for Human Genetics, and THE Aesthetic Show. He has publications in the Journal of the American Academy of Dermatology, Journal of Investigative Dermatology, Free Radical Biology and Medicine, and Cardiovascular Toxicology. He is also a contributing author for the Textbook of Aging Skin.
We are excited to offer a new treatment called the Photofractional Rejuvenation which can address a variety of concerns in a single treatment with a short recovery time.
The Photofractional Rejuvenation is a new combination treatment designed by Dr. Alex to provide our patients with improved results. Dr. Alex has pioneered a number of combination treatments such as the Soft and Smooth Rejuvenation treatment, Tight and Bright Rejuvenation treatment, Ultimate Rejuvenation treatment, Weekend Rejuvenation treatment, and Fountain of Youth Rejuvenation treatment. All of these treatments combine multiple individual treatments to address our patients’ concerns slightly differently and provide superior results than when used alone. The Soft and Smooth Rejuvenation treatment combines a Forever Young BBL IPL photofacial treatment with a Micro Laser Peel. The Forever Young BBL IPL photofacial treatment addresses unwanted discolorations and the Micro Laser Peel removes a thin layer of dead skin cells from the surface to improve the texture and help exfoliate the pigment even further. The Tight and Bright Rejuvenation treatment combines a Forever Young BBL IPL photofacial treatment with a Laser Skin Tightening treatment. The Laser Skin Tightening treatment uses gentle micro-pulses of infrared light to heat up the skin, tightening the skin, improving redness, and helping with enlarged pores. The Ultimate Rejuvenation and Weekend Rejuvenation treatments combine the Forever Young BBL IPL photofacial treatment, Laser Skin Tightening treatment, and Micro Laser Peel with the Pro Fractional Therapy. This offers the improved benefit of stimulating collagen in the deeper layers of the skin, giving an improved texture and providing a better glow and radiance.
What is the Photofractional Rejuvenation treatment?
The Photofractional Rejuvenation treatment combines a Forever Young BBL IPL photofacial treatment with a light version of the Fractional CO2 Laser Resurfacing treatment. The Fractional CO2 Laser Resurfacing treatment works by creating thousands of microscopic holes in the skin and generating heat. This stimulates the skin to form its own natural, new, fresh, and healthy collagen. This provides improvements in terms of color, texture, tone, and radiance of the skin. The treatment is preceded by application of numbing cream for about 15 minutes, and the treatment itself takes another 15 minutes or so. The great thing about the Photofractional Rejuvenation treatment is that the recovery is usually only a few days.
Who is a good candidate for the Photofractional Rejuvenation treatment?
The Photofractional Rejuvenation treatment is ideal for anyone, young or mature, who desires improvement in the color, texture, or tone of the skin. It works well for those with sun spots or uneven color. It will help for those with rough or irregular texture on the surface of the skin. It also works to improve the appearance of fine lines and wrinkles on the skin.
What should I do after a Photofractional Rejuvenation treatment?
After a Photofractional Rejuvenation treatment avoid heat exposure, alcohol consumption, and strenuous exercise for a few days. Avoid hot or spicy foods such as soup, hot coffee, or hot tea. Iced coffee and iced tea are okay. Redness and swelling are normal for a few days and comfort can be provided by applying cold compresses such as ice packs. Sometimes the dark spots get darker before they get lighter; this is normal and can take up to two weeks. Prolonged discoloration beyond this can be treated with creams. We will provide an aftercare kit including a special facial cleanser, the Avene Thermal spray water, and an intense moisturizer with specific instructions on how to use them. Apply sunscreen daily with a minimum SPF of 30 with broad spectrum (UVA and UVB) protection. Depending on the individual some people benefit from a series of monthly treatments and maintenance treatments are performed every three to 12 months.
Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. For a limited time, we are offering a promotional price on the new Photofractional Rejuvenation. Contact us to schedule a free consultation with Dr. Alex in our Encino, CA office.
The chin is a feature of the face that provides symmetry and balance to the rest of the face. A weak chin can affect the appearance of the entire face. Now we can augment a weak chin using hyaluronic acid dermal fillers such as Voluma. This is an outstanding option for those desiring enhancement of the chin without surgery.
What is a weak chin?
A weak chin is very common and has a decreased forward projection. It is commonly seen in combination with a poorly defined jawline. With age, we lose the volume and projection in the tip of the chin. At the same time, due to loss of collagen and gravity the lower face descends which decreases the jawline definition. This is jowls which appear on the jawline on either side of the chin. Also, fat accumulates under the chin over time forming a double chin, which further reduces the definition of the jawline. Treatment of a weak chin can be complimented by treating the double chin with Kybella.
What is involved in a chin augmentation treatment?
The treatment uses Voluma, which has several properties that make it the ideal dermal filler of choice for this area. Since the bony support structures in this area of the face are being enhanced a firm product such as Voluma is required. Voluma will provide the forward projection desired with a low amount of product. Since Voluma is a hyaluronic acid dermal filler it can be dissolved if the desired results are not achieved. It can also be dissolved in the rare event of an adverse effect.
What will the results of a chin augmentation look like?
Voluma can provide a natural appearance without looking like work was done. The ideal candidate is a person in overall good health who desires more of a projection of the chin and/or an improvement in his/her jawline definition and does not want to undergo surgery. Depending on the individual Dr. Alex will individualize the treatment to provide a pointy or square appearance with a fullness and projection to provide a harmonious balance with the other facial features.
What happens during the chin augmentation treatment?
The treatment itself takes only a few minutes and results are seen instantly. Patients resume their normal activities right away without looking like a treatment was performed. Most patients enjoy their results for one to two years depending on the individual and the amount of product used. In our office, we apply complimentary topical numbing and use a vibrating distractor which is placed on the skin called the Beauty bar to maximize our patients’ comfort.
What are the side effects of a chin augmentation treatment?
Side effects are rare for a chin augmentation treatment. The most common side effects are swelling and bruising, which usually resolve in two weeks. Although most people enjoy the swollen appearance, it can be decreased by applying cold compresses such as ice packs to the area. We treat bruises with a laser as early as the next day, which makes the bruise resolve usually in one to three days; however, it could still last a full two weeks. With any injection, there are other risks including, but not limited to, pain, bleeding, redness, tenderness, and infection.
What should I do after a chin augmentation treatment?
After a chin augmentation treatment Dr. Alex recommends that patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours. After that patients may return to their normal activities.
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