By now, virtually everyone is familiar with the use of Botox to reduce horizontal forehead lines, frown lines between the eyebrows, and crow's feet lines around the eyes. The treatment of these three areas with Botox accounts for the great majority of all of the Botox that is used for cosmetic purposes. The results from these treatments are uniformly good, which is why Botox treatments are the single most commonly performed cosmetic procedure in our country and worldwide.

However, you may not be aware that Botox can be used in many other areas on the face and neck to soften lines and relax muscles. The goal of these treatments is to produce a relaxed look to the face while preserving full movement. In this article we will review some of these more unusual cosmetic uses of Botox.

Eyebrow Injection – With age, the eyebrows start to droop. By injecting Botox into the eyebrow, the eyebrow can be elevated. The resulting "Botox brow lift" not only restores the eyebrow to a more youthful position, but it also opens up the upper eyelids.

Upper and Lower Lip Vertical Lines (Smoker's Lines) – Very small quantities of Botox can be injected into the upper and lower lip to soften lines in these areas. Often, Botox is used in combination with collagen or Restylane to soften these lines.

Depressor Anguli Oris – The depressor anguli oris is the muscle responsible for turning down the corners of the mouth. This very unattractive facial feature can be significantly improved by injecting this muscle with Botox. Injecting the depressor anguli oris allows the corners of the mouth to turn in a more upward direction, producing a far more attractive appearance. This is one of Dr. Amerian's favorite injections, and she regularly has this injection done on herself.

Gummy Smile – When some people smile, their upper lip elevates above their upper teeth, exposing their gums and producing an unattractive "gummy smile." An injection of Botox into the upper lip can easily correct this.

Bunny Lines – "Bunny lines" are the lines that occur on the side of the nose when some people smile. They are quite unattractive, and can be easily treated with a small amount of Botox.

Chin – Many patients, especially when speaking, develop folds, creases, and wrinkling in their chin. Two injections of Botox into the chin can significantly improve the chin's appearance.

Neck – An overactive neck muscle will result in vertical bands below the chin, known as "platysmal bands," and horizontal wrinkles across the neck. Injection of Botox into the bands and wrinkles will soften the bands and significantly improve the wrinkles.

The next time you're in the office getting Botox for your frown lines or crow's feet, take advantage of the opportunity and speak with us about whether treatment of any of these other more unusual locations with Botox could further enhance your cosmetic result.

Recently, the FDA gave its approval to Juvederm for use in the correction of facial wrinkles and folds. Juvederm is a technologically advanced formulation of hyaluronic acid that is safe and effective in patients of all skin types and all skin colors.

Hyaluronic acid is a naturally occurring substance found in the body. Its injection into folds and wrinkles creates volume and fullness, and enhances the moisture content of the skin. This combination of effects fills and softens the injected lines, folds, and wrinkles, resulting in the aesthetic correction. Hyaluronic acid has turned out to be an ideal filler for correcting folds and wrinkles. For this reason, the treatment of facial folds and wrinkles with hyaluronic acid is currently the fastest growing non-surgical aesthetic procedure in the United States.

The Juvederm gel is very smooth and flows easily into the skin, creating a smooth and natural look and feel. This allows us to provide a correction for facial wrinkles and folds that is easily tolerated and looks natural. Juvederm contains the highest concentration of hyaluronic acid currently available in a dermal filler. Therefore, it has a long duration of effect, with results lasting for up to six months or longer. Juvederm is an ideal filling agent for moderate wrinkles in the cheeks and moderately severe nasolabial folds. In addition, it can be used in lips to better define the lips and to make the lips appear fuller.

In our office we have used hyaluronic acid fillers for several years on hundreds of patients. Our patients have truly enjoyed the cosmetic enhancement these fillers have provided. We are pleased that Juvederm is now available to provide an additional facial rejuvenation option.

Because of our extensive experience with fillers and other injectable products, the manufacturer provided our office with Juvederm prior to its release into the general medical community. (The general release is scheduled for next year.) Any of our patients who believe they might benefit from Juvederm are welcome to call our office for an appointment.

Eyelid Thermage is a new procedure that smoothes the texture of the eyelids and deceases eyelid hooding and wrinkling without surgery or injections. Patients benefit from a single treatment that has no downtime, bruising, or swelling.

As all of us know, with aging comes wrinkling and sagging of the eyelid skin. Patients who have had eyelid Thermage, which is also known as the “Eyes by Thermage” procedure, report that their eyelid sagging is improved and both the upper and lower eyelids are tighter. The eyes look brighter, the eyes appear more open, and under-eye bags are reduced. In addition, the improved smoothness of the skin makes it easier to apply eye make-up. Patients have reported only minimal if any discomfort during the procedure.

Eyelid Thermage is a good procedure to cosmetically enhance the eyelid tissues in patients who have mild to moderate eyelid aging. The procedure can be performed by itself or it can be performed on patients who receive Botox or other injected materials in the skin around the eyes in order to further improve the results from these treatments.

Patients who would like to improve the appearance of their eyelids without surgery are invited to make an appointment for a consultation with either Dr. Amerian or Dr. Anterasian. Alternatively, the next time you’re in the office, just ask us about eyelid Thermage and whether or not it might be of help to you.