botox/dysport frequently asked questions

Where are dysport and botox injected?

Now, the main areas of injection for both Botox and Dysport are in the muscles of the forehead, the area between the eyebrows called the Glabella (where people can get etched lines which look like "11's" which make them appear angry), and around the corner's of the eyes to treat those fine lines called Crow's Feet. We also use Dysport and Botox to treat those "bands" in the front of the neck which become more prominent as we become older and in the chin to both lift the corners of the mouth as well as smooth out the chin when it gets that puckered "orange peel" look. As mentioned before we also use Botox and Dysport to treat medical conditions such as migraines, tension headaches, and Bruxism (also called teeth grinding) and TMJ (Temporal Mandibular Joint Inflammation). Although these are medical conditions insurance typically does not cover them so patients have to pay out of pocket like they do with all cosmetic procedures. As for using Botox and Dysport to treat conditions such as "Hyperhidrosis" or excessive sweating of the hands and armpits, I typically do not do that until all other options and medical treatments have been explored as these injections are expensive and last only a few months. 

How long do botox and dysport last?

This is a question frequently arises. Essentially, the average duration of Botox and Dysport are 3 months. This depends on several factors:

1) How much is injected and where: Some injectors dilute the mixture to get more out of the bottle or just plain inject less to save money. The result is that your body breaks down the Dysport/Botox that much quicker. We use the strongest concentration known as a 1:1 ratio. That just means we don't dilute the product to try and save money at the patient's expense. This ratio is the strongest, but does not have any danger of producing Botulism or long term effects. Basically, it means Dr. Messenger is an honest guy who puts his patients first and wants his patients to be happy.
 
2)The patient's metabolism: Patients all have different metabolisms, meaning some people break the product down either faster or slower than the average. Thus, someone with a fast metabolism may get 2-3 months and someone with a slower metabolism may get 5-6 months. To be safe I tell patients that they should expect it to last about 3 months and as such, at the last part of the second month they can expect to start noticing some movement back in the muscles signaling it's time for another treatment. 

3) What product is used: Again with both Dysport and Botox, you can say the average time they can expect is 3 months, but with other forms of material it be less than that time span. 

​How long does it take to kin in?

I always tell patients to wait up to 14 days to see the full effect of either Botox or Dysport. However, because of the way we inject, some people will start to notice an effect within the first 2 days. Some areas of the face kick in faster than others, so if a patient is concerned they look "crooked", I tell them to wait no less than 14 days before coming back in. The reason being is that if we inject a second time to correct an area that has not fully kicked in, the patient will most certainly end up crooked when everything does finally settle in. The technique we have developed ensures smooth coverage of all muscles to create a natural, "un frozen" look so I typically do not receive such feedback. It is also important to note that all of us have some asymmetry in our faces which makes us look natural and unique. We maintain the balance of the asymmetrical face to avoid making people look like mannequins. 

​What are the side effects?

The good news is that patients cannot get botulism and there ​are no long term side effect. The most common issue is if someone injects into one of the danger areas of the face (i.e. right in or under the eyebrow or under the eye itself), they can get a facial droop. This is why it is important to have a quality injector who has years of experience in injections and who knows anatomy well. We always stay far away from danger areas and have not had any incidents where patients have a facial droop. Some people also notice they get a headache from the injections. It is a side effect that hits a minority of the patients and is rare considering we use the same injections to treat headaches. The headache usually does not last more than a day or so and I simply tell patients to take Tylenol, Aleve or Ibuprofen. Finally, with any injection there is the chance of injection, bleeding or bruising. To avoid injection we use a sterile technique and clean the area vigorously multiple times throughout the procedure. To avoid or minimize bleeding and bruising we use a very small needle and inject at such an angle as to minimize pain and tissue trauma. 

​How many times a year should i do this?

As mentioned above, the treatment lasts about 3 months. It wears off gradually and at the end of the second month and patients can expect to feel some motion of the muscles return. We ask patients to do treatments 2-3 times per year as we are now finding that keeping up with injections basically keeps those muscles relaxed permanently. As such, it trains the patient not to make those expressions which contract the muscles which "etch" the lines and this in turn can stop progression of and even begin to reverse some of the lines! So is it worth the effort and cost? Definitely! They have done studies on twins where one received regular doses of Botox/Dysport and the other did not. The twin who had the treatments looked 10 years younger than the one who did not when they reached their 50's.

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