Male Voice: The first thing is, as I've said over and over again, we've got to evaluate each patient's musculature, we've got to look at their expressions. Everybody's got a different expression. Me, her, Jim Carrey, everyone else can do different things with that exact same musculature, so we've got to look at the expression, especially with the eyebrow position.

So, when I look at her the first thing I want to have her do is have her frown. So go ahead and frown and you can see that there's not a lot of muscle movement on the frown so she doesn't need a lot of botox there, but you can start seeing some of the lines developing, and this is from the unconscious, subconscious elevation of the eyebrow that happens during time when the eyebrow starts feeling a little bit more heavier. If you raise the eyebrow, you can see the lines go across the entire brow, but she does still have a very nice arch. In younger patients botox works very nicely to prevent these lives from getting deeper or preventing from getting them in the first place. It's much nicer in younger patients, as older and older you get, you might need other options. Botox by itself is just not going to do it, you may need a brow lift where you can see my partner Dr. Koolak, for that, you may need laser resurfacing.
There's other options that you may need, but for this age group botox is beautiful, it works very nicely.
So we're going to do some botox injections and I'll show you how. So I start off by taking a little alcohol wipe, I don't take off women's makeup, they're just not really happy when you take all of their makeup off. Just a little bit of dapping with alcohol is enough. It doesn't need to be completely sterile, it's not a sterile procedure, but it's nice to just be able to see a little better.
I've used different types of needles and syringes in the past. I've showed you how I've liked BD needles with syringes. They do have a hub. The hub loses some botox in it, but the needles are really sharp, and they're less painful, the sharper it is, the less painful. We do have another type of needle or syringe as well, this is kind of the typical insulin, or TB needle and syringe that almost 90 percent of doctors and surgeons use. The nice thing about it, there is no [hub], you don't lose any of the precious, valuable botox. But I'm doing less, meaning a lower amount, and the hub is really important. I don't want to lose much of botox. I'll go to this, because I'm doing just a few little pokes, and the needle's not going to dull out as quickly. If I'm going to do a larger area than I'm going to use the other needle and syringe, because it does dull out normally with this one, I prefer the others...
Is injecting the procerus, I grab it between my fingers. This is the muscle that creates the lines that go across the root of the nose, and I put in about four or five units right there, and you can see that's all there was over there. Then we got the depressor super-celia, it's the muscle that most doctors miss. It's right in this area. And what this does, just one or two units of this, it prevents the eyebrow from going down. I would say that 90 percent of doctors don't do this, so when they botox up here, the brow goes down and it just looks aggressive and it's not a good look. By injecting the depressor super-celia right here, what you're doing is slowing down the muscle that pulls the medial head of the brow down, and by paralyzing that muscle, it actually raises the medial head of the brow, or at least doesn't allow it to go down anymore.
A little bit of pressure here and we continue with the corrugator, so the corrugator starts here with the first injection, and then the lateral corrugator's over here, the second injection. Then I don't want it to have a hyper-arch, so a put a small little dose right here- this is about a unit, not a very high dose. This is so the brow doesn't go too much and she doesn't get that Spock-eyes that not a lot of people like seeing. Then what I want to to go so we're going to do again the medial corrugator right here, the lateral corrugator which we're going to do over in this area, and then my third dose, which was equivalent to the lateral part of the orbicularis, which I'm coming over here. A very small dose right there.

Now we go to the forehead. A medial frontalis. Don't paralyze the forehead totally. We don't want a paralyzed forehead. Another little drop right here to the frontalis. We want to try to kind of use your X-Ray vision to look through the skin and see if we can see big blood vessels, and my last dose, if I have some left over, is right down here in the middle, and what this is going to do is it's going to open up the eyebrows, lift the medial head of the eyebrows, and just soften up the forehead a little bit, but not paralyze her. We don't want to be totally paralyzed. It's not a good feel, it's not a good look. She can be paralyzed here but the forehead still needs to be mobile and moveable.

Botox Injections Works to Prevent Wrinkles By Paralyzing Small Muscle Groups

Botox is an option for consumers who are looking to prevent the development of wrinkles, but it does not reverse the effects of natural aging.