Botox Treatment in Bellevue and Issaquah

Home · Aesthetic Services · Botox Treatment Issaquah and Bellevue

girl with fingers framing face2Botox Injections and Wrinkles

Why Botox Treatment? Wrinkles are an inevitable part of aging. We constantly move our brows, mouth and eyes, which causes an increase in muscle tone. At the same time, collagen decreases as we age. The combination of these two factors can bring about wrinkles such as worry lines, frown lines and crow’s feet. The treatment is a replacement in many cases for plastic surgery.

What is in Botox?

Botox is the name given to a toxin made by the bacterium Clostridium Botulinum. It’s a powerful neurotoxin by itself, but careful use of it has many applications. It works by blocking the signals from the nerves to the muscles and essentially rendering them paralyzed. Because the muscles can’t contract, wrinkly areas relax and soften.

Luckily, for years, there have been many options available for effective wrinkle reduction. VIVAA specializes in delivering a variety of wrinkle treatment solutions with care and expertise, including Botox injections. This simple procedure is the most popular nonsurgical cosmetic procedure in the United States and has passed clinical trials (FDA approved). These injections reduce the appearance of fine lines, wrinkles and facial creases on the forehead, cheeks and eyes. Millions of people undertake Botox treatments every year and most patients achieve the younger look they desire. If you’ve ever wanted an effective anti-aging treatment, find out why Botox treatments, available through our offices, can do for you.

What is Botox?

Botox is the name given to a toxin made by the bacterium Clostridium Botulinum. It’s a powerful neurotoxin by itself, but careful use of it has many applications. It works by blocking the signals from the nerves to the muscles and essentially rendering them paralyzed. Because the muscles can’t contract, wrinkly areas relax and soften.

Seven areas of the face respond well to Botox. These are:

  • Glabellar lines, the area above the nose and below the eyebrows
  • Crow’s feet, the wrinkles that branch out from your eyes when smiling
  • Bunny lines on the bridge of the nose
  • Lipstick lines that run vertically above the lips
  • Marionette lines that start at the corners of the mouth and run downward
  • Chin dimpling
  • Severe underarm sweating
  • Lines between the eyebrows
  • Certain neck pain

Apart from cosmetic applications, Botox has uses in areas other than wrinkle reduction including facial wrinkles. It’s also effective for:

  • Chronic migraines
  • Severe primary axillary hyperhidrosis (excessive sweating)
  • Bladder and bowel disorders (e.g. leaky bladders, urinary incontinence)
  • Muscular disorders
  • Neck, eyelid and shoulder spasms
  • Strabismus (crossed eyes)

Procedure Expectations

25yr old female, First time botox for deep wrinkles on the forehead
25yr old female. First time botox for deep wrinkles on the forehead

Botox is a simple procedure that only takes a few minutes of time while you recline in a chair in one of our clinics. One of our specialists will insert a small needle into the desired area. The procedure only takes about 10 minutes and requires no anesthesia, although we can apply a topical anesthetic before the procedure if you wish. We’ll ensure your utmost comfort throughout the process. Any major or minor restrictions will be discussed with you after the procedure, but no major downtime is necessary. The effects of Botox might take five to seven days to show. Aspirin and anti-inflammatory medications may be necessary to reduce possible bruising. Other unwanted side effects to Botox that should be addressed if they happen to you. These can include:

  • Numbness
  • Headache
  • Trouble swallowing
  • Mild nausea
  • Reddening at the injection site
  • Bleeding
  • Blurred vision
  • Rashes
  • Swelling
  • Hives

Botox is ideal for people who wish to slow down the aging process and reduce the appearance of forehead lines, crow’s feet and frown lines. Wrinkles caused by sun damage and gravity are not suitable for Botox since the botulinum toxin will not respond. Pregnant or breastfeeding women should not undergo Botox, as well as any person with a neurological disorder. It is important to consult in detail with Dr. Sidhu before considering Botox to select the best treatment option for you.

Please be aware that Botox injections are not permanent and last about three to six months. Regular treatments are necessary once fine lines and wrinkles start to reappear.

Other Uses for Botox (Click Title to View)
(VIVAA only provides cosmetic Botox treatments)

Primary Axillary Hyperhidrosis

Hyperhidrosis is a condition of excessive sweating. It is primarily experienced in the armpits. In severe hyperhidrosis, you may sweat up to five times the necessary quantity required to regulate your body temperature. This condition begins at puberty, up to age 25. Those suffering from this condition do not experience the symptoms while sleeping.

How severe primary axillary hyperhidrosis affects you?
Hyperhidrosis affects you physically, psychologically and emotionally. You agonize over the sweat marks left on your shirt, the necessity of showering multiple times a day and the isolation that comes with hyperhidrosis. It may also prevent you from fulfilling your professional goals and building great relationships. Some of the issues you may face include:

  • Embarrassment at social events
  • Lack of concentration at work
  • Frequent wardrobe changes
  • Time and energy lost looking after personal hygiene
  • Skin breakdown and infections

Why we sweat and how it's controlled?
Sweating is a natural way of regulating the body temperature. It is consciously controlled by the hypothalamus, in your brain. When you are exposed to excessive heat or stressful situations, the hypothalamus sends impulses to your sweat glands to produce sweat. When the sweat evaporates, your body cools and maintains a normal temperature of 37°C. With axillary hyperhidrosis, you lose excess water from your body and this can cause dehydration. Your body temperature can also be lowered beyond normal which can affect proper body function.

Triggers of axillary hyperhidrosis
Primary axillary hyperhidrosis lacks a known cause but there is evidence of genetic links. Triggers of excessive sweating include:

  • Exposure to excessive heat
  • Stressful situations at work
  • Stimulants such as caffeine
  • Overactive sweat glands

Diagnosis of severe primary axillary hyperhidrosis
You may be diagnosed with this condition if you experience at least 6 months of excessive armpit sweating and other characteristics as follows:

  • Impairment of daily activities
  • A family history of excessive sweating
  • No excessive sweating while sleeping
  • Both armpits are affected


Antiperspirants are readily available in supermarkets and convenience stores and do not include deodorants. Deodorants mask the odor in sweat while antiperspirants reduce the frequency of sweating.

Clinical antiperspirants
These antiperspirants are only available in pharmacies and contain an ingredient, aluminum chloride hexahydrate, that reduces the amount of sweat produced by the sweat glands.

This is usually the last resort which involves correcting any disorder in the sweat glands. This will alter sweat production and control severe primary axillary hyperhidrosis.

Botox injections can treat hyperhidrosis
Botox treats excessive sweating by blocking or paralyzing a neurotransmitter that stimulates the sweat glands. The injection is given in the armpits and can last up to eight months. The U.S. Food and Drug Administration have approved Botox as a successful treatment for hyperhidrosis. Get in tough with us for botox treatment.

If you realize that your underarm sweating has become intolerable and always interferes with your daily activities, then it’s likely you have severe primary axillary hyperhidrosis. You should schedule a visit with a medical practitioner who will guide you on how to cope with your condition.

