Patel Plastic Surgery Salt Lake City and St. George
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  • Cosmetic
    • Facelift
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    • Lower Blepharoplasty
    • Upper Blepharoplasty
    • Midface Lift/Hammock Lift
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    • Lip Lines
    • Lips
    • Mouth
    • Neck Liposuction
    • Fat Transfer
    • Skin Resurfacing
    • Cheeks
    • J-PLASMA SKIN RESURFACING
    • J-PLAZTY FACE
    • Removal of Moles, Lesions, Tags, Cysts and Blemishes
    • Facial Implants
    • Otoplasty, Ear Pinning, or Bat-Ear Repair
    • Complications?
  • Reconstruction
    • Acquired Ptosis and Dermatochalasis
    • Congenital Ptosis
    • Ptosis in Myasthenia Gravis
    • Blepharophimosis Syndrome
    • Entropion
    • Ectropion
    • Thyroid Eye Disease
    • Nasolacrimal Duct Obstruction
    • Skin Tumors
    • Orbital Tumors
    • Blepharospasm
    • Pterygium
    • Anophthalmos and Microphthalmos
    • Enucleation and Evisceration
    • Exenteration
    • Symblepharon
    • Congenital Anomalies - Lid Disorders
    • Acne Rosacea
    • Trauma
    • Infections
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    • Aerolase Laser
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    • Laser Hair Removal
    • Kybella
    • Chemical Peels
    • XEOMIN ®
    • Voluma
    • LATISSE EYELASH TREATMENT
    • Leg Veins and Spider Vein Treatment
    • Sculptra
    • Neck and Chest Cosmetic Concerns
    • Dysport
    • Accent Radiofrequency
    • Microdermabrasion and Light Chemical Peels
    • Melasma
    • Laser Tattoo Removal
    • Color and Texture Issues – Brown Spots on Face, Redness
    • Scars and Acne
    • Permanent Cosmetic Makeup
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Articles

When should I start getting botox and can it be used for preventive purposes? Here are the answers to when it works and how it is used in Salt Lake City and St. George by Dr. BCK Patel MD, FRCS

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Botox injections to frown muscles, forehead lines and brows by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George
Nice improvement in the severe frown lines ("elevenses") and also in the height of the brows with botox in a patient in her late 40s. Notice the improvement in her skin with the use of lasers

Which parts of the face does botox work best on?

​Botox has become one of the most popular cosmetics treatments sought in the USA. Although the term "Botox" is widely used, the products used are varied and include Botox, Dysport, Myobloc, Xeomin, Jeuveua and others. Cosmetically, any of these products are used for one or more of the following reasons:
  • frown lines between brows ("elevenses")
  • frown line across the bridge of the nose
  • smile lines
  • forehead lines
  • crow's feet
  • bunny lines
  • raise the corner of the mouth (improve the "frowny" mouth)
  • improve the jawline (the vampire lift)
  • improve neck platysma bands
  • make subtle changes in the position of the upper and lower eyelids
  • improving the fullness caused by the masseter muscles (round face to oval face change)
​

Besides cosmetic applications, how else is botox useful?

Botox is also used for other medical conditions:
  • treating migraine
  • treating excessive sweating
  • decreasing sweating
  • treating blepharospasm and hemifacial spasm
  • treating aberrant nerve regeneration after Bell's palsy

Commonly asked questions about when to start botox and when is it too early or too late?

​Common questions we are asked are:
  • "what is the right age to start?"
  • "am I too young to start with botox?"
  • "should I have started earlier?"
  • "am I too far gone with my wrinkles to benefit from botox?"
  • "will the botox get rid of all my lines?"
  • "why do I have to keep on repeating the injections of botox?"
A more recent development is the use of Botox as a preventative measure to decrease the development of wrinkles and lines. Here are all the answers to all your questions about botox and preventative botox in Salt Lake City and St. George, Utah.
Botox injections to frown muscles, forehead lines and brows by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George
The static frown lines ("elevenses") are present in the late 30s age group: these respond nicely to properly administered botox. Note the rise in the brows and the tail of the brows giving an elegant look to the face

What age do I have to be to get botox?

The use of botox for wrinkles is approved by the FDA for people over the age of 18 years. Just because it is legal after the age of 18 years does not mean you should get botox!! Wrinkles begin to appear in the late 20s and early 30s. They depend upon a lot of factors including genetics, sun exposure, use or otherwise of sunglasses, occupation, climate, etc. 

To best understand when botox works and can be considered, it is useful to understand the appearance of facial wrinkles and lines related to the movement of muscles such as the orbicularis (smile lines), corrugator muscle (elevenses or vertical frown lines), frontalis muscle (forehead lines), depressor angularis oris (down-turning mouth), orbicularis oris (vertical lip lines) and the ages where one sees them. 
Botox injections to frown muscles, forehead lines and brows by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George
Botox in the 30s gives a very nice relaxation of the "elevenses" which can make us look angry or serious or even tired as the brows get pulled down

Wrinkles and lines that appear at different ages and how botox can help

Botox reduces the dynamic movement of the muscle it is injected in, thereby reducing the wrinkles that form. As dynamic muscles continue to move, over time they form lines that are initially only there when you move the muscles but eventually the lines etch themselves into the skin. The production of collagen and elastin starts to slow down in our early 30s with factors such as smoking, sun exposure, diet, stress, sleep, etc all having an effect on the static lines that eventually develop. 

