Hi, this is Dr. Phil Nguyen with the Botox® Buyer’s Guide. Today we are going to talk about all the facial areas that we can do Botox® . Mind you these are rough guidelines as to the number of units that I typically use. I take a number of factors into consideration when I do Botox® , including:
1. How does the patient look? Are they heavy or thin?
2. How old are they?
3. How deep are the lines?
4. Do they want to be totally relaxed or do they want more softening of the lines for a natural look.
5. Last but not least, what is their budget so that I can give them the best bang for their buck.
So let’s go over briefly each of these 12 areas that Botox® can be used in.
1. Forehead Lines: Starting from the top, the first area that I do Botox® in are the horizontal forehead lines that are above the brows. Typically this muscle responds very well to Botox® , and I will use anywhere from 6-12 units of Botox® . This is the area that I have to be the most careful with, because if you Botox® this area too strongly, patients will often get a brow droop. Meaning that it is the same muscle that lifts the eyebrows, and if they can’t lift their eyebrows, their eyelids will actually feel heavier. Now this is different from the eyelid droop that can sometimes be seen as a complication when we do the glabellar area.
2. Glabellar Lines: The next area we do are the glabellars, and typically the glabellars are the “1’s”, “11’s” or the “111’s” that are seen between the eyebrows. It’s a very strong muscle and I will do anywhere from 12-30 units of Botox® . 12 units of Botox® for younger patients, 20 units of Botox® is probably my average that I do, and 30 units of Botox® I probably save for men who have really, really strong glabellar lines.
3. Eyebrow Lift: After that, the next area will be a little bit of lifting at the edge (end) of the eyebrows here. We can place 2-3 units of Botox® on each side. That will help lift the brows and cause a little bit of this arching of the brows that women often like.
4. Crows Feet: The crow’s feet are next, and crow’s feet, I’ll do anywhere from 4-12 units of Botox® on each side. The manufacturer Allergan recommends 12 units of Botox® and when you do 12 units of Botox® , you get a nice effect, and it will last 3-4 months. Doing less amount of Botox® units like 4-8 units of Botox® will give a nice softening, and typically won’t last quite as long just because we smile so much and the crow’s feet come back the quickest out of most of the areas that I do.
5. Undereye: Some patients ask for a tiny bit of Botox® , like 1 unit right underneath the lower eyelids. What this does is that it weakens that muscle because when you smile, a lot of Asians have this bunching of the muscles there, and the Botox® can relax that muscle as well as open up the eyelids a little bit. I sometimes don’t like this area because it weakens the muscles of the undereye, making it easier for the fat pads of the undereye to protrude out.
6. Bunny Lines: When we smile, some people scrunch their noses and we get these vertical bunny lines, and you need a small amount of units of Botox® , typically 2-3 units on each side will help with those bunny lines.
7. Gummy Smile: The next area below that would be the gummy smile. Botox® is typically done right at the corner of where the nose is and where the nasolabial folds meet. About 203 units of Botox® on each side will impair the muscles that lift the mouth and upper lips up when you smile. It works great for patients that have that gummy smile.
8. Veritcal Lip Lines: This is the bane of many women, especially when they reach over 45 years old. These lip lines – they are called smoker’s lines – you don’t have to smoke to get them. But many women have them and typically I will do about 4-6 units of Botox® on the vertical lip lines altogether. Now, Botox® in the lip lines don’t last very long because we talk, we eat… Sometimes it can impair your ability to say the “R” sound, or the “P” and “B” sounds. It’s not that significant of a complication and many women do Botox® in the lip lines without getting any impairment in their speech, but just so you know, that can happen.
9. DAO / Marionette Lines: The DAO is the muscle that pulls down the corners of the mouth, and leads to a more prominent marionette line. When you do a little Botox® in this area, anywhere from 2-3 units on each side, it can relax the muscles that pull the corners of the mouth down, so that the mouth actually pulls up. It is a nice alternative to doing fillers in this area, but if you have really deep marionette lines, it will give only a slight improvement. What you really need are fillers in that area instead to give a better cosmetic result.
10. Masseters / Jaw Slimming: These are the muscles we use to chew food. A lot of women who are of Asian descent typically have very strong masseter muscles. This creates a very square jaw. A beautiful woman’s face typically has an oval shape, whereas a square face appears more masculine. Women who have very strong masseter muscles have a very masculine jaw, and if we can shrink that muscle, they actually look more feminine. So it kind of gives this illusion of a raised higher cheek bone and a slimmer lower jaw. It’s basically that triangle of beauty that we are trying to replicate.
11. Chin: Botox® can also be done in the chin area as well. A lot of women have this horizontal line above their chin and placing Botox® in that area will help. Women also tend to have this dimpling/orange peel look to their chin. Doing some Botox® in there will relax that muscle so that the orange peeling and the dimpling will not occur.
12. Neck bands: Last but not least, I often do Botox® in the neck bands that go from the bottom of the chin to down the neck. Typically this is seen in thinner women, more athletic women that don’t have a lot of fat underneath their skin. Botox® in that area can impair the neck bands from protruding.
The longevity of Botox® is dependent upon a few factors. First off, in younger patients, Botox® will last longer. Younger patients tend to need less units of Botox® . Less units of Botox® will often soften the lines, as opposed to a total relaxation of the muscles, so that the patients appear more natural and less “frozen”. Using less units will also mean that the Botox® will wear out quicker. It will be a shorter duration of action for the Botox® . So when you use the full amounts of units, it will last longer – the full 3-4 months before you start seeing the lines coming back. Last but not least, when you use Dysport instead of Botox® , you want to multiply the amount of units by a factor of 3. Thanks for tuning in with us at Happy Clinic’s Botox® Buyer’s Guide, we hope to see you soon. Don't forget to download my e-book on PDF format or at Amazon.com on the Kindle format. We hope to see you soon. Bye Bye.
-Phil Hong Nguyen, MD