Botox®

*Dr. Pilest is a Platinum Plus Botox Physician

Time limited Rebates from Allergan - Ask about available Rebates
(Rebates are sent to you directly from Allergan, but you must have a form from our office)

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BOTOX®

"Botox is magic. Nothing can do what Botox can!" - Dr. Pilest

This procedure is one of the safest available for reduction of wrinkles. BOTOX® has been used safely and successfully in ophthalmology for over 12 years and for wrinkle therapy for almost 10 years. It has been approved by the FDA for neurological disorders. In the amounts used for wrinkle therapy, the only possible side effects are temporary and localized to the area of injection.

At Total Dermatology you will always receive maximum strength, fresh BOTOX®. Although individuals may have slightly varied results, we will work with you to achieve your most optimal results. Dr. Pilest personally performs all injections, both for Botox and dermal fillers.

As a trainer for Allergan, Dr. Pilest presents Physician Lectures and Roundtable Discussions for Juvederm and Botox.

New Benefit Program from Allergan - The Botox Benefits program has been upgraded to a new program - Brilliant Distinctions. Now you will receive redeemable points for all your Allergan treatments and products through Total Dermatology - Botox, Juvederm and Latisse.

If you are an existing Botox Benefits program member, you should have received an email from Allergan which explained the new Brilliant Distinction Customer Loyalty Program - along with a point bonus just for re-registering (that's worth $25 you can use in our office towards your purchase of Botox, Juvederm or Latisse).

IF you did not receive your upgrade email due to a change in email address (or simply didn't open that email), the next time you're in the office, be sure to pick up a Welcome Portfolio and we'll tell you how to get those new bonus points and how the new program works. Welcome Portfolios for the new program will be available in our office from October 13th.

What are the overall advantages of treating wrinkles with BOTOX®?

• Reduces or eliminates wrinkles without surgery.
• No sedation or anesthesia is needed.
• Corrects underlying muscles (as opposed to the skin's surface or
  skin's sub-layer the way peels do).
• Reduces horizontal creases in forehead. Reduces frown lines.
• Minimizes the look of crows' feet and laugh lines.
• Provides dramatic effects.
• Effects are customizable and reversible.
• Some patients report they no longer get migraine headaches.

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How does it work?

First: A few drops of BOTOX® are injected with a tiny needle into the muscle that creates a wrinkle. When BOTOX® is injected into a muscle, it blocks the nerve impulse from reaching that area, and as a result, the muscle weakens. As the muscle weakens, the skin overlying the muscle relaxes and the wrinkles in the skin gradually soften and often disappear. BOTOX® treatment does not effect normal facial expressions.

Botulinum Toxin Type A (BOTOX® Cosmetic) is a protein complex produced by the bacterium Clostridium botulinum, which contains the same toxin that causes food poisoning. When used in a medical setting as an injectable form of sterile, purified botulinum toxin, small doses block the release of a chemical called acetylcholine by nerve cells that signal muscle contraction. By selectively interfering with the underlying muscles' ability to contract, existing frown lines are smoothed out and, in most cases, are nearly invisible in a week.

Basically, the botulinum toxins block the signals that would normally tell your muscles to contract. If a specific muscle can't move, it can't cause a wrinkle.

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Worry Lines	Frown Lines
Bunny Lines	Squint Lines/Crow's Feet
Drooping Mouth Corners	Platysma Stranding or "Banding"

What can BOTOX® be used for?

• Frown Lines
• Worry Lines
• Periorbital Wrinkles (Crow's Feet)
• Bunny Lines
• Brow Lift
• Brow Asymmetry
• Drooping Mouth Corners
• Lip Wrinkles
• Platysma Stranding ("Neck Banding")
• Chest Wrinkles and Vertical Lines
• Hyperhidrosis - Severe Underarm Sweating
• Ophthamological Conditions and Dystonia

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Treatment Procedure

• Dr. Pilest will administer several tiny injections of BOTOX® Cosmetic directly into the muscles of the areas you wish treated.
• The location of the injections will be determined by examining your ability to move certain muscles in the selected area. The location, size, and use of the muscles that create a furrowed brow vary markedly among individuals.
• No anesthesia is required, although you may choose to have the area numbed with a cold pack or anesthetic cream prior to injecting. Discomfort is usually minimal and brief. Most patients compare the sensation to a pin prick and treatment takes only a few minutes.
• You may resume normal activity immediately. You may see a marked improvement in the moderate to severe frown lines between your brows within days. Improvement may continue for as long as a month, and could last up to 5 months. After that, the muscle action returns. When frown lines reappear, a repeat treatment is necessary to regain the results.

