Aesthetic Facial Plastic Surgery Blog- Seattle/Bellevue facelift/rhinoplasty surgeon- Dr. Philip Young » Botox, Dysport, Botulinum

Botox for the glabella, forehead and crows feet.

dryoung — Thu, 09 Jun 2011 01:06:00 +0000

One thing occurs is when you treat the glabella and crows feet, you are able to raise the eyebrows. Also with the way that you put the botox in the forehead you can raise your eyebrows laterally as well. Botox for the glabella help prevent the vertical wrinkles in between the eyes from forming. Within the forehead, botox prevents the horizontal lines from happening. Botox in the crows feet, improves these lines here. Typically, the glabella takes 12-20 units, the forehead 8-20 units, and the crow’s feet 12- 20 or more units. I prefer doing 20 units in the glabella, forehead and crows feet each for a total of 60 units. I have many live videos and photos for you to see and a lot of information for you on our website if you would like to learn more.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Botox and Droopy Eyelid. What are some options on treatment?

dryoung — Thu, 09 Jun 2011 00:55:14 +0000

Botox and eyelid droopiness can be treated with drops to the eye. I typically prescribe aproclonidine or bromonidine. These drops act like epinephrine and stimulate the muscle that also elevates the eyelid called Mueller’s muscle. This muscle is deeper than the levator muscle. You will have to use this until the 3-4 months it takes your muscle to come back and act normally. I have found that the levator recovers faster than most muscles.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Is Dysport available in the United States?

dryoung — Fri, 12 Nov 2010 22:48:35 +0000

Dysport has been available since April of 2009. But has been used in other countries for much longer and has a proven safety record. I have been using this in my office since April of 2009 as well. General differences are that Dysport acts quicker getting max affects in around 4-5 days, while botox takes about a 1 1/2 -2 weeks. They generally last about the same time around 3-4 months. Although Dysport has been approved by the FDA to last 4 months and Botox 3 months, I feel they are about the same. Dysport seems to spread a little more and give more of a generally larger effect for each shot given than Botox.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Botox is good for dynamic smile lines, filler and resurfacing can help static lines

dryoung — Fri, 17 Sep 2010 17:11:53 +0000

Restylane and Juvederm (or Perlane) are both great options for filling and improving static lines and dynamic to a degree. Ipl will, in my opinion, have little effect on the wrinkles. Glycolic peels can help to a minimal degree on fine lines and improving your general skin appearance. Resurfacing is another way to improve your wrinkles on your face by approaching from the outer skin side. Whereas fillers approach the wrinkles from inside.

Botox is good for dynamic smile and facial lines, in contrast filler and resurfacing can help static lines. Botox is a neuromuscular agent that blocks the action of muscles by acting on the nerves that innervate muscles. The way you can tell if botox will work for you is to identify whether your smile lines or wrinkles are accentuated or increased by the act of smiling or the muscles that move your face when you smile. Botox is good for the wrinkles that increase in appearance with muscle movement. If it is the wrinkles that are present when you are not moving a part of the face, botox will have less of an effect. But botox will have an effect on those wrinkles getting deeper when you move your face. But when your face is at rest the wrinkles that are there will not noticeably improve with botox. One thing to realize is that if you use botox for a long time, your static wrinkles can improve but this takes a while. Your cells in your skin have to remodel your skin where the static wrinkles are in order to improve those wrinkles which could take months and years. Part of what makes wrinkles deeper are the the loss of volume within your face. This places the skin closer to your muscles and thus when you move your muscles to smile or talk, there actions begin to have more effect on your skin and the effects are wrinkles with the movement. The volume loss can help this situation by increasing the distance of your skin to your facial muscles. Fillers are a temporary solution (anywhere from 6 months to a year) and Fat injections are more of a long term solution. The YoungVolumizer is a great way to volumize your face in a natural way with no incisions, and no general anesthesia.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Dr Young blogs about Botox and the things that doctors usually recommend after botox (Bellevue, WA)

dryoung — Fri, 30 Jul 2010 21:43:31 +0000

Before botox, as I mentioned in a previous blog, you should always stay away from blood thinners 2 weeks before and after the procedure if you wanted to avoid bruising as much as possible. We have a list of things / medications to avoid before and after botox that you can check out here. But other than that a recent number of consensus panel recommendations showed the preferences of plastic surgeons, dermatologists, and facial plastic surgeons:

100% agreed that you should not massage the area after botox, which I tell my patients as well.

78% said to contract your muscles to help activate the botox more. I tell my patients to contract their muscles as much as possible to help make the botox / dysport work. Doing this for 2 hours will help the uptake of the botox.

Only 30% said to limit your activity after botox. I suggest to all my patients to limit activity for the first 24 hours to avoid diffusion.

Only 29% said to avoid bending over after botox. I tell my patients to avoid bending to prevent diffusion.

Only 20% mention to avoid heat after botox. I dont have a solid opinion on this as there is not enough information to say one way or another.

Only 13% of physicians mention avoiding flying after botox. I don’t tell my patients to avoid flying.

Again, the maximal effect of botox is at 2 weeks and for dysport it is a little less than a week.

