Botox Cosmetic

Botox CosmeticTM for Dynamic Lines, Wrinkles & Facial Expressions

If you haven’t had Botox before, or are wondering how you could get even better results- this will help you understand how Botox works and where it can be used. We divided the areas into upper, lower, mid-face and neck: this is followed by a short section on therapeutic (medical) indications for Botox.


Muscles of expression

Image result for muscles of face and neck

Neuromodulators such as Botox work by relaxing facial muscles of expression, thereby softening dynamic facial lines. Results are dependent on precise placement of the injection, as facial anatomy is quite complex, some muscles overlap, and specific parts of a muscle are responsible for different types of movement.

Some commonly treated zones/problematic expressions are:

Upper Face

  1. Frown lines between eyebrows (Glabella) (Procerus, corrugator muscles)
  2. Crows feet (orbicularis oculi muscle)
  3. Horizontal Forehead lines (frontalis muscle)
  4. Bunny Lines -side of nose (nasalis muscle)
  5. Bunching under eyes (orbicularis oculi muscle)
  6. Low brows (orbicularis oculi, procerus muscles)

Lower Face

  1. Puckering of upper lip-vertical lines (orbicularis oris muscle)
  2. Gummy smile (LLSAN muscle)
  3. Downturned corners of mouth (DAO muscle)
  4. Crinkling or orange-peel chin (mentalis muscle)





Botox for Gummy Smile






Botox for Crinkling or orange-peel chin







Botox for down turned mouth



  1. Botox can be used to improve discomfort associated with bruxism or to create a more oval- shaped face (Masseter Muscle)

Treatment of Masseter Muscle



  1. Nefertiti Lift – for cords in neck to improve jawline (Platysmal Bands)
  2. Horizontal neck lines (platysma)








Platysmal Bands Nefertiti Lift

More about Neck Rejuvenation


Botox will not treat problems caused by volume loss and sagging

Botox will not be helpful in treating jowls, marionette lines, hollows under eyes, or deep nasolabial folds. These are related to shrinkage of fatty tissue in the deep fascial compartments of the face and can be addressed with dermal fillers such as Juvederm

Properly done, Botox creates a more refreshed, relaxed look….

In the hands of an experienced injector with proper knowledge of functional anatomy, Botox treatments will create a more refreshed, relaxed you, softening angry, tense or sad expressions

Lazer Room Case: Before & After Botox (results may vary)


  • Botox starts to work in 2-3 days and reaches its peak effect in 7-10 days
  • Botox lasts approximately 4 months: most people should have treatments 3 times a year. Maintaining  regular injection schedule slows down the external signs of aging. 
  • Going too long in between injections only allows the development of deeply etched lines that will not be completely resolved by Botox. See below

Q: How do I Know if Botox will help my Wrinkles?

A: Do the stretch test – stretch the skin around the wrinkles – if the lines disappear, they will be helped by Botox; no change – next step is laser resurfacing – see example below

Lazer Room patient following Smartxide CO2 laser for deep lines and baggy eyes (results may vary)


   Therapeutic Uses of Botulinus Toxin


Some of the more common therapeutic uses of Botulinus toxin are

  1. Focal Hyperhidrosis (excessive localized sweating)
    can affect underarms (axillae), palms, feet or face & scalp (craniofacial) hyperhidrosis; as opposed to generalized sweating, which can be a result of fever, hormonal imbalances, side effects or withdrawal of medications, underlying systemic disease or neoplasm. Dr Hyland will take a full medical history to ascertain the cause of the problem and discuss treatment options, which may range from topical antiperspirants, iontophoresis, medication, Botox TherapeuticTM injections, or surgery (cervical sympathectomy)
  2. Prophylaxis of chronic severe Migraine Headaches
    Depending on the frequency and severity of migraines and the person’s prior response to prophylactic medications, a patient may qualify for insurance coverage for Botox therapeutic injections, which are administered in a strict protocol at 12- week intervals. A review of the patient’s history, including investigations and responses to different medications, will be undertaken prior to prescription and administration of Botox TherapeuticTM
  3. Cervical Dystonia
    Painful spasms of muscles of the neck and shoulders- which may arise de novo, or as a result of injury eg whiplash. Often patients have undergone months of interventions such as physiotherapy, massage therapy, chiropractic adjustments or acupuncture without significant relief, but may respond dramatically within a few days to small doses of Botox TherapeuticTM
  4. TMJ dysfunction/headaches resulting from bruxism
    Pain may be distributed in front of the ear, the temple, base of skull or even back of the neck/shoulder, and may even result in the erosion of tooth surfaces. This is considered an off-label indication for Botox TherapeuticTM, but may afford significant relief to patients not responding to physio and bite-guards.
  5. Other therapeutic indications
    such as cerebral palsy, overactive bladder, blepharospasm & strabismus fall under the purview of the appropriate specialist.

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