Botox in the 20s and 30s: is it too early to start botox?

Age in the 20s

In the 20s, botox is often promoted for "preventative purposes" or, to use an awful phrase, "prejuvenation".  In this decade, lines only form when you use your muscles and are called "Stage 1" wrinkles. Botox should only be used if the lines remain after you relax the muscles. These are the lines that will deepen over time and it is reasonable to consider getting botox. Unlike what many suggest, I do not believe that getting botox in the early 20s prevents any lines developing. There is too much promotion of "preventative botox in the very young. If you don't have lines that remain after relaxing a frown or smile, do NOT get botox. 

Age in the 30s


The late 20s and early 30s are common ages when patients will seek botox injections. In the high-stress world we live in, together with the very outdoors lifestyle, it is not surprising that the wrinkles and lines begin to appear in this age group. As the collagen production and elastin formation begin to slow down, static wrinkles begin to appear (meaning there are wrinkles even when your muscles are not moving): these are "Stage 2" wrinkles. At this stage, 25 to 35 units of botox will address the issues nicely. However, some people have stronger muscles (depending upon genes, racial background, occupation, etc) and may need a higher dose of the injection. In this age group, the effects of the botox will last up to four months.
Botox injections to frown muscles, forehead lines and brows by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George
Judiciously performed botox to the forehead lines, frown lines and to raise the tails of the brows in a patient in her 40s gives very pleasing results. Laser treatment to the forehead improves the sun damage

Botox in the 40s and 50s: is it too late?


Age in the 40s: is 40 too late for Botox?

"Stage 3" wrinkles may be seen in this age group where the wrinkles are there in a "relaxed face". If makeup stays in a groove or one can see the shadows formed by the grooves with the face relaxed, these are "Stage 3" wrinkles. In such patients, the botox, when judiciously delivered, will relax the muscles and soften the lines but will not eliminate the "grooves" formed by the  muscle movement. Patients will often feel like their botox does not last as long but this is because the lines begin to appear deeper sooner. Most patients with stage 3 wrinkles will need 35 to 45 units of botox every three to four months. 

There is no real upper limit for starting or receiving botox injections. The injections still successfully reduce the movement of muscles that cause dynamic lines like forehead lines, crow's feet, bunny lines, lip lines, "elevenses", nasal horizontal procerus lines, etc. However, some of the lines by the late 30s and early 40s become more "permanent", in that they are there even when the muscles are not moving. In this case, treatment of the epidermal and dermal changes can be improved with the use of chemical peels and one of a number of different lasers, including the CO2 laser. 

Age in the 50s and above: 
is 50 too late for Botox?

"Stage 4" wrinkles are the deeply formed lines where even after botox, the groove is visible.  These wrinkles do respond to botox but the patient will also need some fillers to fill out the grooves. We often do this in the frown muscles, where the effect of the botox will then last much longer. Furthermore, the filler in the forehead lines may last as long as two years or more! Lasers are also used to improve the texture of the skin over the wrinkles and other modalities like chemical peels, microneedling and radiofrequency​ treatments may also be indicated. 

If your lines are deep and associated with structural changes like brow ptosis, deep forehead lines, cheek ptosis and deep smile lines, surgical intervention together with the use of fat grafts and lasers may be the best option. This is where you need to be injected by a surgeon who is used to doing facelifts, endoscopic browlifts, blepharoplasties, necklifts, etc and who can guide you appropriately.
Botox injections to frown muscles, forehead lines and brows by Dr. BCK Patel MD, FRCS of Salt Lake City and St. George
Botox injections in the early 50's works nicely to elevate brows giving an elegant face, soften the forehead lines. Note the improvement in the texture of the forehead with the use of our "microbotox" injections to improve skin texture

Disadvantages of having botox too early

There is a tendency for the cosmetic industry to "sell, sell, sell" and promote botox too early. You should ensure that you get the improvement that can be seen photographically as well as dynamically and only you can be the best judge of that. 

There is some concern that patient's muscles may get "used" to the injections. However, there is little evidence of this as the body sprouts new nerve endings over time and the movement of the muscle returns. On the other hand, we have certainly seen the deeper wrinkles get less deep over time as botox injections are repeated. 

Sometimes it may be necessary to switch from botox to dysport or one of the other types of botulinum toxin to continue to get the best results. 

Finally, cost should always be considered: you can still get a nice result and long-term benefit if you have the injections every four to five months instead of every three months. 