I hope that you enjoyed this and thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Botox or a Browlift would be an excellent option to help you with your arch in your eyebrows.

dryoung — Thu, 15 Jul 2010 01:20:40 +0000

Botox would be an excellent option to help you with your arch in your eyebrows. Whereever the arch is more exaggerated you can place a small amount of botox like 1-5 units to to lower the arch. It could require more than one shot over each arch depending on how the arch is shaped. I would start conservative and find the right amount for you. For a more permanent solution, you can do a brow lift in a differential way to shape the eyebrows. It could entail elevating the lower portion or lowering the arched portion.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Botox or Dysport both work equally well in decreasing the muscle mass of the jaw muscle called the masseter.

dryoung — Wed, 30 Jun 2010 21:03:33 +0000

Botox or Dysport both work equally well in decreasing the muscle mass of the jaw muscle called the masseter. This procedure is very safe. I have never had any serious issues with this use. The amount of botox or dysport to use is dependent on the person because everybody has different responses and different volume of muscle. I usually tell this to people and then explain that I recommend starting at a lower dose like 15-25 units of botox for each side. Dysport requires 2.5 to 3.0 times the units of botox for equivalent dosing. Then I tell them that they can see if this adequate muscle relaxation in 2 weeks for botox and 1 week for dysport. If there is still significant muscle movement of the masseter you can elect to do more. One important point is that the muscle mass reduction lags behind the muscle movement. It takes from 3-5 months to see the maximum volume changes in the masseter muscle and then it slowly increases the mass to normal by one year. So, in short, there are some doctors that are seeing results from botox to the jaws for one year. In my experience, the mass usually comes back earlier than this but the results are more longer lasting than what can be expected with other facial muscles.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Browlifting with Brow Bone Reduction, Hairline Lowering, and Removal of Frown Muscles can Markedly Improve Your Appearance

dryoung — Thu, 20 May 2010 21:23:19 +0000

There are many reasons for browlifting (Dr Young specializes in Browlifts and Facial Plastic Surgery) and working with the upper third of the face. One of the main reasons is to lift the brows when they are drooping. In this case, raising the eyebrows can open up the eyelids and reduce the upper lid skin laxity. This can be done through open approaches, through the eyelid and through minimally invasive means through small incisions behind the hairline. What can also be done is removing the muscles between the eyes that causes the frowning. This can reduce your needs for botox markedly to not having to need botox at all. Some people also have significant brow prominence that can be reduced by burring the bone down. this can be done through an eyelid incision or through an open approach which requires an incision from ear to ear. Although the incision from ear to ear sounds daunting, the incision actually heals really well when you close it accurately. Also through an open approach you are more likely to get longer lasting results. Reducing the brow bone can reduce the stern and masculine look that some women have. Hairline lowering is something that can also be done for people with high hairlines. This is done through an incision right at the hairline. This combination of procedures, browlift, brow bone reduction, hairline lowering, and brow bone muscle reduction is much more commonly done for certain patients that want to have more of a feminine appearance. This typically is more common among my transgender patient. Below is a picture of a just such a patient. Although we have done this for many women. Most of the women we have are more conservative in showing their pictures on our website. Notice in the pictures that his brow bone is less prominent and his eyebrows are elevated to his desired height that we discussed prior to the procedure. Other procedures that he has were a chin reduction, rhinoplasty, and permalip implants.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Before

AFTER

Before

After

Botox treatment (or Dysport) for Facial Palsy and Bell’s Palsy for hyperkinesis and synkinesis

dryoung — Sun, 09 May 2010 01:06:26 +0000

There are many people out there that have suffered from Bell’s Palsy. This is a condition that causes the facial nerve to become weak so that you have a problem moving one side of the face. In fact, it can be so bad that for a time, initially, the whole face will not move for several months and it can take months for it to come back. After regeneration, you can have weakness on that side and also something called synkinesis where the muscles don’t act individually. When you damage your facial nerve, when the nerve starts to grow back, it doesn’t always go to the correct muscles. What happens is that the brain and the area of the brain that controls a certain area (say the left eyebrow and eye muscles of movement) will tell those muscles to contract and the nerve will travel from the brain to the muscles. The problem occurs when the regenerating nerve travels to the wrong muscle when it grows back. So some of the nerve fibers will travel to the mouth instead of the eye and eyebrow. So when you want to move the eye and eyebrow, you also get some movement of the mouth. This is called synkinesis. Also when the weak side has a heard time moving as strong as the unaffected side, it will look different when a person smiles. Botox can improve these situations to a degree. Below I show where I inject botox and how many units in each area to decrease movement on the stronger side to get more symmetry. You can change the amounts based on individual situations. For the twitching you can place it on the weaker synkinetic side just enough to decrease that movement as well. But this is much harder.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Can you inject botox and filler at the same time in the same area?

dryoung — Thu, 06 May 2010 16:41:45 +0000

Injecting botox first and then to follow it immediately with a filler (Dr Young in Bellevue Washington) can risk problems with moving the botox around. There is not sufficient scientific evidence documenting the safety of both at the same time. It is not widely accepted. If the botox and restylane are used in different places then it is more okay and accepted in my opinion. I like assessing the results of the botox first and determining if the results of the botox is achieving the results that you or the client likes. If more results are desired then you can consider the filler 2 weeks later. This also allows the filler to stay longer because the muscles are not causing the dispersement of the filler and also the metabolism of the filler to be increased.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington