Seattle Plastic Surgeon implores patients not to fall for “Botox on Sale”.
Occasionally I have patients come in for Botox or fillers who have flitted around from doctor to doctor looking for the “best price”. I hear statements like “the last Botox didn’t work” , “the Restylane didn’t last”, “I’m not sure what she used but I didn’t like it”, and this is my favorite, “it was on sale but it didn’t last”.
This flitting around in search of a “deal” makes it very hard for a hardworking plastic surgeon (moi, for example) to figure out what, where and how much injectable to inject. In my practice, we keep very accurate records of all of the above so I can judge what works best for any given patient. And believe me, every patient is different.
Sometimes I think just because it is “cosmetic”, patients don’t take these treatments seriously enough. I cannot imagine anyone shopping around for the “best” price on, say, steroid injections into a bum shoulder or the “best” price for an hour of psychotherapy!
Usually continuity of care provides the best value of all, even if the prices are not bargain basement. So for injectables, find a good doctor and stick (nice pun, huh?) with him/her.
Thanks for reading and follow me on Instagram @sowdermd and @breastimplantsanity. Dr. Lisa Lynn Sowder
Seattle Plastic Surgeon knows how to make the Grinch look a little less grinchy.
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.
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.
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.
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.
This flitting around in search of a “deal” makes it very hard for a hardworking plastic surgeon (moi, for example) to figure out what, where and how much injectable to inject. In my practice, we keep very accurate records of all of the above so I can judge what works best for any given patient. And believe me, every patient is different.
@lisalynnsowder