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Are there any side effects?

Side effects of BOTOX® are minimal, with slight discomfort upon injection of the solution. This may be minimized by the use of Emla cream one hour prior to the injection. Bruising at the sight of injection may occur but is not common. One percent of patients develop a slight lowering or ptosis of one eyelid and, also rarely, asymmetry of facial expression. These effects are temporary and may not even be noticed by the patient.

Caution: The Food and Drug Administration (FDA) has issued statements warning of the possible hazards of "BOTOX® parties." Whether used to treat medical conditions such as blepharospasm or strabismus or cosmetic concerns such as furrow lines, a BOTOX® injection is a medical procedure that should be performed in a controlled medical environment by a licensed physician.

Women's Top 10 Questions About Injectables

The Anatomy of a Wrinkle

As an example we'll look at the common "frown" of the glabellar lines. The lines that appear between your brows (glabellar lines) actually result from muscle movement and the passage of time. You may have heard the expression "wearing your emotions on your sleeve," but in reality you wear them on your face. If you're angry or annoyed, for example, you knit your brows together. Underneath your skin, your facial muscles contract, cause a pleating of the overlying skin, and then, as anyone can see, you're frowning.

After years of crinkling and wrinkling, those glabellar lines start to linger longer and can become more pronounced. For women, whose faces tend to be more animated than men's, and whose skin is typically more delicate, these lines may appear exaggerated and more permanent.

How glabellar lines are formed

Glabellar lines are the dynamic wrinkles between the brows caused by the contraction of corrugator and/or procerus muscles.

Movement of corrugator and procerus muscles can cause the skin between the brows to crease. As skin becomes less elastic over time, repeated contraction of these muscles may create visible lines and wrinkles.

BOTOX® Cosmetic works on the muscles that cause glabellar lines

BOTOX® Cosmetic is injected directly into the corrugator and procerus muscles, where it enters the nerve endings to block the release of acetylcholine, the chemical that causes muscles to contract. Once the muscles are at rest, skin becomes smoother.

Results you can see…

In a clinical study results were still visible up to 4 months later

*Unretouched clinical photos taken while frowning both before and 30 days after treatment with BOTOX®® Cosmetic.
(Source: Allergan)

Other above-mentioned wrinkles resulting from muscle contraction are treated in the same way. The resulting effect is of both smoother facial features and a "lifting" effect as the BOTOX® serum allows those muscle functions to become more dominate.

Men are becoming equal fans of BOTOX®, too. Erasing frown and worry lines give a more assured appearance. And a special added  psychological benefit? Seeing yourself "look" less stressed or angry actually triggers more positive emotions.

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BOTOX®-Restylane, Botox-Juvederm or Botox-Cosmoderm Combination Treatments

Using BOTOX® to relax the dynamic muscles that cause wrinkles is frequently combined with follow-up dermal fillers. Some lines on the face are a result of skin laxity aging and are not affected by BOTOX®. These lines are readily improved with the use of either Restylane or Juvederm (both Hyaluronic acid fillers) or Cosmoderm/Cosmoplast collagen products. In some situations the Restylane can be injected during the same visit. Other times, such as when treating lip wrinkles, the Restylane or other selected filler will be placed several days later when the muscles have relaxed.

This particular combination treatment can affect a dramatic improvement for the entire facial area.

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Complementary Treatments

Fraxel Resurfacing
Perlane
Restylane
Juvederm
Sculptra
Radiesse
Cosmoderm

Other De-Aging Treatments

Thermage
Smoothbeam
Vbeam
Chemical Peels
Smooth Peel
Cosmelan De-Pigmentation

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