Where To Get Botox
Well, for starters, Botox is actually a brand name and there are a few brands for neuromodulators (Dysport and Xeomin are a few others) but Botox was the first and most commonly referred to.
Botox is a neuromodulator. All day, everyday, nerves talk to each other and, in turn, produce contraction of the muscles. A neuromodulator basically inhibits this conversation between nerves and relaxes, or temporarily paralyzes, the muscle.
Neuromodulators have been around for over 20 years and were being used in ophthalmology for strabismus when they realized it improved wrinkles around the eyes. Since this discovery, we have been treating not only facial wrinkles with this drug, but hyperhidrosis (excessive sweating), chronic migraine, overactive bladder, blepharospasm (uncontrollable blinking), cervical dystonia (neck and shoulder muscle spasms), and as mentioned before strabismus (misaligned eyes). So much research has been done on this drug and it is used for a wide variety of medical disorders with a great safety profile. The most common side effects indicated for facial wrinkles is pain at the injection site, swelling, and bruising. Less commonly, you could also experience headache, upset stomach or flu like symptoms.
Have I terrified you yet? I hope not! But really, think about it. Every single drug has a side effect profile. If it doesn’t, it’s not approved by the FDA and you should be wary of taking/receiving it!
I inject so many patients with Botox and all I am seeing and hearing is how much more confident they feel or how happy they are they don’t have to wear as much makeup.
That is not to say side effects cannot occur and if they do, talk to your injector ASAP.
And, now, let’s just go ahead and address the fact that Botox is a toxin. The toxin is produced from a bacteria whose spores can be found in canned-foods, soil, and honey. In very large amounts this toxin can cause paralysis of major muscles (botulism) BUT in medicine it is used in very, very small amounts to achieve results.
Now that we got the necessary medical mumbo-jumbo out of the way, onto the fun stuff!
Should you get Botox?
No one needs Botox for facial wrinkles so, really, the answer depends on how you feel. Would you feel better if the wrinkles were softened?
If not, great! I love that you already feel confident in your skin and you rock it!
Pet peeve: be supportive of other individuals decision if they would like to get it, but by no means do you have to!
Personally, I feel like I look more awake and energized (you Mamas know what I’m talking about), my makeup goes on much better and doesn’t settle in creases/wrinkles throughout the day (because they aren’t any wrinkles there). I enjoy not wearing makeup a lot and feel more confident in my bare skin because of Botox and a good skincare routine. I am young, therefore mine is more preventative and to correct a few things that do bother me when I look in the mirror.
If you start Botox now, at a young age, we can prevent so much and avoid having to do multiple procedures to reverse the damage in the future.
Where can you receive Botox injections in the face?
It is FDA approved for the forehead, frown lines, and crows feet. You will hear the term “on label” and the previous 3 areas mentioned are on label. There is a research proven indication and the safety profile for the areas meet the FDA’s criteria.
Off label areas include brows (lateral orbicularis oculi), under the eyes, bunny lines (nasalis), tip of the nose (depressor septi), gummy smile (levator labii- there are actually 3 muscles involved, see below), lips (orbicularis oris), chin (mentalis), corners of the mouth (depressor angularis oris), and jawline (masseter).
What areas benefit from Botox?
Forehead
Raise your eyebrows.. That muscle that is contracting and causing the horizontal wrinkles on your forehead is the frontalis. This is the only muscle that raises your brows and you do this a lot throughout the day, whether you realize it or not. This is why, even at a young age, you see static lines when you’re not raising your brows actively. Botox in this area will soften the lines but you must be careful! Since this muscle is the only one to raise the brows, if your injector injects too much you will get a very heavy feeling and even drooping of the brows. I have several patients come to me and say I do not want you to inject my forehead because I felt like I couldn’t keep my eyes open last time I got it; more than likely, too much was injected!
Frown Lines
Make a mean, angry face… Those frown lines between your eyebrows (a lot of people will call them 11’s) are a result of 3 muscles (procerus, left, and right, corrugator) contracting and over time will etch into your skin. This is the hardest area to reverse if you wait until later in life to treat with Botox. Botox injections will not only soften those 11’s, but it can help to lift the brow by relaxing the pulling down of the brow.
Crow’s Feet
Smile really big!.. Those wrinkles that form around your eyes are a result of a circular muscle (orbicularis oculi) and when it contracts the crows feet appear. When this muscle is relaxed, not only do the wrinkles smooth out, but you appear to be more awake and your eyes larger. This is the most common place patient’s bruise after botox because this is a highly vascular area.