Bladder and Bowel Disorders

Bladder and bowel disorders are essentially problems with urinating and passing stool. They involve the involuntary passage of urine or stool. These conditions can affect you physically and emotionally. If you suffer from these conditions, you should consult a doctor in order to manage them and improve your quality of life.Causes of bladder and bowel disorders
Leaky bladders are caused by:

Damaged nerves in sphincter muscles
When the nerves in the sphincter muscles are damaged, they may malfunction when you require to release or hold urine. This will lead to involuntary urination, something that can be deeply embarrassing.

Prolonged urine retention
When your nerves are damaged, your bladder muscles do not receive the stimulation required to alert you to urinate. Hence, prolonged urine retention causes a pressure build-up, leading to urinary tract infections.

Overactive bladder or frequent urination
If you have to urinate up to eight times a day, the nerves in your bladder can get affected. The nerves will also not send impulses to the sphincter muscles to control the passage of urine. This leads to leaky bladders.

Bowel incontinence is Caused by the Following Factors:

Vaginal childbirth
The dissection that is sometimes done on the vagina to allow passage of the baby (episiotomy) can also extend to the anus. This can promote fecal leakage.

Damage to the nervous system
Nerve damage can lead to fecal leakage as stimulation of the muscles that allow passage of face is not achieved.

Constipation leads to the rapture of anal walls which can allow feces to leak.

This medical condition is characterized by swollen veins in the rectum and anus that cause discomfort and bleeding. When these veins rapture, they affect the normal function of the rectum and this allows fecal leakage.

Management of Bladder and Bowel Disorders

Dietary changes
Your diet should contain plenty of fiber which helps in managing constipation. You should also take plenty of water to avoid constipation. Restricting fluid intakes sometimes can also manage overactive bladder.

Regular exercises
Exercises that contract and relax your pelvic muscles can strengthen the sphincter muscles. This will provide better control of your bladder and rectum.

Some prescribed medications can help your bladder muscles to relax while others containing fiber supplements will control bowel dysfunction.

Electrical stimulation
This type of therapy stimulates the damaged nerves and enables them to control bladder and rectum muscles.

Repair of damaged muscles and nerves can reverse these disorders, although they are rarely recommended.

Botox injections
An overactive bladder contracts too often or without warning leading to bladder leakage. Botox reduces the contraction of the bladder muscles by blocking the transmission of a chemical signal to the muscles. Therefore, you are able to retain urine longer.

8 Muscular Disorders You Ought to Know About

Muscles are the engines behind our walking, talking, sitting and standing. Some muscles are beyond our conscious control but keep us healthy and alive. Injury to any muscle causes muscle disorders. Muscle disorders interfere with movements of any affected part of the body.

Types of muscle disorders

Muscular dystrophy
This is a condition characterized by weakness and muscle wasting. It is mostly caused by unusual genetic mutations that interfere with the production of muscle proteins. Muscle weakness is accompanied by an inability to walk. Some may also have trouble breathing and swallowing. Therapy and medication can reduce muscular dystrophy although there is no known cure for it.

Cerebral palsy
This is an impairment of the motor function due to brain damage. This condition is believed to develop while the baby is still in the mother's womb. However, there are cases where cerebral palsy can occur after birth. This condition affects muscle coordination, balance, body movement and muscle control.

This is an inflammatory disease characterized by weakness in the muscles and a distinct rash. It occurs in both children and adults. Skin color changes to dusky red especially on eyelids, face, knees and chest. Rashes are often very painful and itchy and are the first sign of dermatomyositis. Muscle weakness is observed on the hips, thighs, shoulders and upper arms.

This is a condition where you experience musculoskeletal pain caused by intense pain sensations from the brain. It is common in women. Fibromyalgia occurs after an infection, surgery, physical trauma or psychological stress. There is no cure for fibromyalgia, although symptoms can be managed through medication and exercise.

This condition involves slow relaxation of muscles after contraction or stimulation. Problems associated with this condition include difficulties in walking and inability to release the grip of held objects. Patients need to calm down their muscles to improve their condition.

Muscle cramps
This is an involuntary contraction of muscles. You may experience a muscle cramp during exercise or physical labor. You need to stretch your muscles and avoid dehydration in order to control muscle cramps.

Myasthenia gravis
This condition is characterized by weakened and tired muscles. It can affect any muscle in the body. For instance, if your jaw bone tires it will prevent you from chewing food. You will require rest from the work you were doing to regain strength then resume work.

Rotator cuff injury
The rotator cuff is a group of muscles and tendons that support the humerus on the shoulder socket. An injury to these muscles and tendons can cause shoulder pain which worsens if you sleep on the affected area.

Botox therapy
Botox is used to treat muscular disorders by blocking a neurotransmitter involved in muscle contraction. Botox relaxes the muscle and allows it to function naturally. It also blocks the connection between nerves and muscles thus relieving spasms and the pain caused by spasms.

If you experience any of these disorders it's important to seek medical attention as lack of treatment can lead to paralysis. Regular exercise can help to prevent the occurrence of some of these disorders.

What You Need to Know About Strabismus

Strabismus is a visual problem whereby your eyes are misaligned and face the wrong direction. One eye may look straightforward while the other eye may look inward, outward, upward or downward. This condition is common among children, due to incomplete vision development. In a few cases, this condition disappears as the child grows and the vision system matures.

Types of Strabismus

This type of strabismus is where the eye turns inward. Infants with esotropia cannot use their eyes together. Accommodative esotropia occurs when the eye turns inward as the child tries to focus the eyes to see clearly. This condition may occur while focusing at a distance, up close or both.

This visual problem is characterized by outward turning of the eye while focusing at a distance. It may occur from time to time especially when the child is ill, tired or daydreaming. The child will also have partly closed eyes in bright sunlight.

Large angle strabismus
This type of strabismus is identified if the misalignment of the eyes is large and obvious. Large angle strabismus does not cause eye strain or headaches but causes severe amblyopia if the turned eye is not treated. This is a condition characterized by decreased eyesight due to improper stimulation of the nerves between the brain and the eye.

Small angle strabismus
Misalignment of the eye in small angle strabismus is less obvious compared to a large angle strabismus. As a result, its symptoms are easily ignored leading to more disruptive visual disorders. Symptoms include headaches, eye strain and fatigue when reading. If not treated, it can lead to amblyopia.

These conditions are psychologically damaging and lower the self-esteem of patients with strabismus. It also prevents patients from making eye contact with people due to embarrassment.

Causes of strabismus
Our eyes have six extraocular muscles that control the position and movement of the eyes. Normal vision requires proper coordination of the nerves found in these muscles. Problems in the muscles themselves, or in the visual nerves found in the brain may interfere with your vision. Strabismus is genetic as children can develop it from their parents.

Signs and Symptoms of Strabismus

  • Misalignment of the eyes
  • Inability to read comfortably
  • Eye strain and headaches
  • Fatigue when reading
  • Jittery vision

Treatment of Strabismus

Botox injections
When one eye muscle grows weak, the stronger muscle pulls the eye in the opposite direction. Since the stronger muscle is always contracting, it can become permanently tight. Botox is thus injected in the stronger muscle to relax it. This gives the weaker muscle a chance to recover.

Children and strabismus
Regular eye exams for children are recommended to detect strabismus. The earlier the detection, the better the outcome of the treatment. Lack of treatment can lead to amblyopia and double vision. Eyeglasses, contact lenses and surgery can be used to correct the different types of strabismus. Avoid delays and seek treatment for strabismus to improve the vision of your child.

About Chronic Migraines

A Migraine is a debilitating and a very painful form of a headache. It becomes chronic when you experience headaches for 15 or more days in a month within a three months period. Symptoms of chronic migraines

  • Pain on the lateral side of the head
  • Nausea
  • Vomiting frequently
  • Dizzy spells
  • Pain if you come across bright light, sounds or smells

Causes of chronic migraines
Doctors have not discovered the exact causes of chronic migraines. However, some theories to what causes migraines have been identified as follows:

Genetic factors
If a close family member like a parent or sibling experiences chronic migraines, the likelihood of you experiencing the same is higher than normal.

Chemical changes in the brain
For the brain to function properly, it requires that all chemicals are balanced and the nerve pathways are clear and ready to transmit signals. If these factors are interfered with, migraines will occur.

Vascular problems
If your blood vessels are irregular in terms of shape and size, they will impede proper blood flow to your brain. This will lead to migraine headaches.

CNS disorders
If your neurological makeup is distorted, neuronal signals will not be transmitted effectively. This might trigger chronic migraines.

Chronic migraine triggers
Migraine triggers are situations, behaviors or environmental factors that set off new episodes of migraines. They are unique for every person. These triggers include:

Hormonal changes
Migraines are more common in women than in men. This is because women experience regular hormonal changes, especially during menstruation and menopause. Birth control pills which alter the release of hormones also trigger chronic migraines.

Headache medication
The medication you are taking to treat headaches can also trigger new ones. If you take them for more than three times in a week, you may experience debilitating migraines.

Poor Posture
Your sitting position affects the distribution of blood in your body. Poor posture will reduce blood flow to your brain will trigger a migraine.

Use and abuse of caffeine
Caffeine is a stimulant that triggers migraines as it alters the chemical composition of your brain cells. Excessive use of caffeine can lead to extremely painful migraine attacks.


Lifestyle changes
Certain lifestyle changes such as exercising, avoiding drinks containing caffeine, stress management and having adequate sleep can reduce chronic migraines. Massages and acupuncture can also help.

Botox injections
For a muscle to contract, the nerves release a chemical known as acetylcholine, which sends signals from one neuron to the other. In this case, acetylcholine attaches itself to the cells in the muscles causing them to contract. Botox injections hinder the release of acetylcholine preventing the contraction of muscles. This helps relax the muscles that are sensitive to pain. Botox also blocks pain signals from reaching the brain. This reduces chronic migraines.

If you experience sudden and unusual migraines, seek medical attention immediately. This will help in early diagnosis and treatment. If you identify your migraine triggers, examine them and find a way of getting rid of them. This will help in reducing the severity of your migraines.

About Neck, Eyelid and Shoulder Spasms

A spasm is an involuntary contraction of muscles in any part of the body. It often causes extreme pain that lasts for minutes, hours or days after the spasm subsides. Spasms can occur anywhere as long as there is a muscle. This includes the neck, eyelids and shoulders.

Neck Spasms

A neck spasm is an involuntary contraction of the muscles found on the neck. These contractions are accompanied by sharp pain on any part of the neck and you may experience pain when turning your neck.

Causes of neck spasms

  • Placing heavy load on the shoulder
  • Carrying heavy objects with one arm or both
  • Emotional stress
  • Headaches

Treatment of neck spasms

Exercise Stretching your arm muscles during exercise can reduce the chances of getting spasms.

Medication Over-the-counter painkillers can deal the pain that comes with neck spasms.

Ice packs
This is a form of relieving pain as ice reduces the activity of nerves hence the pain impulse is not easily transmitted.

Eyelid Spasms

Eyelid twitches are involuntary movements of the eyelids. Some spasms are mild while others are strong, leading to both eyelids closing. Twitches are painless but if they occur regularly they may bother you. If accompanied by facial twitches, they may signify an underlying chronic movement disorder, therefore, should not be ignored.

Causes of Eyelid Twitches

  • Inadequate sleep
  • Side effects of medication
  • Irritation of the eyes
  • Use of alcohol, tobacco or caffeine

Fatigue, dryness of eyes and light sensitivity can make spasms worse.

Treatment of Eyelid Twitches

Most eyelid twitches disappear on their own. However, there are those which occur frequently. These can be treated by eliminating certain causes such as stress, fatigue, caffeine and getting enough sleep.

Shoulder Spasms

This is an involuntary contraction of the shoulder muscles that causes them to tighten and become rigid. The blood supply to the muscles is interrupted causing a sudden sharp pain in the shoulders. The pain may vary from mild to severe, extending up to the arms.

Causes of Shoulder Spasms

  • Strenuous physical activities and exercises
  • Psychological stress
  • Degeneration of shoulder muscles
  • Dehydration
  • Poor posture

Management of Shoulder Spasms

Shoulder spasms require plenty of rest to alleviate. Suspend strenuous activities to avoid straining your muscles and rest in a comfortable position.

Ice Application
This provides a soothing effect on the painful muscles on the shoulders. The ice cubes should be wrapped in a cloth and applied on the injury not more than 20 minutes thrice a day.

Heat Application
This promotes blood circulation in the injured muscle which helps to relieve the pain.

Botox Injections
Botox is a protein that helps stop muscle spasms when injected directly in the muscles. Chemical messages sent by nerves to the muscles cause these spasms. Botox blocks these messages and prevents the contraction of the muscles. Injections are given at the area where the muscles are contracting.It's important to take care of yourself as muscles are located all over the body. The health of your muscles will determine the frequency of getting spasms either on the neck, eyelids or shoulder. Diet and exercise will boost the health of your muscles and should be taken seriously.

NBVIVAA only provides cosmetic Botox treatments.Patient Review
"I've come in twice for botox. After experiences at other places, I will keep coming back. Very professional, explains why, follow through is fantastic. I've recommended friends, they have been equally pleased."
Gina B.


We here at VIVAA are committed to a positive patient experience. Even though this procedure can be concerning for understandable reasons, Dr. Sidhu will give you expert recommendations as to the best way to go about Botox wrinkle reduction and help you develop a customized treatment plan suited to your needs. The goal is to see your treatment needs met in a way that is comfortable for you and helps to target the issues you wish to address. Our team is here to make sure that happens in a safe and comfortable environment.

Visit our call centers in Bellevue or Issaquah, WA, today to schedule a consultation. We also service the areas of Kirkland, Everett and Sammamish. Use our Request an Appointment tab to get started.

Q & A about Botox (by Dr. Sidhu from RealSelf)

Chin Botox gone wrong

Q: I had some Botox in my chin a week ago. It was recommended to relax a tight muscle. It didn't asthetically bother me, but I was told it would help fill out my chin and soften it's appearance. Now it looks horrible, and I don't know what might correct it. It looks fatty, misshapen, and I have strange dimpling not present before. It is also difficult to keep my mouth closed all the way. Is there anything to even this out while I wait for the effects to wear off?

A: Sorry to hear that. Its hard to determine what went wrong without looking at the pictures from before the botox treatment and also looking at the face in person but the botox should wear out over next few months and the area will go back to its original state at that time.

Got Botox 11 days ago in forehead and 11 lines. Now inner brows have dropped and have high arches. Advice? 