Related


Picture

Endoscopic browlifts

With certain changes affecting the forehead, frown muscles, brow positions and eyelids, a modern endoscopic brow lift with improvement of the forehead lines, brow positions and upper eyelids may need to be considered. 
Read More
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    August 2022
    February 2018

Conditions

Aging Of The Face
Aging of Lower Eyelids
Aging of the Forehead and Brows
Aging of Eyelashes
Aging of the Cheeks
Aging of the Neck
Aging of the Lips
Aging of the Mouth
Aging of the Chin
Aging of Eyelashes
Aging of the Hands
Aging Of Skin Colour
Aging Of Hair
​Aging of the Jowls
Aging of Men
Aging of the Skin
Aging of Veins and Vessels
Scars

Cosmetic

Facelift
Browlifts
Lower Blepharoplasty/Hammock Lift
Upper Blepharoplasty
Midface Lift/Hammock Lift
Necklift
Lips
Mouth
Neck Liposuction
Fat Transfer
Skin Resurfacing
Cheeks
J-PLASMA SKIN RESURFACING
J-PLAZTY FACE
Removal of Moles, Lesions, Tags, Cysts and Blemishes
Facial Implants
Otoplasty, Ear Pinning, or Bat-Ear Repair
​Complications?

Reconstruction

​Entropion
Acquired Ptosis
Ectropion
Congenital Ptosis
Blepharospasm
Anophthalmos and Microphthalmos
Thyroid Eye Disease
Enucleation and Evisceration
Nasolacrimal Duct Obstruction
Symblepharon
Congenital Anomalies - Lid Disorders
Acne Rosacea
Trauma
Infections
Skin Tumors
Orbital Tumors

Non- Invasive

 Photorejuvenation
Aerolase Laser
Botox
Laser Hair Removal
Kybella
Juvederm
Chemical Peels
Fractional Carbon Dioxide CO2 Laser
XEOMIN ®
Voluma
Latisse Eyelash Treatment
Leg Veins and Spider Vein Treatment
Sculptra
Neck and Chest Cosmetic Concerns
Restylane
Dysport
Accent Radiofrequency
Microdermabrasion and Light Chemical Peels
Melasma
Fractional Resurfacing Lasers: Erbium lasers
Color and Texture Issues – Brown Spots on Face, Redness
Laser Tattoo Removal
Radiesse
Acne
​Permanent Cosmetic Makeup

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Patel Plastic Surgery  .  Copyright 2022 . All Rights Reserved
  • Home
  • Locations
    • Plastic Surgery Salt Lake City
    • Plastic Surgery St. George
  • Conditions
    • Aging Of The Face
    • Aging of Lower Eyelids
    • Aging of the Forehead and Brows
    • Aging of Upper Eyelids
    • Aging of the Cheeks
    • Aging of the Neck
    • Aging of the Lips
    • Aging of the Mouth
    • Aging of the Chin
    • Aging of Eyelashes
    • Aging of the Hands
    • Aging Of Skin Colour
    • Aging Of Hair
    • Aging of the Jowls
    • Aging of Men
    • Aging of the Skin
    • Aging of Veins and Vessels
    • Scars
  • Cosmetic
    • Facelift
    • Browlifts
    • Lower Blepharoplasty
    • Upper Blepharoplasty
    • Midface Lift/Hammock Lift
    • Necklift
    • Cosmetic Surgery for Men
    • Lip Lines
    • Lips
    • Mouth
    • Neck Liposuction
    • Fat Transfer
    • Skin Resurfacing
    • Cheeks
    • J-PLASMA SKIN RESURFACING
    • J-PLAZTY FACE
    • Removal of Moles, Lesions, Tags, Cysts and Blemishes
    • Facial Implants
    • Otoplasty, Ear Pinning, or Bat-Ear Repair
    • Complications?
  • Reconstruction
    • Acquired Ptosis and Dermatochalasis
    • Congenital Ptosis
    • Ptosis in Myasthenia Gravis
    • Blepharophimosis Syndrome
    • Entropion
    • Ectropion
    • Thyroid Eye Disease
    • Nasolacrimal Duct Obstruction
    • Skin Tumors
    • Orbital Tumors
    • Blepharospasm
    • Pterygium
    • Anophthalmos and Microphthalmos
    • Enucleation and Evisceration
    • Exenteration
    • Symblepharon
    • Congenital Anomalies - Lid Disorders
    • Acne Rosacea
    • Trauma
    • Infections
  • Non Invasive
    • Photorejuvenation
    • Aerolase Laser
    • Botox
    • Radiesse
    • Restylane
    • Juvederm
    • Fractional Carbon Dioxide CO2 Laser
    • Fractional Resurfacing Lasers: Erbium lasers
    • Laser Hair Removal
    • Kybella
    • Chemical Peels
    • XEOMIN ®
    • Voluma
    • LATISSE EYELASH TREATMENT
    • Leg Veins and Spider Vein Treatment
    • Sculptra
    • Neck and Chest Cosmetic Concerns
    • Dysport
    • Accent Radiofrequency
    • Microdermabrasion and Light Chemical Peels
    • Melasma
    • Laser Tattoo Removal
    • Color and Texture Issues – Brown Spots on Face, Redness
    • Scars and Acne
    • Permanent Cosmetic Makeup
  • Resources
    • Patient Forms & Downloads
    • Out Of State and Overseas Patients
    • Reviews
    • VIDEOS Patel Plastic Surgery
  • About
  • Blog
  • Contact