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Posts for tag: Botox

By Dr. Alex Eshaghian, MD, PhD
February 17, 2019
Category: Services

There are many cosmetic treatments available for rejuvenation of the face and neck. Here we will discuss treatments to address specific concerns with the lower face and neck.

What changes occur in the lower face and neck over time?

Liquid Facelift before and afterThe majority of changes associated with aging in the lower face result from loss of collagen and volume loss. Collagen is the protein that keeps the skin firm, tight, and youthful in appearance. Over time and with sun damage, we lose collagen. It is broken down faster and we make less of it. Also, the bone structure in the face changes. For example, the bones in the upper cheeks move downward and inward. At the same time the fat pads in this area move downward. Together this leads to a descent of the lower face. We start to see laugh lines (from the sides of the nose to the corners of the mouth) and sometimes they continue to the jawline as marionette lines. Loose skin and wrinkles are seen in the lower face and neck. The jawline definition is also reduced as we see the formation of jowls.

Restoring Volume in the Mid-Face

Voluma before and afterVoluma is a filler that is used to restore lost volume in the mid-face. Voluma is placed on the upper cheek bones and provides and immediate volumizing and lifting effect. Voluma will restore the youthful apple of the cheeks and pull up on the lower face to address many of these changes seen as we age. The active ingredient in Voluma is hyaluronic acid, a naturally occurring sugar found in the skin that draws water into the area to provide volume. You will see your results with Voluma right away and enjoy these results for one to two years depending on how much product is used.

Creating More Collagen

There are a number of ways to create more collagen in the skin. First it is important to use good skin care products to protect your skin. This includes daily sunscreen along with products such as retin-A and vitamin C, which stimulate collagen formation and protect your skin from damage. Treatments such as laser skin tightening and Ultra Microneedling will help this even more. These treatments stimulate your body to produce its own natural, new, fresh, and healthy collagen. This helps with wrinkles and loose skin. It will pull the skin from above and below, providing a natural lift.

Treating Wrinkles in the Lower Face

Volbella before and afterMarionette lines and fine lines around the mouth can be treated with fillers. Vollure is an outstanding product that provides natural and long-lasting results for the laugh lines and marionette lines. Vollure can also be used to volumize the lips. Fine lines around the mouth are best treated using Volbella, another filler that works well to fill in the small lines without providing much volume.

Getting Rid of the Double Chin

Kybella before and afterKybellla is a great treatment to get rid of the double chin. Kybellla is the first and thus far only FDA-approved, non-surgical, injectable treatment for the double chin. The active ingredient in Kybellla is a salt found in the body that is used to digest that fat that you eat. When Kybellla is placed in the skin Kybellla will dissolve the fat and it’s naturally eliminated by the body over time. Most people have two to four session Kybellla spaced every three months. A series of laser skin tightening treatments between the first and second Kybellla sessions will give even better results.

Defining the Jawline

Voluma chin before and afterSome people have a weak chin or jaw bone. Fillers such as Voluma can be used to enhance a weak chin and the corner of the jawline. This provides a natural result and can make the face look more balanced. Also, Botox can be used in what is called the Nefertiti Neck Lift to relax the muscle in the neck. This muscle pulls down on the lower face. When relaxed with Botox, it will provide a natural and subtle lift to the lower face to complement the other treatments described here.

Combining Treatments

Rather than simply having one treatment done, most people find that they get the best results when combining many or all of these treatments. These combinations address all of the different aspects associated with aging: volume loss, collagen loss, buildup of fat under the chin, and relaxing muscles.

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
January 13, 2019
Category: Services
Tags: Botox  

Botox for TMJBotox is one of the most popular treatment in our office. Botox is most commonly used to treat wrinkles on the face. However, Botox can also be used for a number of other purposes that are not cosmetic.

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 your upper forehead when you raise your eyebrows, the vertical lines seen between your eyebrows when you frown (frown lines), and the crow's feet seen around your eyes when your smile.