Q: 11 days ago Botox was put in forehead and 11 lines. extra was added to one brow to lift it. 24 units in total. Now the inner brows have dropped and the arches seem way higher Skin in lids seems to be bunching The side that was raised has less movement then the other which looks odd when raising them I look very odd and so upset with myself for doing this! Is there a chance the brows will lift back up and correct themselves before the 3 months it takes for it to wear off completely? Will it get any worse?

A: This happens because of the placement of botox at certain spots . The high arch eye brows can be easily fixed with some additional botox laterally on the forehead.

Harsh lines in chin with smile, would Botox fix this?

Q: I do not like the lines that appear in on the lateral sides of my mouth when I am smiling as well as how tight the skin under my chin gets with a smile. would botox fix this?

A: Thanks for the pictures and yes botox will help relax the muscle action in chin and help with the lines.

Received roughly 15-20 units of Botox/alternate product 2 years ago for a line between my eyebrows and it was too much. Advice?

Q: After almost a year I had more and stronger lines across my forehead and especially the injected area I knew that it was too much after I saw it and now one eyebrow seems lower Seems like theres no way to reverse it but any advice would be appreciated

A: The best way will be to see you in person to address the areas of concern but there is no way botox has any effect 2 years out.

Kidney donor and botox

Q: I’m a kidney donor will Botox effect my one kidney?

A: Botox is absolutely safe among kidney donors. It should not affect any of the kidney function since the medications stays local where injected. Kudos to you for being an organ donor.

Is it possible to get Botox that allows movement?

Q: I want to prevent the fine lines in my forehead from getting deeper bit I don't want to have a completely frozen forehead or have spocking. Is it possible to simply minimize movement without stopping it completely or is there another way of doing the Botox so it looks natural?

A: Yes its possible to get the results you want by adjusting the dose but can take few treatments to figure out the right dose for you. Thanks1

Need help with droopy eyelid after Botox.

Q: Botox for the first time 3/20. Forehead/frown lines. Now with R eyelid drooping x3 days. Contacted injecting MD to ask for Apraclonidine 0.5% solution. RN informed me he doesn't prescribe it. Stated it will wear off, suggested I go to my PCP. I don't have a PCP, I rarely go to the Dr. (trauma RN, we are the worst patients). I don't want to look crazy for months. It's worth a try to me, ANY improvement would be better than this. How do I get the RX if injecting MD won't prescribe it?

A: Sorry to hear that. Droopy eye lid after botox will wear off with time but if its significant the eye drops do help. You will have to see an MD to get the prescription. Other option is to see an ophthalmologist and get the prescription. Good luck.

Circular, bruised-like indentation on right side of forehead after Botox

Q: I received botox on my 11s on 2/16/18. Before stepping into the shower tonight i noticed a circular, bruised-like indentation on my forehead. As i go to feel it with my hands, the area is smooth and doesn't feel painful. In person it looks like i bumped my head on something or a golf ball flew and hit it. Could this be an overworking muscle, or collapsed vein and will it go back to normal? Please advise.

A: Sorry to hear that. First of all those are not the regular spots to take care of 11s. But if those were the spots where botox was injected then it should settel down soon. It will jsut take some time.

Is my chin suppose to look like this a day after chin Botox?

Q: I had chin Botox done yesterday. Is this how it’s suppose to look like as its taking effect?

A: One day is too early to tell if botox is working or not and without a pre injection picture its hard to tell what the area of concern is. Best is to visit the injector again and discuss in person.

Went for my 1st consultation with a dermatologist. What popped out most to her was my naturally crazy lifted eyebrow?

Q: Hi, went for a consult, the doctor told me that she would recommend some botox for my crows feet, but what popped out most to her was my right eyebrow? It's always been higher than the other. She suggested 2 units to drop it just a bit? Not to complete symmetry, just a bit?? Can she do this safely, without it looking unnatural? I wouldn't mind it dropping a bit, but I think a bit of assymetry is natural. It doesn't bug as much in normal setting, I hate pictures of myself, that's where I really notice it.

A: Yes facial asymmetry is common and botox can be used to correct that. If placed at right area there should not be any droop.

Not sure what to do? Botox, filler, or a mix of both? Finances are a big issue for me.

Q: Hello, will choose to consult with a derm. Or plastic surgeon in my area of Seattle, in the soon. What I'm trying to do now is to just get an idea of what can be done for my situation? I've been thinking botox for 11 and crows feet, bunny's? worried with crows feet will cause extra bunching in my lower lid above my cheek. 3 pictures just to give an idea of my situation? Looking for natural not frozen look. Would I need a mix, filler and botox? How many units do you think I may need?

A: For all your areas of concern I recommend starting with botox. You don't need fillers looking at the pics. Good luck.

Does Botox for wrinkles between eyes cause vertigo?

Q: I had Botox in early December; 10 units only for wrinkles between the eyes. I have very large sinuses In early Jan I developed vertigo, which is believed related to the sphenoid sinus but two courses of antibiotics and I still have severe vertigo. If it’s the Botox, can it be reversed?

A: Botox doesn't give such symptoms and 10 units should be wearing out soon anyways. I recommend evaluation by ENT. There is no reversal for botox.

Is it okay for a nurse practitioner to do Botox? Is it worth exploring this place? GP suggested it?

Q: Hello, I asked my family doctor if she new of any great derms or surgeons that perform botox in Seattle. She gave me a name of a place of a dermologists office. I looked it up to see who would be doing the work, and noticed there are 3 dermatologists 1 astatician and 1 nurse practitioner. In the details I read that the nurse performs botox?? This makes me a bit nervous! Should it?

A: Good question and I would say there are lot of practices where the physicians don't perform the injections but have a mid level provider who does those. I think straight forward injections should not be an issue but if there is any complexity its better to work with a surgeon. Good luck.

Had filler in NL folds and marionette lines same time as Botox. Any risk for infection/biofilm from infected tear due to stye?

Q: 24 hours later stye developed. Not too long after I had a crying episode and a tear from infected eye traveled down to NF injection sites... Sorry if this sounds crazy but the photos of infections online scare me.

A: Fillers and botox injection sites are very small and there is close to xero risk of infection from tears with active stye.

Stye occurred day after Botox? Any chance of infection from stye to treated area?

Q: I have been having reoccurring styes past few months and am currently being treated for them. Had Botox injected around eyes (no stye was present at the time) but developed one 24 hrs later. Any chance of infection from stye to treated area?

A: There should not be an issue with botoc with active stye. The botox injections are outsdie the are of concern.

What is causing this bulge below my lips and what treatment would help?

Q: A plastic surgeon told me it was a muscle and Botox could relax this muscle and make it less prominent. A non surgeon cosmetic specialist told me it could be fat and dissolved with kybella. The buldges create an ugly shadow underneath that looks unappealing. I am 35 years old and normal weight however I weigh approx 10lbs more than 3 years ago when I didn't notice the bulges than. This is why I originally thought it was fat because I only notice this after gaining 10lbs. Opinions? Thank you!

A: The best opinion will be after the examination but usually this area looks like that because of volume loss most likley in upper face and also excessive laxity. Muscle action can pull the angle of mouth down a bit so will need combination therapy.

How do I get rid of my vertical dent between my eyebrows on my forehead?

Q: It is extremely noticeable when I look in the mirror or take pictures a certain way. It wouldn't bother me as much if I was older but I am only 18 suffering with this and it is a huge insecurity of mine. Is there any way this can be treated other than Botox because I feel as if I'm too young to have something injected in my face.

