Named Among the Best Plastic Surgeons in Boston
Botulinum toxin (BOTOX ® Cosmetic or Dysport®) or neuromodulators are the most popular minimally invasive procedure performed in plastic surgery with more than 7 million injections each year.
For patients who have not had facial rejuvenation, this treatment is also a good place to start as the treatment is not permanent, which is good news and bad news. Botox ® and Dysport ® work by relaxing muscles and removing deep wrinkles on the face.
Common areas treated are the horizontal wrinkles of the forehead, vertical wrinkles between the eyebrows ("elevens") and the corners of the eyelids ("crow's feet"). Patients with migraine headaches may also experience tremendous relief when treated with Botox. Botox ® Cosmetic and Dysport ® (both types of botulinum toxin) are well known neuromodulators, and the most common treatment performed by board certified plastic surgeons to help make your face look fresh and beautiful.
Is it natural? Yes, Botox is natural, and is the most common form of non-surgical facial rejuvenation.
When patients hear about botulinum toxin, they may be afraid and think it isn’t natural or may think about "botulism" and poison from eating tainted cans of soup. In nature, the bacterium Clostridium botulinum produces a protein that causes bolulism.
Neither Botox ® Cosmetic nor Dysport ® contain actual bacteria - they are made of very diluted amounts of this naturally occuring toxin protein. This natural and diluted protein is instilled directly into muscles and not throughout the entire body. If you have signs of advanced facial aging, you might consider evaluation by our Top Boston Plastic and Cosmetic Botox surgeons at Mount Auburn Hospital, a Harvard teaching hospital in Cambridge Massachusetts.
Unlike many practices or spas with nurse "injectors" or aestheticians, Dr. Helena O. Taylor and Dr. Stephen R. Sullivan personally evaluate you and perform all cosmetic treatments. Dr. Taylor and Dr. Sullivan, both diplomats of the American Board of Plastic Surgery and fellows of the American College of Surgeons, are also both fellowship trained in Facial and Craniomaxillofacial Plastic Surgery so they have particular expertise and experience with facial rejuvenation and treating facial muscles. Using the most advanced techniques and products, they will determine if you are an appropriate candidate for facial volume enhancement or wrinkle reduction. To remove wrinkles, botulinum toxin such as BOTOX ® Cosmetic or Dysport ® may be recommended. Each patient is carefully evaluated and if Dr. Taylor and Dr. Sullivan consider you to be a good candidate, they will customize a treatment plan for you.
Botox Cosmetic and Dysport relax muscles of the face to remove deep wrinkles and restore a fresh and youthful appearance.
Specifically, botulinum toxin works by blocking the release of acetylcholine (Ach) from the nerves that activate facial muscles. Without acetylcholine release, facial muscles treated with Botox Cosmetic or Dysport remain soft and relaxed and wrinkles and skin become smooth and youthful.
Facial expressions of strain, worry, or frustration can be softened and facial contours can be rejuvenated safely and quickly with this treatment. Each muscle and each patient has an individual response. Dr. Taylor and Dr. Sullivan will learn your individual response to Botox Cosmetic or Dysport and work closely with you to customize a treatment plan. The protein is injected slowly and gently into specific muscles - there are 43 muscles in the face.
The muscles are in specific locations and depth, so have a medical doctor (MD) who is actually trained in facial anatomy, such as a plastic surgeon, perform the treatment. Some muscles are considered approved by the FDA while others are considered "off-label". The forehead or frontalis muscles are commonly treated in four to six spots. The frown lines or corrugator and procerus muscles between the eyebrows (the "elevens") are treated in three to seven spots. The corners of the eyelids or orbicularis oculi muscles ("crow's feet") are treated in three to five spots on each side. The neck bands or platysma muscles are treated in four to six spots on each side. The effect is not immediate - Botox Cosmetic may take seven days before you start to see the effects while Dysport may start as early as four days later. When properly performed by a board certified plastic surgeon, you will still have facial expressions and movement, though softened.
The cost of treatment varies and is based on the number of units.
The goal is to use the smallest number of units necessary to obtain the desired result - relaxed facial muscles, smooth skin, fewer wrinkles, and youthful appearance all while still having some facial expression. Too much Botox Cosmetic or Dysport can cause a frozen or emotionless appearance. Some offices may charge "per syringe" or “per area” while Dr. Taylor and Dr. Sullivan charge "per unit" because they feel that every patient deserves to know exactly how many units are used to treat each muscle.
This allows transparency and consistency with each treatment you receive from Dr. Taylor and Dr. Sullivan and is also the best value for you. Pricing "per syringe" or “per area” is problematic for a patient because it prevents you from knowing the number of units as well as potential dilution of the product. If you live in the Cambridge Mass area, consider learning more about having Dr. Taylor and Dr. Sullivan perform a home visit for Botox or Dysport treatments.
