Posts for: May, 2018
Botox is one of the most popular cosmetic treatments performed worldwide. As the popularity of Botox has grown over the past decade, the interest has grown significantly. Many people have questions about what Botox is, how Botox works, etc. Here we discuss a specific question about why people see new wrinkles after a Botox treatment.
What is Botox?
Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. 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 (frown lines), and the crow's feet seen around the eyes when one smiles.
When patients present with concerns about specific wrinkles in the upper face such as the frown lines, it is important to assess and treat the other wrinkles in the upper face including the horizontal forehead wrinkles and crow’s feet. The reason is to maintain a harmonious and natural balance to the appearance of the upper face. The muscles between the brows (glabell) which are responsible for the formation of the frown lines serve to pull down on the inner brows when a person frowns. Similarly, the muscles around the eyes which are responsible for the formation of the crow’s feet seen when smiling (orbicularis oculi) are also responsible for pulling down on the brows, but in this case the outer brows. On the other hand, the muscle in the upper forehead (frontalis) which is responsible for the formation of the horizontal forehead wrinkles when a person raises the brows serves to pull the brows upward. If one of these muscles is relaxed with Botox and the others are not, the other muscles will still be active. This will lead to an unbalanced and unnatural appearance of the upper face where the brow can be elevated, depressed, or uneven in shape or position. Therefore, Dr. Alex recommends that patients take a global approach to the upper face when receiving Botox treatments and treat all three of these areas. Sometimes bunny lines on the bridge of the nose are also treated.
Will the results of my Botox treatment look natural?
Many people are concerned about how their appearance will change after a Botox treatment. This is understandable given the amount of both positive and negative publicity there has been around Botox and other cosmetic treatments. When done properly, Botox will provide a natural appearance that makes a person look more youthful and rested. With the increase in popularity of v treatments many offices now provide such treatments. It is important to find an office where the injector has experience and expertise in Botox injections. Dr. Alex recommends looking for experience, before and after photographs, and testimonials.
Does a Botox treatment hurt?
One of the most common questions regarding v is whether the treatment is painful. We use a painless technique to maximize our patients comfort during the treatment. This starts by reconstituting the Botox with preserved saline, which contains benzyl alcohol, to decrease the discomfort with the injection. We use a tiny needle, similar to the size of the needle used for TB test on the forearm. During the Botox treatment, we provide a relaxing environment by playing a calming video with gentle music. We provide stress balls to our patients to hold during their Botox treatment. We blow cold air on the area which serves to numb the skin. We also use the Beauty Bar, which is a vibration device which distracts the patient from the Botox injection itself. Finally, with experience, Dr. Alex has developed a technique to inject Botox to minimize pain. This includes pinching the area, pushing the skin into the needle (as opposed to pushing the needle into the skin), using a slight rotation, and using gentle pressure. Most patients are surprised at how comfortable the Botox treatment is.
How long does a Botox treatment take?
The Botox treatment is very fast. Depending on the area, only a few injections are required and each injection takes a few seconds. For example, the most common technique for treating the frown lines with Botox uses five injections between the brow, one in the center and two on either side. This is usually accomplished in less than 30 seconds. The most common technique for treating the crow’s feet involves three injection points per side. Most patients are surprised at how fast the treatment is.
Is Botox safe?
The safety record of Botox is well established. Botox has been used for over 20 years for a variety of treatments with minimal side effects. Botox is amongst the safest treatments for treating facial wrinkles.
While Botox is one of the safest treatments offered, there are some situations where it is not appropriate. These include anyone who has an allergy to any of the inactive ingredients or who has had an allergic reaction to any botulinum product including Botox, Dysport, Xeomin, or Myobloc. The safety and efficacy of Botox has not been established in women who are pregnant, trying to become pregnant, or breast feeding. Therefore, women in these categories are advised to wait until breast feeding is completed prior to having a Botox treatment. Botox should not be placed in the skin on the site of an infection. Those who are taking an aminoglycoside antibiotic, an anesthetic, D-penicillamine, antimalarials, or immunosuppressants should not be treated with Botox, nor should those who have undergone chemotherapy within the previous six months. It is important to avoid blood thinners before and after a Botox treatment. These include both prescription and non-prescription medications such as warfarin (coumadin), aspirin, ibuprofen, alcohol, fish oil, vitamin E, and ginko biloba. Those with conditions that affect muscles and nerves such as amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), myasthenia gravis, or Lambert-Eaton syndrome should not undergo Botox treatments.
What are the risks of a Botox treatment?
With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless Botox technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
What should I do after a Botox treatment?
After a Botox treatment, Dr. Alex recommends that patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids.
Botox Treatment Demonstration
Why am I seeing new wrinkles after a Botox treatment?
A phenomenon seen with Botox is called muscle recruitment and compensation. When a muscle has been relaxed with Botox, sometimes other muscles are recruited and contract when one attempts to make the facial expression. This serves to compensate for the inability of the primary muscle to contract. A common example is the bunny lines (caused by contraction of the nasalis muscle) that are seen on the sides of the upper nose after treatment with Botox in the glabella or for the crow's feet. Since the muscles in the treated area are relaxed, the nasalis muscle contracts in an attempt to compensate for this loss when one frowns or smiles. In such a situation, the bunny lines can be treated with a small amount of Botox (2-4 units per side). In the lower face, compensatory recruitment can occur when the platysma muscle in the neck contracts after muscles in the lower face have been relaxed with Botox. Similarly, this muscle can be relaxed with Botox as well. Dr. Alex usually uses approximately 10 units of Botox per band. If placed properly it does not affect other muscles. Relaxing the platysma muscle may also lead to an improvement of jowls and jawline definition. When such recruitment occurs, Dr. Alex recommends preventive (prophylacitc) treatment of the recruited muscles at the next treatment.
On Friday May 18, 2018 Dr. Alex attended the Allergan Medical Illumination Tour at the Westin hotel in Pasadena, CA. This is an event held in numerous cities nation wide to teach doctors about the newest technology and techniques in the use of dermal fillers for facial rejuvenation. The speakers with plastic surgeon Dr. Arthur Swift of Montreal, Canada and oculoplastic surgeon Dr. Steve Fagien of Boca Raton, FL.
What are dermal fillers?
Dermal fillers are injectable products used to restore volume in the face. Botox and dermal fillers are two of the most commonly used products for facial rejuvenation. Dermal fillers can be used to fill lines and folds such as the laugh lines (or nasolabial folds), improve hollowing under the eyes, restore the youthful apple of the cheeks, straighten a nose with a hump, enhance a weak chin, rejuvenate the jawline, and restore volume in the temples.
The products covered in the Allergan Medical Illumination tour were the fillers in the Juvederm collection. These include Juvederm Ultra and Juvederm Ultra Plus, the first ones available, as well as the newer products Voluma, Vollure, and Volbella. All of these products use a sugar found naturally in the skin called hyaluronic acid as the active ingredient. This brings water into the skin to restore volume and fill in wrinkles and folds. The newer products (Voluma, Vollure, and Volbella) use a new technology which allows you to enjoy your results longer than Juvederm Ultra and Juvederm Ultra Plus. These products are also softer, which allows them to move when you make facial expressions, providing a natural appearance.
The theme of the talk was light and shadows. These are two important things to understand when thinking about beauty. Makeup artists think about light and shadow all the time. The reflection of the light to highlight certain areas of the face is very important for beauty. At the same time, shadows formed on the skin provide a three-dimensional appearance of a contoured face. Using these ideas, the products are placed strategically in certain areas to maximize the effects of light and shadows. This allows for outstanding results without the requirement for a large amount of product. For example, certain points on the cheek should have maximum projection and more product is place there. Additionally, understanding anatomy allows injectors to place the products at the appropriate depth for safety as well as ideal results.
Dr. Alex attends numerous educational events to learn about the newest advances in the field of cosmetic medicine. He uses this knowledge to provide the best care for his patients in order to exceed their expectations. Dr. Alex also educates patients by writing a weekly blog and answering thousands of questions on Real Self. He also wrote a book, Everything You Ever Wanted to Know about Botox.
We are excited to offer a new treatment called the #nofilter treatment which can address a variety of concerns in a single treatment with a short recovery time.
The #nofilter treatment 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 #nofilter treatment?
The #nofilter treatment combines a Forever Young BBL IPL photofacial treatment with an Ultra Microneedling treatment. The Ultra Microneedling 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 #nofilter treatment is that the recovery is usually only a few days.
Who is a good candidate for the #nofilter treatment?
The #nofilter treatment is ideal for anyone, young or mature, who desires improvement in the color, texture, or tone of the skin. The #nofilter treatment works well for those with sun spots or uneven color. The #nofilter treatment will help for those with rough or irregular texture on the surface of the skin. The #nofilter treatment also works to improve the appearance of fine lines and wrinkles on the skin.
What should I do after a #nofilter treatment?
After a #nofilter 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. Dr. Alex recommends an initial series of six monthly treatments followed by one maintenance treatment every three 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 #nofilter treatment. Contact us to schedule a free consultation with Dr. Alex in our Encino, CA office.
Are you unhappy with your wrinkles, age spots, loose skin, or acne scars? Laser skin treatments offer a quick, virtually painless way to improve your skin without surgery. Our Encino, CA, dermatologist, Dr. Alex Eshaghian, provides several laser treatment you may want to consider.
Laser skin tightening
Collagen, the protein that helps keep skin elastic, tends to decrease as we age. As a result, skin begins to sag, forming fine lines and wrinkles. Laser skin tightening treatment heats the deep layers of the skin. As the laser energy penetrates the skin, collagen contracts, firming the skin. Treatment also promotes the growth of new collagen. Laser skin resurfacing can improve the appearance of your cheeks, jawline, chin, and neck and can be combined with chemical peels, other laser treatments, and Botox injections.
Fractional CO2 laser resurfacing
Fractional CO2 laser resurfacing creates tiny pinpricks in the skin that trigger collagen production. The laser only treats a fraction of your skin and doesn't affect surrounding skin, which helps promote rapid healing. The treatment can minimize fine to deep wrinkles, make scars and large pores less noticeable, and improve the texture of your skin. It's often used on the neck, face, hands or chest.
The microlaser peel removes the top layers of the skin where fine lines, age spots, freckles, and shallow acne scars reside. After your treatment, the top layers of your skin will peel away, revealing younger-looking skin underneath. The treatment also triggers the growth of new cells during the healing process. Because the microlaser peel is only used on the outer layers of the skin, you may not even need a topical anesthetic during treatment in our Encino office.
AE skin ultimate rejuvenation
The AE skin ultimate rejuvenation treatment combines several types of treatments to help your skin look youthful and radiant. During your visit, you'll receive a Forever Young IPL Photofacial that targets discolorations, reduces redness and close enlarged pores, followed by a laser skin tightening treatment. Other steps include a microlaser peel treatment, Pro Fractional Therapy, and treatment with hydroquinone liquid to brighten skin.
Turn back time with laser skin treatments! Call our Encino, CA, dermatologist, Dr. Alex Eshaghian, at (818) 835-1833 to schedule your appointment.
We are excited to announce that A E Skin has been named Best Medical Spa in Encino, CA for the sixth year in a row! This award is given by the Encino Awards Program and recognizes achievements and accomplishments of businesses in Encino.
A E Skin is a medical spa in Encino offering a variety of cosmetic services and products such as Botox, fillers, laser rejuvenation, and skin care products. Established in 2010 by Dr. Alex Eshaghian, MD, PhD (Dr. Alex), A E Skin is proud that all of our patients see Dr. Alex every time. With his experience and expertise in cosmetics, Dr. Alex strives to provide outstanding results. Dr. Alex treats each person individually because each person has different features and desires. By providing direct care and communication with his patients, Dr. Alex is able to exceed our patients’ expectations.
Dr. Alex has performed over 10,000 cosmetic treatments with outstanding results as seen in our before and after photographs and patient testimonials. Dr. Alex has also done a decade of scientific research; his dissertation in graduate school focused on genetic changes involved in photo-aged skin. Dr. Alex continues his education by attending many seminars and conferences each year. At these events, Dr. Alex learns the newest innovations in aesthetic medicine to incorporate it in his practice. Dr. Alex has designed a variety of treatments to rejuvenate the skin without surgery. For Dr. Alex it is also important to educate his patients, which is why he has published a book entitled Everything You Ever Wanted to Know about Botox, publishes a weekly blog, and has answered thousands of questions on RealSelf.
Comfort, convenience, and customization are what sets A E Skin apart from other medical spas. We always use products such as numbing cream, relaxing music, and cold air to keep patients comfortable throughout their treatments. We are available on evenings and weekends for those who cannot take time off from work. And we always take high quality before and after pictures so patients can see their own transformations.