A: The exact nature of treatment for that would be after looking at the area of concern but overall a combination of botox and fillers will get rid of those deep wrinkles.

Can Botox lengthen the upper lip, and if so, how many mm could I expect to gain?

Q: I had an upper lip lift which has pulled up my lips high centrally and made it difficult to close my mouth. I'm wondering if botox can help lower the upper lip. If so, how many mm could I potentially gain?

A: Its hard to tell without looking at the lips but yes botox can help lower the lip and it does enough to cover the gums and make the smile look better.

What could this dent be? I had Botox in July which wore off already could this be related?

Q: I had Botox one time done this past July. The Botox wore off by September and today I woke up and had this dent in the center of my forehead. I did not sleep weird because it has not A: gone away or improved. Could this be related to having Botox before? I am pregnant now and am wondering if maybe that has caused this, if Botox wasn't the issue?

A: Congratulations on the pregnancy. For the dent I don't think that is related to botox treatment. Its natural to have that in the forehead region and can be fixed with combination of botox and fillers.

Botox and Cigna PPO?

Q: I have Cigna PPO can I use my insurance for Botox?

A: Insurance will not cover cosmetic procedures and sometimes they will cover for medical conditions like head aches etc but is very cumbersome.

A few hours after having Botox new lines showed on my face that I didn't have before.

Q: November 1,2017 ,i did botox for my forhead(7unit) and lines between my eyes(8unit) ,but 7hours after between my eyebrown show up two new lines , i never have that before , i want to know this two lines will dispeaerd ? or stay there forever ? what is the reason to make two new lines show up on my face in 7 hours ? any medicine can make botox not affect my face ? (English is not my first language )

A: Sorry to hear that you have new lines but botox doesn't give new lines. Botox will start working after 3-4 days and usually on day 7 you will see no muscle action. If there is any concern after day 7 then I would recommend going back to your injector.

A vertical indentatiom in my forehead has become more pronounced after first-time Botox! Should I get more?

Q: I got only 5 units in the very top of my forehead around 2 weeks ago (when photo was taken). I've always had indents in my forehead but now this vertical indent seems very pronounced. Would you get more treatment or wait for it to wear off?

A: Its very hard to see on the pic from far, but usually I like to treat that areas regularly with botox to relax the muscle and then add a filler to get rid of the deep wrinkle.

What treatment options are available to fix a downturned mouth?

Q: I had Sculptra injected into my nasolabial and melolabial folds. However, it did not seem to make a difference in the downturn of my mouth. Is there another injectable to fix this? Do I need Dysport or Botox for that area? Is surgery my only option?

A: There are different options to address that issue and they include: botox, filler and non surgical tightening like ultherapy. Best would be a in person consult to determine the ideal treatment option.

Would Botox help my asymmetric eyebrows and give them a little lift?

Q: My eyebrows a low and one is naturally much lower than the other, making my eyes appear small. Would Botox be a good solution? I'm 24

A: Yes botox can be used to fix the asymmetry in the eye brows and also to get the desired lift. Best will be to schedule a consultation.

Are there any alternatives to botox and fillers for wrinkles and volume loss?

Q: After a severe allergic reaction t9 botox o refuse to try filler and will never be getting botox again.

A: Its hard to give any recommendations without looking at the face but yes there are options and if the laxity is mild to moderate combination of ultherapy and certain laser procedures can give you the face you like. Also you can try other neuromuscular relaxants and see how you respond to them.

TMJ Botox to slim down jaw line

Q: I don’t have TMJ, but I was looking into bucchal fat removal and was recommended to do TMJ Botox. How many times would I have to get this done to see results?

A: You will need a consultation to see if the masseter muscle is dominant and prominent and in that case using botox will help you slim the face but if the muscle is not prominent then its probably buccal fat.

Botox for Bruxism?
Q: Hello, I am a teeth grinder at night and sometimes in the day without noticing. I was wondering if botox or another injection can help with bruxism? I have heard of this before. Will fillers change the way my face looks (will it appear larger or smaller, sharper, rounder etc..) if I were to get a procedure done for teeth grinding?

A: Botox can be used in the masseter muscle to help reduce the grinding of the teeth. It also gives your face a slimmer look if the muscle is prominent.

How long to wait before getting more Botox after unsatisfactory results?

Q: I had Botox eight weeks ago and unfortunately my usual doctor was away and apparently the replacement didn't look at her diagram and notes. I usually get a very nice eyebrow "lift". This time I actually got drooping on one side and zero lift. I went back and was told she had "de-spocked" me and there was nothing that could be done. I am wondering if I am going to need to wait until the Botox is completely gone or if I can now get some Botox to lift my eyebrows. Thanks!

A: If there is asymmetry that can be corrected with botox even at this stage but it won't give you the lift. To get the lift at this stage you will have to wait until all the botox effect wears out and then you do botox again.

Mild eyelid ptosis from Botox and forehead wrinkling after 4 units of Botox on each side. Can more Botox with an expert help?

Q: 10 days after 4 units in the midpoint of brow- single injection on each side w. new injector- (it was supposed to help w. botox browlift, but my previous Dr. did not inject there) , i noticed mild eyelid ptosis on one side. It has been one month since the injection and it is still there. Drops help a little, but not much. And i got no browlift. Can i get more botox to help at least with the browlift (i think I wrinkle my forehead more since i got this botox job probably to compensate )

A: I would recommend letting the botox wear out completely before doing any more. Also that is most likely wrong placement of botox for the brow lift.

How can I fix my asymmetrical face? Would you suggest a small amount of Botox? What is the best solution for this?

Q: I have always been very self conscious about my crooked face. My right side looks completely different from the left-my right eye slants down, my right cheek is fuller, and my eyebrows grow way differently too. I also do not have much of a chin so my profile is bad. I’m a poor college student though, so I do not have money for surgery. I just feel ugly and that my whole right side slants downward.

A: First of all facial asymmetry is very common so minor differences on either side are left alone but if there are certain areas that really bother you, they can be looked at in depth at the consultation and addressed with botox or fillers or combination.

August 2nd had 40 units Botox in forehead and crows feet. Notice movement on top of forehead and spock brows.Will this wear off?

Q: had botox in forehead and crowsfeet I am noticing movement on top of forehead 3 big wrinkles but only my eyebrows go up on the sides it looks like spock. will rest wear off soon? It's weird and looks funny Will my crowsfeet be next? Will they wear off at same time? My forehead definitley has more wrinkles appearing?

A: The forehead wrinkles or muscle action will just get worse with waiting so only way to fix that is by more botox in the area. For the spock look either let the forehead botox wear out or inject little more above the eye brows to make them look more normal. Easy fix overall.

Follow-up Botox treatment still not relaxing 11s, do I get another touch-up?

Q: I went to doc to get my 11s, forehead area, and crows feet relaxed with botox. I assumed this meant no movement. I understand there may be etched in wrinkles but I am still Abel to frown. I have been to derm for followup and they injected more. It's been a week and it's not much better. Should I request they touch up again? Is it standard practice to touch up until treatment has acheived desired look?