Botox for TMJ pain

Many people grind or clench their teeth. This can result in pain in the TMJ joint in front of the ear. Botox can be placed in a muscle in the lower face used for biting called the masseter to contour the lower face and address pain associated with TMJ. In this area 20-40 units of Botox are used per side. Depending on the reason for the enlargement of the muscle, permanent results may be achieved using Botox. For example, some people have a habit of grinding, clenching, or biting their teeth subconsciously. Often times this happens in their sleep when they are not aware of it. Botox placed in this muscle will relax the muscle and the grinding, clenching, and/or biting will decrease. This will reduce the size of the muscle. If the brain gets accustomed to this and the person stops grinding, clenching, or biting, then the muscle will not become enlarged or as enlarged again. However, if the habit starts again, the muscle will likely get larger.

To determine if you are a good candidate for this Botox treatment it is necessary to look at your lower face when biting and comparing it to when you are not biting. If a bulge is seen on the outer portion of the jawline, then you are likely a candidate for a Botox treatment. It can also be felt with the fingers when biting.

The picture shown here is that of a patient who had a Botox treatment for her TMJ pain. Botox also slims the lower face, making it look like she has lost weight.

Botox for Migraine Headaches

Botox works to treat migraine headaches in the same way it works to treat wrinkles: by relaxing muscles. In the case of migraine headaches (and sometimes other headaches such as tension headaches) the muscles in the upper face and head contract. This puts pressure on the bones which can be very painful.  Botox will relax the muscles to relieve the pain. The areas treated with Botox for migraine headaches are those treated in the upper face. Sometimes additional muscles are also treated with Botox such as those in the temples and back of the head. The dose of Botox used is in the range of 60 to 70 units. Full results are seen in two weeks and after a Botox treatment. However, many patients feel improvement as early as the next day after a Botox treatment.  Botox treatment for migraines will significantly reduce the frequency of migraines and is a great alternative for those for whom oral medications are ineffective. Most people enjoy their results from a Botox treatment for three to four months. At that time a maintenance treatment is recommended. A video demonstration of this treatment is shown below.

Botox for Migraine Headaches Treatment Demonstration

Botox for Enlarged Pores

One of the side effects that people notice when they get Botox to treat their wrinkles is an improvement in the appearance of the pores. The Botox can also decrease production of oil in the glands to reduce the size of the pores and to treat oily skin. For such a purpose Botox is used slightly differently. The Botox is diluted more than normal and spread out over the skin surface. Therefore, there are many injection points rather than just a few. Also, the Botox injections are placed in the very surface layers of the skin so that it can best reach the oil glands, in contrast to deeper placement of Botox when used to relax muscles. Usually about 40 units of Botox are used for the entire face. The results of such a Botox treatment are seen in a few days and most people enjoy their results for three to four months.

Botox for Excessive Sweating 

Excessive sweating, a condition known as hyperhidrosis can be a serious concern for some people. Excessive sweating can occur even when it is not hot. It sometimes occurs when a person is nervous. This can become very embarrassing for a person, especially when it happens frequently. The most common areas of concern include the underarms, palms of the hands, and soles of the feet. Fortunately, Botox is an easy and effective treatment for excessive sweating. These areas are more sensitive and therefore numbing cream is usually applied on the area for about 15 minutes prior to the treatment. To determine exactly where the sweat glands are, sometimes a test is performed called the starch iodine test. Iodine is placed on the area of the skin which will be treated. The areas with more sweat glands will appear dark. This allows the provider to know exactly where to place the Botox. Despite this, typically the entire area is treated and the Botox is placed to cover the entire area. Usually 50 units of Botox are used on each side. Some people enjoy their results from a Botox treatment for six months or more. Similar to when Botox is used for cosmetic purposes, periodic maintenance treatments are required.

Botox for the Scrotum

One of the newest and also most controversial uses for Botox is for scrotal enhancement. The scrotal sac needs to be slightly colder than body temperature for sperm production. Normally the sac hangs below the body to provide a slightly colder temperature. There is a muscle in the scrotal sac which is used to pull the scrotum toward the body. This muscle contracts normally in cold weather so that the scrotum is not too cold. When this muscle contracts the sac appears wrinkled. When this muscle is relaxed with Botox these wrinkles are not seen since the muscle does not contract. Therefore, it is not able to function appropriately for temperature regulation and sperm production may be abnormal. This is important for men who are trying to have children. The other benefit of placing Botox in this area is that, similar to the underarms, palms of the hands, and soles of the feet, Botox will reduce sweating in the area.

