Blog — Notes of a Plastic Surgeon

Welcome to my blog. I am a plastic surgeon in Seattle and have been in private practice since 1991. I've seen more than a few interesting faces and cases through my years spent in the exam room, the operating room and the emergency room. And I have an opinion on just about everything relating to plastic surgery (and a lot of unrelated stuff). If you like my blog, let me know. Thanks for reading! Lisa

Category: Botox

Botox and Facial Filler for the Grinch Who Stole Christmas

December 16th, 2016 — 12:28pm

Seattle Plastic Surgeon knows how to make the Grinch look a little less grinchy.

Botox Restylane Juvederm Seattle

It’s those glabellar frown lines and nasolabial folds that make this Grinch look soooo grinchy.

Take a look at the Grinch.  What is it that makes him look so old and cranky?  It’s his glabellar from lines between his eyes that make him look like he’s having a pretty bad day and it’s his nasolabial folds (those creases that go from the sides of the nose to the corners of the mouth) that make him look a billion years old. All he needs to do to work himself up into a really bad mood is to look in the mirror every morning.  No wonder he has such a bad attitude.

If the Grinch were to come into my office, here is what I would recommend:

His forehead creases would be softened and smoothed out with Botox.  He looks like he needs a pretty large dose, maybe 60 units.  The injection would sting but would be quick and he would see a remarkable improvement within 3 days or so.  Also, he would feel so much more relaxed.  If he wanted to scowl at his poor little dog, he would be unable to!  Smile, yes but scowl, no.  This amount of Botox would set him back $900 and would last at least 3 months.  If he kept coming back for treatment, his dose would likely drop considerably.

His nasolabial folds could be filled in with one of the hyaluronic facial fillers that I inject almost every day of the week.  They are terrific for treating the area around the mouth that is such a problem in some people and is hard to treat with other methods.  Even a full face lift doesn’t help this area very much.  I would use 2 or 3 syringes to get as full of correction as possible.  It’s been my experience that patients who opt for just partial correction (to keep the cost down) are not nearly as satisfied as those who just go for it.  Three syringes of a filler such as Juvederm would set him back about $1600.  Juvederm lasts at least six months and I have many patients who have had nice lasting improvement for up to two years.

Do what about the redemption of his rotten soul?  I’ll leave that up to the transcendent love and forgiveness of Whoville. But he’s got to save his face for me.

Thanks for reading!  Dr. Lisa Lynn Sowder

Botox, Facial Fillers, Nasolabial Folds, Non-invasive

Botox for Excess Sweating

May 23rd, 2014 — 10:56am

Seattle Plastic Surgeon and her male patients go through a lot of Botox this time of year.

This time of year Seattle men put away the flannel and fleece and Gortex and some of them make appointments for Botox injections to their armpits.   Excess underarm sweating is fairly easy to conceal in heavy winter clothing but not so easy to conceal once the temperature gets above 65 or so.

Botox injection for excess underarm sweating is one of the most common procedures I do on men.   At first, all of my underarm Botox patients were women but now the word is out to men.  And it’s not just the metrosexuals and hipsters who come in.  It’s guys from every walk of life.

Botox is a miracle treatment for excess sweating but it does have its downsides.  It’s really expensive for me to purchase and I have to pass that expense along to my patients.  Underarm Botox injection is done with 100 units of Botox and costs, gasp, $1500.  And it is an injection which means needles (although they are teeny, tiny needles).  The injection is moderately uncomfortable.  And the real bummer is that Botox does not last forever.  It usually lasts at least 6 months and I have some patients who get relief for a whole year.

For permanent relief, I offer axillary sweat gland excision which involves an outpatient operation in which the sweat glands are scraped away from under the axillary skin using a couple of small incisions and a special curette.  See this page on my website for more information.

Soooo, if you are tired of being Sweaty Eddie, come on in for a consultation and we can discuss your options.

Thanks for reading and Keep Cool and Carry On.  Dr. Lisa Lynn Sowder

Botox, For Men Only

The FDA finally catches up with the use of Botox for crows feet.

September 12th, 2013 — 2:29pm

The FDA’s approval of Botox for the treatment of crows feet makes Seattle Plastic Surgeon smile.

Botox is the best treatment for crows feet.

Botox is the best treatment for crows feet.

I’ve been using Botox for the treatment of crows feet (both my patients’ and my own!) for well over ten years.  But I had been using Botox off lable which means that the FDA had not yet approved Botox for this particular area.

Well, finally, the FDA has issued its approval stating that Botox is safe and effective for the temporay treatment of crows feet so now I can begin crowing about what an excellent treatment Botox is.  In fact, Botox is by far the fastest, safest and most effective way to tame these creases that pop up with smiling.

Thanks for reading and keep smiling.  Dr. Lisa Lynn Sowder

Botox, Government and Politics, Non-invasive

I’ve given up Botox for now. I need my scowl!

April 1st, 2013 — 4:59pm

Seattle Plastic Surgeon admits that scowling has it’s place, especially when teaching teenage sons to drive.