The treatment lasts for three to six months, with an average duration of approximately four months. As the medicine wears off, the facial muscles will slowly become more active and the deep wrinkles of the forehead, eyebrows, and crow's feet will reappear. Some patients return every four months to prevent wrinkles from coming back while others may wait six or more months to retreat facial muscles. Fortunately, follow-up treatments take only a few minutes once Dr. Taylor and Dr. Sullivan learn your individual treatment plan.
Just a few minutes! Once Dr. Taylor and Dr. Sullivan have a customized treatment plan for you, repeat treatments with Botox or Dysport are relatively quick and easy. Nevertheless, the process should never be rushed and Dr. Taylor and Dr. Sullivan will take the time you need for a gentle and precise treatment to ensure the best possible result.
Prejuventation prevents wrinkles and creases in the skin and can begin in your 20s and 30s. With treatments each four to six months, wrinkles and signs of aging can be delayed or prevented. It can often be easier to prevent wrinkles and skin creases from forming than to treat them.
Rejuventation softens wrinkles and creases to help make the skin smoother when you are in your 40s, 50s, 60s, 70s, and 80s. With treatments each four to six months, creases can be improved and further wrinkling can be prevented.
Other common reasons to receive Botox include migraine headaches, hyperhydrosis (arm pit sweating), masseter muscle hypertrophy and masculine appearing jaw, bruxism (jaw grinding) with jaw pain, and even depression.
Releasing the strain of muscles on the face and scalp can also help reduce the frequency and severity of migraine headaches. Patients with frequent migraines causing disruption in school or work schedule can benefit tremendously from Botox treatments when other treatments fail. Improvement with Botox may also be an indication for surgical release. Patients who are followed closely by a neurologist and who benefit from Botox might also consider a procedure for decompression of nerves on the forehead or back of the skull. Dr. Taylor and Dr. Sullivan are craniofacial surgeons as well as board certified plastic surgeons and have expertise with operating on facial and scalp nerves.
Forehead nerves, known as the supraorbital and supratrochlear nerves, can be decompressed through cosmetically favorable incisions in the upper eyelid such as those used for an eyelid lift. Eyelid lift, or blepharoplasty, can also be performed simultaneously with releasing compressed nerves causing migraine headaches. This procedure can be performed under local anesthesia with limited downtime and a relatively rapid recovery. Another common site of nerve compression is the occipital nerves on the back of the head. The occipital nerves can become compressed by the occipital arteries and muscles leading to migraine headaches. Through an incision hidden in the hair on the back of the head, Dr. Taylor and Dr. Sullivan can release and decompress the occipital nerves to help alleviate nerve compression that may be contributing to migraine headaches. No hair is cut and patients recover rapidly and go home on the same day with this short procedure.
Patients with jaw grinding or bruxism and associated pain may find considerable relief with Botox or Dysport injection into the masseter muscles or temporalis muscles or both. Reducing the strength and tension of these muscles can reduce the strain across the temporomandibular joint (TMJ) and the frequency of tooth grinding.
Repeated botulinum toxin injection (Botox and Dysport) into the masseter muscle for patients with masseter muscle overgrowth results in decreased thickness of the masseter muscle, mandible bone angle remodeling, and decreased mandible angle flair for patients with a square shaped and masculine appearing jaw. This treatment is very common in Asian countries such as Korea, China and Japan for women who desire a more delicate and feminine appearing face and jawline. Transgender patients who identify as female may also wish to soften the appearance of the jaw. While Botox offers a non-surgical solution, it is most helpful for mild masseter hypertrophy and mandible angle flair. Treatments can be repeated every four months in the office. Patients with moderate or severe deformity may consider surgical treatment with jaw contouring, mandible angle reduction, and masseter muscle release. Dr. Taylor and Dr. Sullivan are both craniofacial surgeons as well as board certified plastic surgeons who have particular expertise in contouring facial bones such as the lower jaw or mandible angle.
Excess sweating of the armpits, hands or feet (hyperhidrosis) and muscle spasms may also benefit from Botox Cosmetic or Dysport. If you wish to decrease armpit sweating during the hot summer months, you might consider a treatment in the spring to get through the summer.
Despite treatment with anti-depressant medications, some patients with depression continue to feel sad, down, or angry. Many studies have found that treatment of facial wrinkles with botulinum toxin such as Botox Cosmetic or Dysport also helps alleviate symptoms of depression. The mechanism is still being investigated, though perhaps the facial feedback mechanisms of fear, anger or sadness contribute to the benefits of Botox or Dyport with Depression. Look good and perhaps feel better.
Call Today 617.492.0620
To schedule a private consultation with Dr. Taylor or Dr. Sullivan, please call the office or request an appointment using our form. We welcome your visit and your questions.
300 Mount Auburn St. Ste 304, Cambridge, MA 02138