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Doctor: We're going to focus on Botox treatment for the elevens or frown lines. This was the first cosmetic application for Botox. Traditionally, when we have placed Botox in this area, we focused on treating it in kind of a V-shape fashion because there are a number of muscles in that area and we want to make sure we get all of those. As we followed our patients over the years, though, we found that that V-shape pattern would often lead to a little bit of a Botoxed look. Here's our patient today, and we've pre-treated her with a little numbing medicine. Whenever we do a repeat treatment for a patient, we always like to make sure its nice and comfortable. I'm first going to mark out the traditional treatment. When we replace her Botox, we would place a small amount right in between the eyebrows, a little bit right at the end of the eyebrow, and then the last injection would be placed over on the side, creating this V. But its this last injection that often time would drop the eyebrow. So instead of placing our injection out on the sides here, we're going to keep it more in the middle and that's going to give her a much more natural look. Botox is something that is dose-related. The original FDA studies were done with 20 units. Subsequent studies show, though, if you use more, it lasts longer and it's more affective. So I prefer to use 25 units in this particular area. We're going to divide that 25 units in between our five little areas. Go ahead and frown for us. Wonderful, and just relax. Botox is something that does not work immediately. It generally takes anywhere from about two to seven days to start working. And the little lumps will disappear just within about a day. Congratulations, you're officially Botoxed.

Patient: Thank you.

Doctor: In this procedure, we're doing to focus on Botox treatment for the horizontal lines in the forehead. These lines are caused by one muscle that raises our eyebrow. If we were to look at our patient...go ahead and raise your eyebrows up...as she raises the eyebrows, this creates the little horizontal lines across here. The way our forehead is designed, we have one muscle that raises the eyebrows and we have the group in between the eyebrows and the muscle out of the outer part of the eyebrow that all pull the eyebrow down. So as we treat the forehead, in the past, we would only treat the middle because we were very worried about that eyebrow drooping. As we gained more confidence, we began to become a little bolder and we began to treat the entire middle triangle, coming up higher as we got out towards the side. With that type of injection pattern, though, it would give the patient movement in the outer part of the eyebrow. If they were going to a Star Trek convention, that might be okay, but for most of us that would be a true tell-tale sign of Botox. The best way to treat the forehead with Botox and obtain a natural look is to place our Botox at the same height following the curve of the eyebrow.

I have a little ruler here and I'm going to inject two and a half centimeters above the brow. So my injection pattern is going to be following the arch of the eyebrow. And we're going to follow that right on the other side here as well. So then if we connect the dots, we can actually see that this begins to mirror the patient's eyebrows. This is going to allow a nice even amount of muscles that will allow her to maintain normal eyebrow movement without any dropping of the eyebrow. Okay 1, 2, 3... We place the Botox in several spots right alone our little line. In the forehead, for most patients, I like to use about 25 units. Botox is something that is dose-related, the more we use, the longer it typically lasts for most patients. So congratulations, your forehead is officially Botoxed.

Prevent That "Botox Look" With These Injection Patterns

Dr. Brian Maloney explains the best injection patterns to avoid looking like you got Botox.

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