Today I had a patient ask me about my personal use of Botox.  Maybe it was a hint?  My scowl lines are alive and well right in the middle of my forehead and I have no plans to eradicate them anytime soon.

Mama lion scowling.

Mama don’t like it when you forget to signal.

I have found that my scowl has been quite useful the past 6 months.  You see, my twin sons are learning to drive and my scowl saves me a lot of verbal nagging.

My sons have excellent peripheral vision and their eyes are constantly darting from the rear view mirror to the side mirrors to the road and to the look on my face as they grind the gears, slam on the brakes and otherwise torture their mother and her car.   I’m not sure if they would be quite so responsive if their mother had that nice serene look that I get when I’m nice and Botoxed up.

So if you are thinking about Botox, make sure that your scowl really is something you can do without.  If you have teenagers, you may want to wait until they are out of the house!

Thanks for reading.  Dr. Lisa Lynn Sowder

Botox, Uncategorized

Botox for Bunny Lines

September 21st, 2012 — 12:32pm

 Seattle Plastic Surgeon discusses “Bunny Lines”

I saw a patient today who wanted treatment for those funny little horizontal wrinkles on the nose that we plastic surgeons refer to as bunny lines.  She was surprised that I recommended Botox instead of a filler.

Botox works very well for bunny lines because these creases are caused by the underlying procerus muscle.  This muscle allows for that expression that people have when they smell something really, really bad.  Botox weakens the muscle and the wrinkles smooth out over several weeks after injection. 

Filler, such as Juvederm or Restylane could be used to fill in these creases but filler woud not treat the underlying cause and could make the bridge of the nose look a little bulky. 

Botox and fillers are both “injectables” but they treat wrinkles in completely different ways. 

Thanks for reading.  Dr. Lisa Lynn Sowder

Botox, Now That's a Little Weird

Happy Birthday to BOTOX! It’s been 10 years since the FDA approved Botox for cosmetic use.

April 23rd, 2012 — 5:20pm

Seattle Plastic Surgeon shares a very quick history of Botox. 

My very first Botox patient. I injected her scowl lines and was met with great success.

I remember, years ago,  hearing about doctors injecting each other with Botox to reduce their scowl lines and thinking:  how crazy is that?????

But the anecdotal reports kept coming in and in 1992 a Canadian ophthalmologist, Dr. Jean Carruthers and her husband, Alastair, published their finding that Botox is effective in treating moderate of severe glabellar frown lines (those nasty vertical scowl creases right between the eyes).  Dr. Carruthers got the idea to try this because Botox had been used for years by ophthalmologists to treat involuntary squinting.    She and other astute opthalmologists noticed that the areas injected with Botox would loose their wrinkles. 

Botox quickly became one of the most widely researched pharaceuticals in the world with more than 2500 articles in scientific and medical  journals written about it.   Ten years after the paper by Drs. Carruthers and Carruthers, the FDA approved Botox for cosmetic use and well, the rest is history.  Botox is now approved for 25 unique indications in 85 countries.  In 2011, according to the American Society fo Plastic Surgeons’ procedural statistics, 5.6 million Americans opted for Botox treatment.  Some days when Botox is flying off my freezer shelf, I feel like I’m the one doing all those injections!

It is the scientific serendipity of the Botox story that I find so interesting.  It makes me wonder what other  discovery is just an astute observation away from being the NEXT BIG THING.

Thanks for reading!  Dr. Lisa Lynn Sowder

Botox, Now That's Cool

Botox flying off the shelf

July 8th, 2011 — 6:44pm

Don’t let that excess sweating ruin your nice summer frock.

Seattle Plastic Surgeon just loves Botox for excessive sweating.

It is finally, maybe, hopefully summer in Seattle and my plastic surgery office is rockin’ with the demand for underarm Botox injections.  Excess sweating (hyperhidrosis) is a fairly common condition and Botox injections are the treatment of choice for cases that are not controlled with prescription strength antiperspirant.

During the cold months, it’s easy to hide those sweaty pits under sweaters and jackets but come summer, it’s not so easy.

Botox treatment is a quick outpatient procedure with no down time.  The injections smart but within a few minutes the sting is gone and within a few days the excess sweat production is gone.  Bring on those lovely  silk and linen summer blouses, ladies.  And for you gentlemen, get those colorful polo shirts out of your closet.  Forget about the navy blue ones.  You won’t “need” them.

The downside of Botox treatment (the only downside in my opinion) is the cost (Botox is really expensive for the doctor and thus the patient) and the need for repeat treatments (about every six to nine months).

Some patients eventually elect to have a procedure where I remove the sweat glands through a couple of small incisions in the axilla but most of my hyperhidrosis patients include their Botox injections when planning their budget.  What Botox cost will save you bundle in clothing and dry cleaning costs and a real bundle in embarrassment.

Let’s do the math.  Underarm Botox:  $1500, lasts 6 months, costs about $8/day.  Dry arm pits:  Priceless.

Thanks for reading!  Dr. Lisa Lynn Sowder

Botox, Hyperhidrosis, Non-invasive, Now That's Cool, Plastic Surgery

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