A: Great question. Looking at the picture the line appear pretty deep. So if the other areas: forehead and crow's feet are totally relaxed, it tells you that the injector is most likely doing good job for you and its just the glabellar area that is slow to respond or the muscle is just strong and needs more dose. If the muscle action is gone and wrinkles still bother then you will need fillers to help that area.

Botox and facial.

Q: How long must one wait after Botox before getting a facial?

A: Great question and I don't think there is a definitive answer for this question. I n my practice I tell my patients to wait for 24 hours.

Fine lines on nose bridge between eyes. Caused by facial expression, but lines have formed permanently. Will Botox work?

Q: I have horizontal lines on bridge of my nose between my eyes. I couldn't get them to show up on camera so I drew black lines right where the 3 horizontal lines are. Also have a vertical line in the glabella, not an "11" more like a "1." They are clearly caused by facial expression as they are super pronounced when scowling, but my concern is that since they are now present without facial movements, botox won't help. Can botox fix movement lines that have become permanent when face is at rest?

A: Great question, These lines I tackle with two staged process. First start doing botox in the area to prevent these lines from getting deeper and then if after few rounds of botox they don't get smoothened out then fillers will do the trick. But the key is regular botox before the muscle action returns.

Is there a right or wrong way to insert Botox in masseter?

Q: I had 2 treatments in the masseter area, for both of the treatments it was inserted while relax. When I went for my third top up I was told by the nurse to clench my teeth during the whole process. (All treatments are different Drs and nurses) My masseter aches more than the last 2 treatments. I know every drs and nurses have their own technics. I just wanna make sure if it's okay with what I went through.

A: There are several different techniques to inject botox and every injector is little different. I ask the client to clinch to feel the muscle boundary and then inject while the muscle is relaxed. Bottom line is follow up with the injector where you got the best result.

What works best for forehead wrinkles?

Q: Hello, I am 22 years old and I have a lot of wrinkles in my forehead. I have been thinking about getting botox but I was wondering if there are more permanent treatments for these types of wrinkles?

A: Forehead wrinkles can be successfully treated and maintained with botox. Several small injections are done and repeat it as needed.

Botox has made the ends of my eyebrows high and the start of my eyebrows really low, can this be correct?

Q: I had Botox done 8d ago &a touch up 1d ago as I still had the frown lines between my eyebrows. I also had one eyebrow higher then the other which she said she can correct by making the other eyebrow higher. But the trouble is they are higher at the ends but the start of my eyebrows in the middle of my forehead are lower& have totally changed my eyeshape. I also had Botox done on my crows ft which has worked & got rid of all the lines there. Will my eyebrow shape still change after the top up?

A: This can be easily corrected by injecting more botox laterally over the forehead to relax the muscle on top of the lateral part of the eyebrow. Just have to be careful about the dose and site to avoid eyebrow droop.

I received 7 Botox units in my forehead 22 days ago. When raised, my brows are uneven. How long will it last?

Q: Please see photos attached. The botox is very minimal (as assured by my practitioner); my wrinkles are still visible on the forehead and it really doesn't look like I got anything done. The only effect I see is the inability to raise my right eyebrow fully, which becomes especially evident when raising both brows. I do not want more botox, just an estimation of how long the effect will last based on the # of units and photos. Thanks for your input.

A: This is easy to fix and you don't have to wait all the time to let the botox wear out. Go back to your injector and should be able to balance out the eye brows.

How long should I wait to shower after Botox?

Q: Hi there, I just had my first ever Botox injection on my glabella lines (age 24) I'd like to know how long I have to wait to have a hot shower? I'm going to have a lukewarm bath when I wake up tomorrow but I want to know when I can have a hot shower and properly wash my hair. I really don't want to mess up the injection results so will do whatever to make sure I am being careful. Also, how long do I need to wait to drink alcohol and go to the gym? Thanks so much. Tara

A: Great question. If you read the instructions on the botox pamplet there are several restrictions but there is no scientific reason for most of them. I tell my patients to go back to normal activity and life right after the botox injections. You can shower, have a drink or go to gym any time after the botox injections.

Botox and forehead lines.

Q: Is Botox the best thing to fix these lines on my forehead?

A: Botox works great for the forehead wrinkles but looking at the pictures these look like static lines which will need frequent botox injections before the full muscle action returns to finally smoothen out the wrinkles. In addition to that start anti wrinkle cream too.

Deep Glabella lines at 30. Botox and fillers and still noticeable. What can I do?

Q: I'm 30 and have deep glabella lines. I've been getting Botox every 3 months for a year. As well as fillers even went back twice for a touch up. The lines have improved but are still noticeable. What should I do?

A: Just looking at that pic I think there is more room to add a filler and completely get rid of the lines and then from there onwards continue with regular botox to prevent those from coming back.

Droopy areas on sides of mouth, what are my treatment options?

Q: I'm 46 and have lost 60 lbs over the last two years and the drooping areas next to my mouth are really bothering me. Can anyone tell me what procedure(s) can improve this?

A: Its very hard to see the areas of concern on the limited pictures, but over all to address that area the options are botox/fillers or non surgical lifting and tightening with ultherapy. Best will be to have a consultation so that you can get the pros and cons of each and you can make an educated decision.

I had Botox and lip injections. I left $100 tip, the lady asked if it was for Aesthetician or Injector Dr. Do Dr.'s take tips?

Q: I have had several services at this medical spa, facials, microderm, Botox and others. I have always left a tip but never imagined it my go to the Dr. Am I wrong? should I tip the Dr/ injector? It seems like the aesthetician/assistant does everything but the injection. He does a wonderful job but I have never thought of tipping him or the RN Injector. I send my friends there also what do I tell them about tipping so they don't feel the same awkwardness? Thank you

A: Great question. At our practice the physicians don't expect a tip and we don't accept the tips either. The aestheticians are tipped if they do a good job and that's pretty much normal all over the country to tip aestheticians if some likes to.

Can Botox help uneven eyebrows?

Q: I have uneven eyebrows, one lifts up a bit higher seems to arch more. I am not sure if its the bone that causes the unevenness bcuz my eyebrow bone is more prominent on one side than the other. I also ALWAYS have my eyebrows lifted up(prefer how i look lifted), sometimes I get a headache from doing it so long.. so ive notice some faint lines forming on my forehead. Can I get a brow lift effect, evening of eyebrows, & smoothing of forehead lines w/ botox? I am only 22, is it too early 4 botox?

A: Yes botox can be used to even out the uneven eye brows. Face always has asymmetry and those can be corrected with botox. If there are wrinkles that bother you, age of 22 is not too early.

Is it possible to get Botox for TMJ pain or tight muscles?

Q: I'm 23 years old and I'm tired of waking up with jaw pain every morning, I also have a lot of tension and I don't know how to relax my jaw muscles it's difficult. I don't want to take pills for pain so I would rather have something that will last a while! Also I'm in Upstate New York and I would love to know the price range for Botox here, thank you in advanced!

A: Good question. The masseter muscle in the angle of the jaw area can be injected with botox for the condition and good success. The cost is variable from zip code to zip code.

Botox for line in nose?

Q: I have a line in my nose ahead can i do a botox for it?

A: For botox to work and help the muscle in that area has to be moving and looking at the pic it doesn't appear that way. Will be nice to see in person to give the right answer but most likely will need fillers.

Brow lift Botox gave me droopy eyes?!

