Looking for an effective non-surgical solution to combat visible signs of aging such as crow’s feet and forehead creases? BOTOX® Cosmetic treatment is a very popular simple office-based procedure that can smooth away unwanted facial wrinkles. When administered by an expert injector, BOTOX® can provide natural looking results to leave you looking refreshed and revitalized. Our San Diego facial plastic surgeon, Dr. John Hilinski, utilizes his extensive experience to skillfully perform BOTOX® injections to restore a youthful appearance while ensuring that patients never look “frozen” or “overdone”.
“I have been going to Dr.Hilinski for injections for about a year now. The results are always exactly as we discussed, and most importantly natural. Dr. Hilinski is really amazing at what he does. I have referred many of my friends to his office, they all have had the same experience, and look amazing. He is so friendly, and extremely knowledgeable. I have never had a better experience with a Doctor. I have complete trust in him as a patient and will continue to recommend him to anyone that is looking for a Facial Plastic Surgeon.”
How Does BOTOX® Work?
Skin loses elasticity as we age and repeated facial movements can eventually lead to fine lines and wrinkles. BOTOX® works by preventing muscles from contracting. Because muscles are the source of skin creases and wrinkles, relaxing their movement results in a smoother skin surface.
BOTOX® is used most commonly on the sides of the eyes (crow’s feet), in-between the eyebrows for vertical skin creases, and within the forehead for horizontal skin creases. Dr. Hilinski performs a series of tiny injections strategically placed into select muscles to relax their movement. The injection itself takes just five to ten minutes to complete.
What to Expect – BOTOX® Results and Recovery
BOTOX® can deliver noticeable results quickly, with little to no downtime. An improvement in wrinkles can be seen as early as 48 hours after the procedure, and will continue to improve for several weeks. Patients typically enjoy a well-rested and refreshed appearance for 3 to 4 months after their procedure. Most patients return to normal activity within a few hours of BOTOX® injection.
BOTOX® and Forehead Movement
Dr. Hilinski is double board certified in both Facial Plastic and Reconstructive Surgery and Head and Neck Surgery, which gives him a deep understanding of facial anatomy and uniquely qualifies him to meet individual patient needs and goals for BOTOX® injections. Patients who understand how forehead movement works can be more empowered in their cosmetic choices. One way to approach injectables for the forehead is to consider the forehead as two opposing regions. The lower forehead corresponds to the eyebrows, the area in between the eyebrows, and the area immediately above the eyebrows. Then there is the mid to upper forehead that corresponds to all the areas above the lower forehead.
Why does anatomy matter when it comes to Botox injections and rejuvenating the face?
This matters because these groups of muscles act very differently when it comes to facial movement. Some muscles act as brow depressors and some act as brow elevators. For example, when the lower forehead muscles contract (when you move them!), they pull the eyebrows down. This is shown in the adjacent Botox diagram. Go ahead and make a frowned face like you are mad – you will see how your eyebrows get pulled down and inward toward the nose. These muscles are responsible for creating those unwanted ’11s’ that lead so many people to get Botox cosmetic injections.
In contrast, the mid to upper forehead muscles move in the opposite direction and act as brow elevators. When these muscles contract, they pull the eyebrows up toward the top of your head. Again, try it for yourself. Make surprised look in the mirror and you will see how your eyebrows pull up. You’ll realize that these are the muscles that create unwanted horizontal wrinkles across the forehead.
So in summary, the brow depressors are responsible for making those pesky ’11s’ in between the eyebrows and pulling the eyebrows down. The brow elevators are responsible for making all those horizontal wrinkles across the forehead and pulling the eyebrows up.
So what is the best BOTOX® method for forehead injections?
If BOTOX® is injected only into the brow depressors, you will not be able to frown and the eyebrows will sit in a higher position. If BOTOX® is injected only into the brow elevators, the forehead will appear very smooth, but the brows may drop lower and feel heavy. Dr. Hilinski customizes his injections to correspond with the unique anatomy of each patient, but typically focuses first on stopping movement of the brow depressors and then takes a conservative approach when injecting the mid to upper forehead muscles. This strategic BOTOX® method can offer more balanced and natural looking results.
BOTOX® for Bunny Lines
Did you know that Botox and Dsyport are commonly used to treat our San Diego patients who have bunny lines? But wait a minute. Bunny lines sound kind of cute, right? But they aren’t when it comes to facial animation and wrinkle formation.
Bunny lines are wrinkles that form along the side of the nose as a result of facial animation and movement. When someone makes a mean face or snarls, the underlying nasalis muscle of the nose contracts. The overlying skin then bunches up in several different folds creating the unwanted bunny lines. It is actually fairly common to see the bunny lines form in conjunction with the unwanted ’11s’ that so often form in between the eyebrows. While people often schedule BOTOX® injections for unwanted forehead lines, this area is sometimes neglected. For San Diego patients bothered by bunny lines, Dr. Hilinski carefully injects BOTOX® under the skin of the nose to help target the underlying nasalis muscle. Once the injection takes effect, the muscle movement is greatly reduced, thus reducing the wrinkle formation in the bunny lines.
If you have heard of baby BOTOX® or micro BOTOX® as a more natural looking alternative to BOTOX®, it can be confusing to learn that it is the same exact product as traditional BOTOX®! Although the term baby BOTOX® has only recently gained more popularity in the cosmetic industry, Dr. Hilinski has been performing these micro BOTOX® injections for years! Just ask the countless numbers of BOTOX® patients that have come to our office and continue to get treatments done religiously every three months. As part of his goal in trying to achieve more natural BOTOX® results for all of his San Diego patients, Dr. Hilinski incorporated these baby injections long ago.
