Botox

When you arrive for your procedure, a potent topical anesthetic cream is placed on your face at the location where the botulinum toxin will be injected.  A tiny needle is then used to inject the toxin.  Dr. Capuano performs the injections himself, and he is remarkably experienced in the art of pinpointing the specific muscles within your face which need to be weakened to reduce wrinkles, while preserving your natural facial expressions.

Schedule a consult with our Board Certified Plastic Surgeon, Dr. Aaron Capuano.  He will perform a comprehensive assessment and make recommendations to best meet your needs.

Contact the office of the Northern Center for Plastic Surgery at (201)820-5280 to schedule an appointment.

You may schedule an appointment with Board Certified Plastic Surgeon Dr. Aaron  Capuano, who will address your interests and goals.

Thank you for the question.  Botulinum toxins can be injected into the masseter muscles to improve the contour of your jawline.  The optimum dose must be tailored to each patient based on the size of their masseter, and extent of contouring they desire.  Injections can be effective with doses as low as 15 units per side (typical starting range 15-25 units), especially if care is taken to inject into all portions of the muscle that contribute to the appearance of widening of the lower face.  Although the toxin will cause weakening of the muscle in 7-10 days, in my experience, it usually takes 6 weeks to three months to see a significant change in muscle mass.  For this reason, I recommend waiting at least 6 weeks before incrementally increasing the dose.  Effects can be quite dramatic, but the more toxin that is injected, the more likely patients are to have complications, like asymmetry of smile.  An in person consultation with Dr. Capuano who is Board Certified by the American Board of Plastic Surgery, and is experienced with selective masseter injection for jawline contouring is an essential first step to obtaining the results you desire.

The short answer is, no.  No you cannot get Botox when you are pregnant.  Though there have been no official studies to prove the effects Botox or its alternatives may have on an unborn fetus, there is simply no reason to find out.  It is also not recommended to have Botox injected while you are nursing.  The time that you are pregnant and nursing are not a long enough time frame to have any significant impact on permanent wrinkling.  In other words, Botox can wait, your wrinkles will still effectively be treated after this time.  We recommend drinking plenty of water during pregnancy, taking your prenatal vitamins and creating healthy shakes and a healthy lifestyle. If possible, taking plenty of time for yourself for rest and relaxation.  Congratulations and enjoy your pregnancy!

Baby botox and microtox are names that have been given to a certain manner of injection that a patient prefers.  When a patient asks for either Baby botox or Microtox it means that they are not interested in being expressionless.  They only want certain areas of their face to receive botox, concentrated in areas that are deemed as "problem" areas.  This is a term that is used for people who don't want to have people question their use of a toxin.  It is a great first step if someone is concerned with being question yet interested in addressing "key" areas.  

When applied to the appropriate areas as a cosmetic treatment Botox and its counterpart toxins are not a permanent, the effects of a single treatment last for roughly three months.  Though this can vary from one patient to the next as each of our metabolisms break products and toxins down at a slightly different rate.  We have seen people become intolerant of Botox and have a greater need as a result of overuse of the toxin.  

Hello and thank you for the question. I am sorry to hear that you are unhappy with your injection results.  Optimum patterns of injection are formulated by your board-certified plastic surgeon after evaluation of the dynamic movements and relationships of the muscles of your forhead and periocular region. To answer your question regarding how long the toxin lasts, it is important to understand that Botox is a biological product so it’s efficacy can vary slightly from dose to dose and every person’s ability to remove it and restore their muscle function is a little different as well.  On average Botox lasts about three months but we know in some people it wears off in much less time while in others, it can last for much longer. I believe there are two separate reasons for the varying duration of toxin effect. Reason 1: Once the dose is reached that provides weakening of a muscle the average person will metabolize that toxin to an amount below the threshold required to paralyze that muscle in an average of three months. If less than that amount is injected (muscles just slightly weakened) it may take that person less  time to metabolize the toxin molecules below the threshold level required to paralyze that muscle. If more than that amount is injected (beyond the amount required to totally paralyze the muscle) it may take a person longer to metabolize the additional toxin below the threshold level. Reason 2: Peoples ability to metabolize the toxin can also very depending on whether they have developed antibodies to the toxin itself or to the proteins that it is bound to which will shorten it’s duration of action.  It has also been observed that if a person exercises vigorously, the duration of action can be shorter. There are eye drops tht can help if you have a droopy lid, you are most welcome to come in for a visit so that we can see how we can best help you.  Good luck with your wedding. 