Q: so why dont doctors explain this beforehand? I got a bit of botox injected to lift my eyebrows. This was two days ago. Since then, my eyes look smaller and my eyelids dropped. Is this permanent? Its like i got the opposite of what I went there for!

A: Sorry to hear you didn't get the desired effect. Typically combination of forehead and glabellar area botox will give you the eye brow lift but sometimes the trickle effect can relax the muscle that elevates the eyelid and usually this is temporary and recovers much faster than the actual botox for the eyebrow lift

Can Botox be used to lower eyebrows?

Q: Most people want to lift their brows but i want to lower one of mine... My eyebrows used to sit low and straight but over the years for some reason one of my brows cant relax and it makes that half of my face look long. The other half with my straight low brow looks much much better. Ive heard of people having their brows lowered on accident because the botox was done wrong.... But is it possible to purposely get them lowered?

A: Yes botox can be used to help relax the muscle that lift the eye brows and eventually make them look the way you want. Its has to be a very specific dose and area of injection because little change can actually droop the eye lid too much. Good luck.

Am I being given correct info about Botox?

Q: I just went for Botox and asked about my static crease. they said i would need at least 4 prp treatments and one EC02 treatment. That's a lot of money. Any input on the validity of these recommendations? Thanks in advance!

A: My recommendation: start with botox and moment the muscle action starts to come back do botox again and give it about 9 months to a year like that with botox treatment before full muscle action returns. This way the static line will soften and since we have inhibited the muscle there won't be any dynamic line. At that time I do filler in the area to further do the finishing touches and from there.

What is the price of Botox?

Q: I want to get Botox for my forehead lines, I was just wondering how much that would cost

A: Botox cost is variable depending upon the clinic and location. We recommend certain units of botox for specific area that needs to be addressed and if the client ends up getting the recommended dose then if there is any touch up needed we don't charge extra for that. There is a range of botox price from $10 to 16 per unit in Seattle area but you have to be comfortable with the injector first

Botox diluted?

Q: How to make sure botox is not diluted too much?

A: Great question. There are specific instructions how to prepare botox but there is no way to how how dilute it is except the person preparing it. I would say if you got perfect response on the muscle at one place and not same at other place with exact same dose, there can be a concern of dilution. Hope this helps.

Botox at too young an age?

Q: I hear that when you use botox at a young age that the face muscles will at a later stage need that botox to function?

A: Starting botox at early age helps relax the muscles and prevent the wrinkles from happening. Botox is a temporary muscle relaxant and once the effect is worn off the muscle goes back to normal activity level.

Eyelid ptosis after Botox, will it change in 3 weeks time?

Q: Had botox 8 days ago, between my eyebrows and under the curve Of both eyebrows, 1 Siringe in total.The 5th day my right eye lip droop. In 6th day i started iopidine drops wich opens my eye 2 mm but still the ptosis is noticeable. I read that if the ptosis starts the 5th day and after and if from the beginning my eye responds to the drops,ptosis will go away in 3 weeks. Is it true? Will it at least get better in 3 weeks so that the droop isn't so noticeable?

A: Good questions and very sorry to hear you had this experience. It all depends on the actual spot where the botox was injected. Usually it is a spill over effect of the botox while doing the glabellar area and in that case in 3 weeks it should wear off. Now if the botox is actually injected into the muscle that lifts the upper eyelid then it can take little longer. In my experience its mostly a spill over effect and will wear off faster than the botox in actual glabellar area.

Is this normal after Botox and Juvederm?

Q: I had Botox in my forehead about 4 days ago, and Juvederm under my eyes. 3 days after the procedure, i noticed these bumps on my forehead and even around my eyes and it's really scaring me. Is this normal??

A: Sorry to hear about the bumps. These bumps after botox and fillers are not common at all. It could be completely unrelated to the injections. Recommend visiting back with your injector and even a dermatology consultation.

Forehead wrinkles appeared 3 weeks after glabellar lines treated with botox - should I get forehead treated next time?

Q: I had my '11s' treated with botox 3 weeks ago. Whilst I am generally pleased with the very natural results (it was 'light' botox) I'm noticing a couple of new fine lines now right in the middle of my forehead that weren't there previously. I have just a few fines lines on more forehead but only at the lateral sides of my brow. These new lines weren't showing up a week ago when I had my 2 week follow-up apt. Should I get botox on the rest of my forehead in my next apt to avoid this happening?

A: Yes forehead area can be treated with botox and doing together will give good results. If they are concerning you now even doing at 3 weeks is not too bad. Combination treatment will give excellent look to the area and will provide you with a brow lift too if done right.

Hyperhidrosis Botox Treatment Area, will the effects spread? Or do they stay in the injected site?

Q: I've had my first Botox treatment (both armpits) today. The doctor used iodine and starch to find the "black area" and then proceeded to inject Botox into that area only. On both sides, the area was quite small and I usually sweat in a higher place - and have noticed this evening that I am sweating a lot in this higher place, which is untreated. My main question is whether the Botox effects will "spread" (in which case all should be fine!) or whether they would just stay in the injected site?

A: Botox will not spread more than a cm or so. I would wait 2 weeks and see how the results are and if not satisfactory you might need wider area injection. I go my the dominant hair bearing area rather than using any dye.

Fixing asymmetrical top lip with Botox? Please help?

Q: As I went in for a consultation to fix my assymetrical lips with lip fillers I was told that my uneven lip could be fixed with 1 or 2 units of Botox. She claimed that because I sleep on my left side every night it has tighten that muscle on that side of the face and if I use Botox to relaxen that muscle, it will lift the lip back up making it symmetrical. Could this be possible as I've never heard this before and I'm worried I won't be able to move one side of my lips.

A: Its very hard to answer the question without a picture. Its important to see the face in person to determine if its actually a lip asymmetry or the lower face asymmetry. If its just in the lip then fillers might be a better option and if its the lower face then it could be adjusted with botox.
Good luck.

Botox and heavy brow?

Q: Can anything be done to alleviate a heavy brow after receiving Botox in the forehead and glabellar area?

A: Sorry to hear you are having the issue with botox. In my experience the best is to just let the botox wear out over time. The wear out from the spill over effects of botox usually happens quick.

Are there areas for Botox/filler that require less expertise than others where I can save by using a less expensive doctor?

Q: I have a great doctor in NYC, but her prices are at the very top of the range. Can I save by seeing her for the trickier areas and someone cheaper for the more routine areas? Botox: glabella, upper horizontal lines, masseter, platysmal (haven't done this yet but want to). Filler I'm more nervous about trusting someone else, but: cheekbones, lips (and sometimes presuculus), a bit in nasal folds, tear troughs. I'm mid 40s and don't require more than syringe per area, but at $950 a pop it adds up.

A: Good question. The y is to find someone who is experienced and knows whats best for you. Sometimes it involves extra cost to get the expert to work on you. You can find some one doing it at lower cost but overall having two injectors will not give you the best results and you will end up paying more over long term.

My 11s just won't go away! The issue is a pucker. The 11s are not etched into the skin as of yet.

Q: I am very self conscious of my 11's.This past June, I had my first Botox treatment.I had 18 units of Botox injected into the Glabellar muscle and 2 units injected in my upper forehead sides.The Botox did not even touch my 11's, however, the area just above my 11's smoothed out.However, that really wasn't the problem nor a concern. I went back last week (August 3) for 20 More units to the Glabellar area and 10 units in my upper forehead.Six days later and there is no change at all!What is going on?

