I recently participated in an Advisory Board Panel Discussion on Botox®. As always, the conversation was lively and there were a number of very valuable insights that I learned from interacting with my Plastic Surgery and Dermatology peers.
First, we talked about the relative growth of Botox® over the last few years and how this treatment has grown in popularity, despite the economic downturn, and effectively out-performed many of the other elective procedures that we are all performing in our offices. That being said, there was a common feeling that while a majority of our Botox® patients previously saw it as a “nice to have”, they now see their treatments as a “must have” and will actually budget and allot dollars towards each session. In fact, some practitioners even went so far as to say that their clients saw it as their edge in a workplace that has grown increasingly competitive and that they wouldn’t think of giving it up. And from the sentiments of my clients, I can certainly support that.
Next, we talked about trends in the number of units and treatment areas that I clients are choosing. The overwhelming sentiment was that a glassy, polished forehead is no longer the norm and that more and more clients are opting for fewer units in this area to allow for maximal lifting of the brows. What many of us have found is that the more aggressively we treat the forehead muscle and the more we target these lines, the less lifting and shaping we have of the lateral brows. Think of this way. The face is essentially comprised of muscles that lift and muscles that depress. To reverse aging, we generally try and treat the muscles that pull tissue down to allow for maximal lift. However, given that the forehead muscle is a “lifter”, the more we treat it the less arching we see of the brows. So many of us have opted for a more conservative approach to the treatment of the forehead and explain to our patients that they can either have fewer lines and wrinkles or more optimal shaping of the brows. For the most part, my clients generally prefer the latter.
In contrast, the central brow (or “glabella”) appears to be an area where most of our clients still prefer a stronger treatment. The more we furrow our inner brows over time, the more chance we have of developing the notorious “11’s”. And when we do, we can look angry, mean, or simply upset when in reality we are none of these. And so the treatment pattern here is still focused on a stronger blockade of the brow muscles along with gentle elevation and shaping of the inner brow.
The crow’s feet area is less well-defined. Some clients like a stronger treatment and a more thorough eradication of these lines while some prefer to maintain these lines of expression and go for a more subtle approach. As with all of the other areas, discussion with our clients before treatment is essential in determining what should be treated and how aggressively it should be managed.
With that in mind and with seemingly every person somehow connected to the medical profession injecting BOTOX®, how in the world do you know who to choose? The answer is simple. Look for a trained professional with an aesthetic eye who has enough experience to know not only what to do but also what not to do in order to help you achieve the most optimal results. And, above all, do not let price be the determining factor. Unfortunately, you often get exactly what you paid for and so keep in mind that it is far easier to achieve a good result the first time around than to try and fix a bad result after it happens.