BOTOX® (botulinum toxin, Type A)
As there is a trend to have results with the least invasive method, Botox has become one of the most popular procedures. Botox A® is a derivative of Botulinum toxin and works by temporarily paralyzing the muscle which in turn helps decrease facial wrinkles. It has been used for years for injection into the vocal cords for vocal cord spasms and other indications such as blepharospasm (intermittent uncontrollable spasms of the muscles surrounding the eye) since the early 1990’s.
It was only recently that it became FDA approved for cosmetic use specifically in the area between the eyebrows although it has been used for cosmetic purposes for several years. Dr. Liu has been injecting Botox® for both cosmetic and non-cosmetic purposes since the late 1990’s.
Injections typically do not require any anesthesia. Sometimes ice may be placed for several minutes or if needed a topical numbing ointment. The area may be red for several hours but there is essentially no “downtime.” The entire procedure is relatively quick and can be performed in a 15 minute office visit. The maximal effect occurs after about 2 days. After the procedure, one should not rub the area for the next day to prevent possibly diluting the material into the surrounding tissues. Botox® typically lasts 4 months but can be highly patient dependent. There are no specific age limits but optimal results typically occur between the ages of 18 to 65. The procedure is equally effective in women and men.
The most common area to inject is the mid lower forehead referred to as the glabellar lines. These are the vertical “frown” lines that occur when you try to bring your eyebrows towards the middle. Other areas of common injections include the horizontal forehead wrinkles, the lines on the sides of the eyes known as crows feet, and muscle bands under the chin in the upper middle neck. Botox® will help but usually will NOT remove all wrinkles that are present with the face at rest although it may somewhat smooth them out since repetitive muscle movements are halted.
LATISSE (bimatoprost ophthalmic solution) 0.03%
Latisse is an FDA approved liquid solution to grow longer, fuller, and darker eyelashes. It is a once a day treatment applied topically to the base of the upper eyelashes where they meet the upper eyelid skin. Results may take at least 4 weeks and full growth is achieved by 16 weeks.
In any one given area of the body, the hair follicles are in different stages of growth. Latisse works by increasing the length of the growth phase of the hair follicles and also increasing the number of hair follicles that are in the growth phase as opposed to a resting phase.
Patients who are under treatment for eye pressure problems such as glaucoma or who are already using eye drops to treat these problems should always inform the physician. Eyelid skin darkening can occur but is reversible. Latisse is not for lower eyelids. Brownish discoloration of the eyes has been reported with similar medications to Latisse but when used as eye drops and not specifically with topical application as with Latisse.