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
January 10, 2019
Category: Skin Treatments
Tags: Botox  

Find out how Botox treatment could give your skin the refreshing look you’ve been wanting.

If you’ve been wondering about the many ways in which you can get younger-looking skin in Encino, CA, our med spa doctor Dr. Alex offers simple non-surgical options like Botox to give you the cosmetic spruce you are looking to start the New Year.

Treat Fine Lines and Wrinkles

Botox is designed to treat dynamic wrinkles, or wrinkles that appear when moving your face. Take a look in the mirror and smile for a moment. What do you see? If you find that wrinkles and lines develop on your forehead, around your mouth or your eyes, these are wrinkles that Botox treatment will be able to smooth away. How? Botox relaxes the muscles of the face, reducing contractions to smooth away these lines and wrinkles that form when you make certain facial expressions.

A Fast, Minimally Invasive Treatment

Botox is one of the fastest cosmetic treatments we offer. In fact, in just a few minutes we can administer the Botox treatment through the use of very thin needles. Some patients choose to get this done during their lunch break because it’s that quick. Plus, pain is very minimal. Even without applying a numbing gel to the treatment area, most people don’t feel anything more than a slight pinch or burning sensation. Botox can target lines and wrinkles without surgery.

No Downtime

You can also go right back to your normal routine right after Botox treatment. While there may be some slight redness or swelling at the injection sites, it’s very minimal and will go away within a couple of days. Not having to take time off work is a big deal for many people, and Botox makes it easy to get the cosmetic treatment you want without having to take days off from your normal routine. Botox fits into your busy life!

Results are Temporary

In many cases, people wouldn’t normally see this as a benefit; however, if this is your first time turning to cosmetic dermatology in Encino, CA, you may want to take it a bit slower and ease into these types of treatments. Many of our patients want to improve their appearance but worry about treatment options that offer long-term results. After all, what if you aren’t happy with the results that a treatment gives you? Botox allows you to treat those early signs of aging without the long-term commitment.

Maintain Your Results

Just because results are temporary doesn’t mean that you can’t keep your appearance looking young and fresh for longer than 3-4 months. If you love the way you look with Botox talk to our Encino, CA, medical spa physician to find out how often you should come in for maintenance treatments to keep your results looking their best.

If you are looking for a quick, easy and non-invasive way to cosmetically enhance your appearance while boosting your self-confidence, then Botox may be the right treatment option for you. If you are interested in Botox call A E Skin in Encino, CA, to schedule your consultation.

By Dr. Alex Eshaghian, MD, PhD
November 04, 2018
Category: Services
Tags: Botox  

Botox to contour the lower faceA slim face is a feature of youth and beauty. Over time the structures of the face change. Fortunately, we can reverse some of these changes with Botox.

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 you raise your eyebrows, the vertical lines seen between the brows when you frown (frown lines), and the crow's feet seen around your eyes when you smile. Full results are seen two weeks after a Botox treatment and most people enjoy their results for three to four months.

What is the ideal facial shape?

The ideal shape of a face depends on a number of things. First it is different between men and women. And second, there are some differences from culture to culture. In the United States, the ideal shape for a female is that of a heart. In a heart-shaped face the mid-face is widest where the cheeks project outward near the ears and the lower face tapers down to a point at the chin. In men, on the other hand, a square lower face with a well-defined jawline is more desirable.

What changes the shape of the face over time?

There are many things that affect the shape and appearance of the face which change over time. As mentioned, the cheeks should be prominent. Over time the fat pads in the cheek get smaller and the cheek bones move downward and inward. These make you lose the projection in the cheeks. At the same time, we lose collagen in the skin. Collagen is the protein that keeps the skin tight, firm, and youthful in appearance. Over time we stop making as much collagen and it is lost. This leads to loose skin, wrinkles, and sagging, making the face look like it is sinking down. In some people, especially those who clench or grind the teeth, a bulge can appear in the lower face, making the lower face appear wider. This is a result of using the muscle that sits in the lower face which is used to bite.