Hello and thank you for the question.   I’m sorry to hear that you’re having these symptoms following your injection.  Botulinum toxin can diffuse away from the location where it was injected and cause symptoms of upper eyelid droop. If your lashes or your upper lid margin are encroaching on your pupil, you can have symptoms of blurry vision. If however, you still have blurry vision after lifting your eyelid margin is up away from your pupil you may have blurry vision from the toxin itself diffusing into the eye, which is rare.  I would return to the physician who injected you for a thorough evaluation and possible referral to an ophthalmologist.  Lopidine eyedrops can raise the eyelid margin by stimulating the Muller’s muscle, which assists the voluntary elevator of the eyelids.  I hope this helps and is resolved quickly for you.

Hello and thank you for your question. After a thorough evaluation of your photographs, the degree of orbital dystopia (unevenness of eyes) that you have is very minor (only a few millimeters).  Many people have some degree of orbital dystopia. I do see a larger discrepancy In the height of your eyebrows.   You’re right eyebrow is lower than your left and consequently the fold of your upper eyelid skin is also lower on the right.  A right sided endoscopic brow lift would likely improve this discrepancy and improve the apparent symmetry of your eyes.  Another option, which is much less invasive may be to try a brow lift on the right using Botox. Lifting the right brow by just a couple of millimeters by injecting toxin into the orbital orbicularis muscle or dropping the left brow by injecting toxin into the frontalis muscle may also help to improve symmetry, at least temporarily.   Dr. Capuano is a double board certified plastic surgeon and has successfully injected thousands of patients with botox and fillers.  Book your consultation with confidence, call 201-820-5280 to discuss your options with Dr. Capuano.

Yes!  Recent studies suggest that Botox can be used effectively as a means of decreasing oil productivity in the skin, therefore reducing the amount of breakouts one may incur. Yet another wonderful benefit of having Botox administered.

Hi! This is a great question. Botox is not used to improve one's skin texture.  We recommend Botox for numerous reasons including wrinkle reduction and to reduce pronounced muscles and to provide a lift here and there. 

We recommend Botox with a good skin care regimen including a Retinol that is designed to improve skin texture and wrinkles.  If you have more pronounced skin texture issues we have multiple resources that will greatly improve your skin texture, including microneedling, laser procedures and therapeutic retinol peels. 

Thank you for the question. Botox and Dysport can be used to decrease the muscle function of your procerus depressors and corrugators which can in some individuals, accentuate or deepen this line when they frown.  The line will soften if it is dynamic (goes away when you gently stretch the skin above and below), but will not if it is static (remains when the skin is gently stretched).  If the line is static, additional treatments may be necessary to improve it.  These may include filler, placed directly within the skin where the line is and serial micro-needling or laser treatments.  Also, a profile photo would be helpful to see how deep the radix area of your nose is because the relationship of your glabellar and radix projection can play a role in the development and recurrences of these horizontal lines.  An in person evaluation by Dr. Capuano who is a double board certified plastic surgeon and experienced in treating this region of the face, is an important first step.

Botox can last from 3 - 4 months. We find that Botox breaks down quicker in those who have a high metabolism and who work out often. Please make sure you are being injected by a board certified plastic surgeon or board certified dermatologist as in rare instances one can have an adverse effect to Botox and should have proper support and care given by these professionals.  Also, keep in mind that having Botox regularly is a wonderful treatment but it is good to take a break from Botox once in a while if you seem to have developed an immunity to it or if your features have seemed to thin out.  Botox weakens or paralyzes the muscles that are injected for brief intervals, if you continuously have Botox injected in these areas the muscles can atrophy, which means it gets weak and smaller.  It is important to be honest with your injector about the frequency of your injections so that he or she can properly administer Botox to you. Call the Northern Center for Plastic Surgery at book your consultation with Dr. Capuano at 201-820-5280.

The units of Botox used per procedure is contingent upon the individual needs as suggested by Dr. Capuano.  There is no definitive measure that is used globally, there is an average units used for womens faces (32-36 units which usually includes the forehead, glabella area, eye lift and crow's feet around eyes and for mens it can be 40-50 units or more depeneding upon facial muscle girth).

Great question.  Yes, when botox is injected properly it will raise the eyebrows in most patients.