Under the Eye
Same muscle as above (orbicularis oris) and people only notice underneath the lash line “bulging” or wrinkled (can be one or the other, or both!) when we’ve relaxed the lateral portion of the muscle for the crows feet and the other areas not relaxed begin to compensate. This will also further open the eye for that wide-eyed look that is popular right now (fads change!)
Brows
We can inject the lateral tail of the brow to give you a subtle brow lift, enhancing the arch but also compensate for if we inject the forehead and any heaviness occurs.
Bunny Lines
Scrunch your nose (like a bunny, hence the term “bunny lines”). This is a muscle (nasalis) that runs over your nose and a lot of times is hard to treat or often neglected with Botox. Have you ever been talking to someone that their face looks very smooth and not a ton of obvious movement.. Except for those wrinkles on each side of their nose? The main reason a lot of people get this area injected is because their makeup will crease and settle on their nose and it’s very noticeable when the rest of your face looks flawless.
Tip of the Nose
If the tip of your nose is downturned you can try to inject the muscle right under the septum (depressor septi) to upturn the nose. Honestly unless patients have researched it and happened upon someone suggesting this treatment, I am the one to suggest it if they are concerned with the appearance of the nose.
Gummy Smile
Give your natural smile when you’re taking a photo. If you feel a lot of your gums are showing you can get Botox on either side of the nares to bring the lips down when you smile and hide the gum. I only perform one injection on each side but it hits 3 muscles (levator labii superioris alaeque nasi, levator labii superioris, zygomaticus major).
Lips
Ever heard of the recently popular term “lip flip”? The muscle around your mouth (orbicularis oris) is circular and constantly contracts toward the opening of the mouth when you are talking. When you relax this muscle it “flips” the lip outward and gives the perception the lip has been augmented, showing more of the pink mucosa. I highly recommend botox in the upper lip if they are wanting filler because if they aren’t wanting drastic changes, Botox will do the trick! Now, I have to warn all patients when getting Botox around the lip it will feel different. This sounds so vague but it honestly is the only way to describe it. Think about it, you use the muscles around your mouth all day and then you alter them in any way, it will take getting used to. You may, at first, have trouble saying “O” and sucking from a straw but this will fade and you will begin to compensate. Most patients love the results and don’t mind the irregular feeling. You can also inject around the lips to smooth the vertical “smokers lines.” I inject patients more often than not who have never smoked and have these vertical lines so don’t be offended by this term!
Chin
Stick that lower lip out and give a good pouty face.. The same face you give when crying. Or say “January, February, March” and watch your chin while doing so. A pebbly appearance of the chin occurs when the muscle (mentalis) contracts. Botox injected into the chin will smooth out the orange-peel look.
Corner of the Mouth
Do you feel like the corners of your mouth are downturned? This commonly happens as we age. The muscle (depressor angularis oris) that runs from the corner of your mouth to the lateral chin causes not only a downturned mouth over time, but prominent melolabial folds. By relaxing this muscle we can restore the youthful mouth at rest and prevent/soften melolabial folds. You must be careful in the lower face. Muscles overlap and if you relax one you aren’t meaning to it would appear you are having a stroke because one side is relaxed but the other is not.
Jawline
The muscle that contracts when you clench your teeth on either side of the jaw can hypertrophy (naturally or from things such as grinding the teeth at night) and cause a prominent jawline. Injections in this muscle will soften the jawline for a more feminine look or even to just relieve TMJ if there is no hypertrophied appearance.
The only reason I stated all the muscles for you is to not only convince you I do know the anatomy behind the injecting, but also if you google “Botox Frontalis Before and After” you can get a really good look at the results you could receive.
With that being said, make sure your injector does know the anatomy behind injecting. Anyone can inject botox, especially in Tennessee where I practice. Literally, you can take a weekend course here and start injecting the next day if you want to (so scary!). Hopefully nothing will ever go wrong with Botox for you, but if it does, you know your injector is a qualified injector if they know how to fix it.
I have injected the DAO muscle multiple times and one, knock-on-wood only one, dear patient (and now friend) did have an adverse event, but I knew how to fix it and even got my supervising physician involved. To this day she still comes to me because I knew what I was doing and how to reverse the adverse event.
I hope I didn’t get too medical with you and you learned a little about Botox and the locations you can receive injections. Please do not hesitate to reach out or comment below if you have any specific questions!
Be sure to follow me on Instagram because I will post stories (and add them to highlights) so you all can see what I am talking about on video, especially the areas to inject and why!
Comment below with any questions you have!
As always, thanks for reading 🙂
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It’s really nice to hear that botox is FDA approved so that you don’t really have to worry about seriously negative side-effects. My wife has been thinking about getting botox recently because she wants her face to look younger. I think that botox mixed with other natural remedies is a really great place to start.