What can I do to slim my lower face?

There are a number of things you can do to slim the lower face. First fillers such as Voluma can be placed in the upper cheeks, restoring the projection and lifting the lower face. Also, laser skin tightening treatments can be done to stimulate the formation of collagen. This will tighten the skin and lift the face. Another simple treatment for those with a bulge in the lower face is with Botox. Botox works by relaxing muscles. In the upper face, when you make facial expressions you are using the muscles. Over time this leads to the formation of wrinkles such as frown lines and crow’s feet. When the muscles in the upper face are relaxed with Botox these wrinkles smoothen out. In the same way, Botox can relax the muscle that is used for biting. When relaxed it becomes smaller, making the bulge less visible. This slims the lower face. This is the treatment the patient shown here did. She got a slim lower face and she looks like she has lost weight. At the same time she no longer has pain associated with grinding of the teeth.

Botox Demonstration to Contour the Lower Face

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By Dr. Alex Eshaghian, MD, PhD
October 07, 2018
Category: Services
Tags: Botox   neck  

Botox before and after for neck bandsVertical bands on the neck can often be seen slowly over time as we mature. Botox is an easy solution for these bands.

What is Botox?

Botox is a purified protein used to address wrinkles that are associated with facial expressions. These include the horizontal lines seen on the upper forehead when we raise our eyebrows, the vertical lines seen between the eyebrows when we frown, and the crow’s feet seen around the eyes when we smile or quint. When placed in the skin, Botox will relax the muscles and smoothen out the overlying wrinkles.

How does Botox work on the neck?

A common concern on the neck is what are called vertical neck bands. These are caused by contraction of a muscled in the neck just under the skin called the platysma. They can be seen or accentuated when the neck is contracted, often times by slightly lifting the chin and moving the lips to show your lower teeth as seen in the photograph shown here. Just like any other muscle on the body, over time the more it is used the stronger it gets. This leads to muscle definition, which is seen as neck bands. Botox works for neck bands in the same way it works for frown lines, forehead wrinkles, and crow’s feet: by relaxing muscles. In this case Botox relaxes the platysma muscle in the neck, preventing it from contracting and forming the bands. The results from a Botox treatment for neck bands are outstanding. Usually 10 units of Botox are used in each of the four bands, for a total of 40 units of Botox.

Additionally, Botox can be used in the neck for what is called the Nefertiti neck lift. Nefertiti was an Egyptian queen known for her long and beautiful neck. In the Nefertiti neck lift Botox is placed just under the jawline from one side to the other side. This relaxes the upper part of the same platysma muscle that is treated for vertical neck bands. When this part of the muscle contracts it pulls down on the lower face. Once it is relaxed with Botox it is unable to pull down on the lower face. This provides a subtle lift of the lower face and improves jawline definition. Sometimes a small amount of Botox is placed in a muscle called the DAO in the lower face. This muscle goes from the corners of the mouth to the jawline and when it contracts it pulls down the corners of the mouth. When the DAO muscle is relaxed with Botox the corners of the mouth are elevated about one or two millimeters. This really helps with a sad face appearance. The Nefertiti neck lift can be complemented by placing fillers in the mid-face, laser skin tightening, and Kybella for the double chin.

Botox for Neck Bands

When will I see the results of by Botox treatment?

Although some people notice the results of their Botox treatment in a few days, it can take up to two weeks to see the full results of your Botox treatment. Therefore, patience is important. We take baseline photographs of you making facial expressions before your Botox treatment and have you return tow to three weeks later to take the same pictures. If you receive the recommended dose of Botox and the results are not perfect, we provide complimentary additional Botox units. This way you don’t have to worry about the possibility of diluted Botox.

How long does Botox last?

Most people enjoy the results of their Botox treatment for three to four months. Dr. Alex recommends a maintenance Botox treatment at that time. We participate in the Brilliant Distinctions Program. This is a rewards program designed by Allergan, makers of Botox, Juvederm, Voluma, Vollure, Volbella, Kybella, and Latisse, where you get points for each treatment. These points are then used toward discounts at your next Botox (or other) treatment.

What are the side effects of Botox?

With any injection there are risks including pain, bleeding, bruising, redness, swelling, infection, and tenderness. We take special precautions to minimize these risks. Dr. Alex uses a painless Botox injection technique where cold air is blown on the skin to numb the skin. We also place a vibrating distractor called the Beauty Bar nearby for further comfort during your Botox treatment. Bruising is rare with Botox treatments and bruises can last up to two weeks after a Botox treatment. If you get a bruise after a Botox or other treatment we are able to treat it with a laser as early as the next business day. This makes the bruise go away much faster, typically in one to three days, although it may still last two weeks and sometimes it gets darker before getting lighter. Headaches can occur for up to a few days after a Botox treatment. Dr. Alex recommends taking over-the-counter strength Tylenol for pain relief. There is also a very small risk (less than one percent) that some of the Botox spreads to nearby muscles. Depending on the area treatment, the spread of Botox make lead to things like droopy eyelids or an asymmetric smile. Such side effects are always temporary and often times treatable.

What should I do after a Botox treatment?

After a Botox treatment, Dr. Alex recommends avoiding heat exposure, alcohol consumption, and strenuous exercise for 24 hours and maintaining an upright posture without bending forward or lying flat for four hours. These activities can lead to the movement of Botox, leading to side effects, and/or increase the risk of bruising.

Patient Review - Botox

Patient Review - Botox

 

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[Dr.] Alex was my first and only Botox doctor and he was very good to let me know know it was OK and to not be nervous. He did a great job and my Botox has laster well over 3 months. And now I am hooked. 

    — Victoria S.

 

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Real SelfI had a wonderful experience I'm 33 years old and I had Botox for the very first time I was so scared but after he explained it to me the painless procedure, NOW that was quite the experience I highly recommend Dr.Alex he is amazing and trustworthy not only that the stuff is very friendly. Thank you so much Dr. Alex

    — Iris Sanchez

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GoogleI was referred to Dr. Alex by friend. At first I was afraid of getting Botox injections because I thought it would make me look weird. But Dr. Alex and his wonderful staff explained that it is a purified protein and the results will be natural. And they were right. It looks completely natural, the treatment was painless, and I did not even get a bruise. If you want great results and outstanding service I highly recommend A E Skin.

    — Rod Fani

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
July 15, 2018
Category: Services
Tags: Botox  

BotoxBotox is one of the most popular treatments we perform and we are now using Botox to treat migraine headaches.

What is Botox?

Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin, Botox will relax muscles and smoothen out the overlying wrinkles. The most common areas of treatment with Botox are in the upper face. These include the horizontal forehead wrinkles seen when raising the eyebrows, the vertical frown lines seen between the eyebrows when frowning, and the crow’s feet seen around the eyes when smiling.

How does Botox work to treat migraine headaches?

Botox works to treat migraine headaches in the same way it works to treat wrinkles: by relaxing muscles. In the case of migraine headaches (and sometimes other headaches such as tension headaches) the muscles in the upper face and head contract. This puts pressure on the bones which can be very painful. Botox will relax the muscles to relieve the pain. The areas treated with Botox for migraine headaches are those treated in the upper face as described above. Sometimes additional muscles are also treated with Botox such as those in the temples and back of the head. The dose of Botox used is in the range of 60 to 70 units. Full results are seen in two weeks and after a Botox treatment. However, many patients feel improvement as early as the next day after a Botox treatment. Botox treatment for migraines will significantly reduce the frequency of migraines and is a great alternative for those for whom oral medications are ineffective. Most people enjoy their results from a Botox treatment for three to four months. At that time a maintenance Botox treatment is recommended.

Botox for Migraine Headaches Treatment Demonstration

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
June 17, 2018
Category: Services
Tags: Botox  

Clear faceBotox is one of the most popular cosmetic treatments available and now we are using it for another indication: to decrease the appearance of pores.