A: Good question. For the glabellar area if the wrinkles are now static and in skin I recommend using regular botox- inject botox when even slightest of muscle action comes back. Try that for few times and if it still doesn't soften the wrinkles then add filler and that should do the trick rigth away. Just make sure you follow up with botox regularly so it doesn't come back.

What has Botox done to me and will my temporalis muscle go back to normal?

Q: I received botox treatment 4 months ago 6/4/17 on my head crowsfeet & jaw muscles. I was 4 months past my other botox previous but had lighter units as I hate frozen look this time I received much smaller dose I noticed almost immediately my Temple muscles or crows feet eye muscle a distinctive line or pull to my eye muscle that looked distorted and sunken was told it was just the pull unfortunately and worst case it will wear off as botox is not permanent. Will this ressolve ? Thank you

A: Great question and good concern. The lateral part of the eye brow is pulled up and its simply because there is no botox injected in that part of the forehead. options are to let the botox wear out or inject a small amount in the forehead above the lateral part of the eyebrow and that will balance the forehead.

Botox and anxiety?

Q: How long will the anxiety last after Botox 4 days ago? 24 units in frown lines.

A: You should be starting to see the effects of botox soon. The window is 4 days to 2 weeks but in my experience most people will start to show the effect in a week. if you don't see any effect by day 10 time to discuss with injector.

My mouth has become asymmetric following Botox treatment. Is this fixable?

Q: Or will I have to wait for it to wear off? I had Botox injected in between the brows, in the crow's foot regions and in my chin. The left side of my upper lip has been affected, and you can see how much flatter it is than the right side.

A: Sorry to hear you had issues with botox. These are usually because of botox being injected either too much or at wrong location and it can happen with any injector. Two options: let it wear down and you will be surprised how quick this will wear out if it is a trickle effect. Other option is to balance the effect but that can lower your upper lip but will be worth discussing with your injector.
Good luck.

Botox and smoking lines?

Q: Can I get Botox above my lip for smoking lines?

A: Great question. So first thing is to try to quit smoking not just to prevent worsening of lip lines but also for other medical reasons. For the vertical lip lines you will need a combination of botox and fillers to get rid of them. Just one of them will not completely give satisfactory results.
Good luck!

Would Botox in the masseter muscle help slim my jaw?

Q: I used to clench my teeth, and I realize that my jaw area has widened slightly. Will getting Botox help slim it back to the way it was?

A: Yes botox injections in the masseter muscle will help slim the jaw line if the muscle is prominent on clinching the jaw. Its a wide muscle so need more botox than usual but does give satisfactory results.

I had Botox and Restylane injections above for lips for the lip creases. Spider veins above my lip after injections?

Q: Now I have 2 blue/purple lines that look just like spider veins above my lip. Is this normal and will they go away in time? I have 2 blue lines after botox and restylane were injected above my lip. I think it might be what one doctor described as a "Tyndall effect". Is anyone familiar with this and do you know if it will go away on its own? I had the injections done 3 days ago.

A: It is very hard to say without looking at it. Most likely its a bruise or the filler under the skin. Other simple way is to push on that area and if it blanches and then refills then its a vein. Now the veins don't show up after botox or fillers. They were probably there before but can get little prominent after relaxing the muscle. Best is to get evaluated.

Is there alcohol of any kind in Botox?

Q: Hello, I regularly get botox and have an appointment this weekend. I recently had an alcohol monitoring bracelet put on to help with my addiction. My question is if there is any alcohol in the solution? Small amounts will set off the device. Also, is there an alternative to alcohol wipes for prepping the skin prior to injection?

A: Great question. There is no alcohol in botox so it should be safe. Now the cleaning swabs used have alcohol so when you schedule an appointment it will nice to discuss the issue before the treatment so the practice can use non alcohol cleaning agents. Good luck.

Can Botox fix what appears to be a droopy eyelid? Price for treatment?

Q: What can correct what I have and what is the price for treatmeant?

A: great question. Botox can help lift the eyebrows a little when done right. The botox has to be injected at the right places to get the lift otherwise you can get a droop too. The price varies from clinic to clinic so you will have to get a consultation to get the price quote.
Good luck.

I was told not to have Botox injections pre or post op because I'm having an ACL reconstruction?

Q: I was not given the timeframe and this does not make much sense. I can't have dental work for 3 months post op but then I can with antibiotic treatment. Would this be the same Protocol?

A: Botox treatment should not interfere with any surgical procedure unless you are having a surgical procedure in the area you are getting botox.

Can I have Botox for masseter muscle 1 week after removal of wisdom teeth?

Q: OR when I can have this Botox injection will be more safe?

A: Its good idea to wait for 2 weeks to let swelling get better but if the extraction is simple with no swelling post op you can do it earlier too. Good luck.

Is it okay to get blood work done BEFORE getting Botox?

Q: I’m getting Botox for the first time soon. I am getting one blood test done and I was considering scheduling my blood work appointment one day before getting Botox. Is it OK to have this one blood test done one day prior to getting Botox? I wasn’t sure if getting blood drawn a day before Botox would cause any negative side effects to my Botox result. If it’s not OK, what is the minimum amount of days I need to get the blood work done before getting Botox?

A: Botox will not affect your blood work and blood work can be done any time and even simultaneously.
Good luck.

Eyebrow drop after Botox 1 week ago.

Q: I had 55 units of Botox injected 6 days ago. 20u for frown, 10u forehead, 12.5 u crowsfeet each side. Today I noticed a cignificant drop of my right eyebrow. What else can I expect? Are there any more changes coming? Is it going to drop more? Is my left brow going to drop too? How long will this last? Thank you.

A: Sorry for the uneven result. If you get regular botox then this might be your final result since in my practice people who do regular botox will get their maximum result by day 6. Now for the treatment there are two options:
1) Leave it the way it is and and 1-2 weeks the right side will start improving
2)If the uneven look really bothers you, small dose of botox can be injected on left side to lower the left eyebrow so it looks even. This won't give you the lift but at least it will look even.
I do recommend going back to the injector so they can see the uneven result and adjust the areas for next time so you don'e get similar results.

Botox and dental work.

Q: Will having an anesthetic from dental work two days before Botox cause bruising or any other side effect?

A: Anesthetic and dental work before botox should not affect the botox treatment. If you are on any blood thinners then you will be at increased risk of bruising otherwise enjoy the outcome of good botox treatment.

Vertical crease in forehead removal. What is the best procedure?

Q: I am interested in getting rid of the vertical crease in my forehead. I have had this crease for many years. What is the best procedure?

A: I would recommend starting with regular botox treatments before the full muscle action comes back to soften the crease and once its softened if needed fillers can be used to totally eliminate the crease.

Sign up for One of our CoolTone Webinars


Dr. Sidhu
Dr. Ramandeep Sidhu

Author - Dr. Ramandeep Sidhu

SPECIALTIES: Percutaneous aneurysm repair, endovascular treatment of peripheral arterial disease, treatment for varicose veins, open vascular surgical procedures, deep vein thrombosis/pulmonary embolism treatment and aesthetic services.


scroll to top clickable image