What is Botox?

Botox is a purified protein used for a number of different purposes. Traditionally Botox has been used to address wrinkles associated with facial expressions. These include the horizontal lines seen on the upper forehead when raising the eyebrows, the vertical lines seen between the eyebrows when frowning, and the crow’s feet seen around the eyes when smiling. Botox works by relaxing the muscles and smoothening out the overlying wrinkles.

How does Botox work for pores?

One of the side effects that people notice when they get Botox to treat their wrinkles is an improvement in the appearance of the pores. The Botox can also decrease production of oil in the glands to reduce the size of the pores and to treat oily skin. For such a purpose Botox is used slightly differently. The Botox is diluted more than normal and spread out over the skin surface. Therefore, there are many injection points rather than just a few. Also, the Botox injections are placed in the very surface layers of the skin so that it can best reach the oil glands, in contrast to deeper placement of Botox when used to relax muscles. Usually about 40 units of Botox are used for the entire face. The results of such a Botox treatment are seen in a few days and most people enjoy their results for three to four months.

Join our mailing list

Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
May 27, 2018
Category: Services
Tags: Botox  

Botox before and afterBotox 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.

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian
April 22, 2018
Category: Services
Tags: Botox  

Botox before and afterBotox is the most common non-surgical treatment in the United States and Botox has become a household term. With so many different indications for Botox so many people are getting a treatment and it is no longer taboo. One of the most common questions is how early a person can get Botox.

What is Botox?

Botox is a purified protein used to treat wrinkles associated with facial expressions. Common areas of treatment with Botox include the horizontal lines on the forehead seen when raising the eyebrows, the vertical lines between the brows seen when frowning, and crow’s feet around the eyes seen when smiling or squinting. Botox is also used in other areas to shape the lower face, smooth out the chin, address a gummy smile, provide a pout to the lips, improve neck bands, treat migraine headaches, decrease sweating in the underarms, and more. When injected into the skin, Botox will relax the muscles and smoothen out the overlying wrinkles. Full results are seen two weeks after a Botox treatment and most people enjoy their results from a Botox treatment for three to four months, at which point a maintenance Botox treatment is recommended.

I want to 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.

Is Botox painful?

One of the most common questions regarding Botox 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 apply 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 developed a technique to inject 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 treatment time for a Botox treatment is very short. In our office, we take photographs of our patients with a neutral facial expression and with various other expressions depending on the area(s) treated before the Botox first treatment. The Botox treatment involves cleaning of the area and the placement of the product takes only a few minutes. Most people can expect to be out of the office in 15-30 minutes.

When can I get my first Botox treatment?

A common misconception is that Botox is only for those who are in their 60's or 70's. On the contrary, we have a lot of patients in their 20's who receive Botox. This is either for prevention or for those who have expressive faces. Dr. Alex finds that the younger a person is when one starts receiving Botox treatments the more signs of aging will be delayed. In other words, Botox can be used to prevent wrinkles from either appearing in the first place or from getting deeper over time.

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.

What are the risks of a Botox treatment?

With any injection such as Botox, 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 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 of Botox 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, 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 Botox and consequent side effects such as droopy eyelids as described above.

How much does a Botox treatment cost?

The investment for a Botox treatment varies from office to office. It depends on the region, office, and injector. The total investment also depends on how much Botox is required, the areas treated, and the individual. For example, if someone has a larger forehead, a higher dose of Botox will be required. If multiple areas such as frown lines and crow’s feet will be treated the investment will be more than that if only a single area is treated. In general, men have stronger muscles than women both on the body and on the face. For this reason, men usually require higher doses of Botox than women. The investment range for a Botox treatment is $200 - $500 per area. Areas include frown lines, crow’s feet, etc.

Botox Treatment Demonstration

 

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
February 11, 2018
Category: Services
Tags: Juvederm   Botox   Voluma   Volbella   Vollure  

Liquid Facelift before and afterThe liquid facelift if one of our most popular treatments and we are getting amazing results. This treatment uses multiple liquid products such as Botox, Voluma, Vollure, Juvederm Ultra, and Volbella to improve wrinkles and restore lost volume to the face. As compared to a traditional surgical facelift, the liquid facelift does not involve anesthesia, surgery, or recovery. The liquid facelift treatment itself is customized for each person.

The patient whose picture is shown here saw significant improvement in her skin with the liquid facelift. This was complemented by using the A E Skin line of products. In this case 54 units of Botox, two syringes of Voluma, three syringes of Vollure, and two syringes of Volbella were used. This treatment provides over 10 years of youth. Those who have the liquid facelift treatment state that they have increased confidence and enjoy their interactions with others more.

Liquid Facelift Testimonial

Botox

Botox is used in the non-surgical facelift to address wrinkles associated with facial expression. Usually this is in the upper face. The most common areas treated with Botox are the horizontal lines seen on the upped forehead when a person raises the eyebrows, the vertical lines seen between the eyebrows when a person frowns, and the crow’s feet seen around the eyes when a person smiles or squints. Typically, 50-60 units of Botox are used in this area. Botox can also be used in the lower face to relax muscles that pull the face downward. This will provide a further lift.

Fillers

Fillers are used to restore lost volume in the skin. The Juvederm family of products is the most popular group of fillers in the United States for a number of reasons. First, the active ingredient in the Juvederm family is hyaluronic acid, a naturally occurring sugar found in the skin and elsewhere in the body. It binds 1,000 times its weight in water and draws water into the skin to fill the wrinkles and folds. It has a high safety margin because it can be dissolved in the case of undesired results or a rare adverse event. The Juvederm collection of fillers includes the Vycross family: VolumaVollure, and Volbella. These products use a new technology that allows patients to enjoy their results longer. It also provides very natural results.

Voluma

Voluma is usually used in the upper cheeks to restore the apple of the cheeks. This provides a youthful appearance to the face and pulls up on the lower face. It can help improve the appearance of jowls and provide a more defined jawline. Voluma is a firm product and provides a noticeable but natural lift that is seen immediately. Unlike a traditional surgical facelift where only the skin is tightened, when using products such as Voluma, volume is restored to the face. Most people start with one syringe of Voluma per side, a conservative amount. The results of the Voluma treatment are assessed approximately two weeks later and more product can be added at that time if further enhancement is desired.

Vollure

Vollure is the second filler used in the liquid facelift. Vollure is slightly softer than Voluma and is commonly used in the nasolabial folds (the lines that go from the sides of the nose to the corners of the mouth) and the marionette lines (the lines that go from the corners of the mouth to the jawline). Most people start with two to three syringes of Vollure in this area, a conservative amount. The results of a Vollure treatment are assessed approximately two weeks later and more product can be added at that time if further enhancement is desired.

Juvederm Ultra

Juvederm Ultra is the original Juvederm product that uses the previous Hylacross technology. Similar to Vollure, Juvederm Ultra is used in the nasolabial folds and marionette lines. The difference is that Juvederm Ultra contains a higher level of hyaluronic acid, which means it brings even more water into the skin. Juvederm Ultra is best suited for those who have deeper folds in this area. Most people start with two syringes (one per side) of Juvederm Ultra in this area, a conservative amount. The results of a Juvederm Ultra treatment are assessed approximately two weeks later and more Juvederm Ultra can be added at that time if further enhancement is desired.

Volbella

Volbella is the softest filler available in the Juvederm collection of fillers. It is ideal to address fines lines on or around the lips as well as shaping the lips. Volbella can also be used to restore lost volume to the tear trough area. This is the area directly below the eyes where hollowing is commonly seen as people mature. Most people start with two syringes of Volbella in either of these areas, a conservative amount. The results of a Volbella treatment are assessed approximately two weeks later and more product can be added at that time if further enhancement is desired.

The liquid facelift is an ideal treatment for anyone who desires a more youthful appearance to make them look as good as they feel. When these treatments are combined, patients really love their results.

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.



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A E Skin

818-835-1833
16311 Ventura Bl. Suite 845 Encino, CA 91436