How Does Baby BOTOX® Work?
Baby BOTOX® is a method of using a lower dose of BOTOX® to achieve more subtle results. When we say a lower dose of BOTOX®, we are referring specifically to the number of units of botox that are being injected into the skin. It really doesn’t have to do with the volume of the solution being injected, but the fact that there are fewer units of botox being used in a certain area.
Take, for example, the mid to upper forehead region. In many cases, practitioners will inject between 10-20 units across the entire forehead to address those pesky horizontal wrinkles. Unfortunately, injecting this amount of BOTOX® will risk causing the forehead to look too frozen. Plus, it will risk dropping the eyebrows down – creating a heavy feeling and look to the forehead. Baby BOTOX® – in comparison – would involve injecting perhaps 5-7.5 units of botox instead. It is the same surface area being injected as with the 10-20 units of BOTOX®. But only 5-7.5 units of BOTOX® will be used across this area – making the ‘density’ of the BOTOX® injection much lower. It is called baby or micro BOTOX® because it is a fraction of the normal units being injected. The end result of these baby injections is that the forehead muscles will not be as frozen. The baby BOTOX® helps to slow down their movement, and reduces the wrinkling, but not as densely as normal injections of BOTOX® in the forehead. Patients may still see some residual movement in the forehead – but that is a better scenario than looking overdone and frozen.
Is a Different Technique Used for Baby BOTOX®?
The answer really is – sometimes. If you are very knowledgeable regarding how to inject botox – like Dr. Hilinski and his staff – then you are already injecting botox in the precise areas that need it to get the best cosmetic result possible. So in that sense, there is not going to be a huge shift in the technique of injecting baby botox. It would simply be a matter of injecting less numbers of units in each location. There are instances, however, when the injection technique for baby botox will differ compared with traditional botox injection.
Is Baby BOTOX® Cheaper?
The answer is – usually. Since baby botox involves injecting less BOTOX®, this treatment should typically cost less compared with traditional injections.
Who Should Get Baby BOTOX®?
Baby BOTOX® is particularly well suited for younger patients interested in wrinkle prevention, as well as patients who are in the public eye and prefer to maintain a consistent appearance with more frequent injections of fewer units. Keep in mind that if you happen to have very vigorous muscle movement (and associated wrinkling), then baby botox may not be the best option for you. This is particularly true and applicable for men seeking botox injection (see our discussion regarding ‘Brotox’ treatment).
The Truth About Diluting BOTOX®
Many patients in our San Diego office ask us how they can tell if a doctor is diluting their Botox. Understanding how BOTOX works can help you be an educated patient.
How do I know if my BOTOX® injection is being diluted?
The only way to determine if you are getting the right amount of BOTOX® is to confirm the number of BOTOX® units you are getting (and paying for!) You can’t tell based on looking at the syringe or judge the strength of your injection by how many syringes the doctor has given you.
Diluting & Reconstituting BOTOX®
Allergan, the maker of BOTOX®, delivers units as frozen powder and the doctor or provider is instructed to add in 4 cc’s of liquid into a 100 unit bottle. This translates into a dilution of 25 units of BOTOX® in 1 cc of solution. The syringes used to inject BOTOX® are 1 cc – so one full syringe would have 25 units of BOTOX® in it. If a provider dilutes their BOTOX® by adding more than 4 cc’s of liquid, then the patient will not get the strength of BOTOX®, or the results, that they expect. BOTOX® dilution may be more likely if the office charges by the syringe or by the area being treated, rather than charging by the unit. Dr. Hilinski is committed to transparency and maintaining the trust that his patients have in his skill and integrity. Our office has always charged by the number of units of BOTOX®.
Fortunately, most places don’t charge per syringe of BOTOX®. But some San Diego clinics will charge per area of BOTOX® injection, which is just as bad (or wrong) in our opinion. That is because you still don’t know how much actual BOTOX® you got for that one area. They may pull out one syringe – which looks just like a syringe that might be properly diluted with BOTOX® – and use that for the 1 or 2 areas. But as a patient, you should know exactly how much BOTOX® you just got – and are paying for! Why wouldn’t they tell you how many units of BOTOX® you are getting? The answer is because they can get away with giving you less units of BOTOX® by charging by the area!
The only true (and honest) way for patients to know how much BOTOX® they are getting is based on the number of units of Botox. If someone is charging you by the syringe of BOTOX® or by the area(s) injected with BOTOX®, there is much more of a chance you are getting cheated on the price – we’ll explain why.
Charging by Units of BOTOX®
Let’s say we charge $12 per unit of BOTOX® and you are getting 20 units for treatment of forehead wrinkles. That equates to $240 for the BOTOX® treatment ($12 x 20 units). Dr. Hilinski pulls out one syringe, which was diluted the proper way for BOTOX® and contains the 25 units it should. Dr. Hilinski does the BOTOX® treatment and you are utterly happy with the outcome!
Charging by Syringes of BOTOX®
Let’s say a doctor is charging you by the number of syringes of BOTOX®. And they are offering a special on BOTOX® at $200 per syringe. You may think that is a deal on BOTOX® since you can get one ‘whole syringe’ of Botox for $40 cheaper than Dr. Hilinski was just offering. So you go in there and get a BOTOX® injection to your forehead. What you don’t realize is that this office diluted their BOTOX® as explained above and one syringe of their BOTOX® contains only 10 units! You just paid $200 for what you thought was a normal amount of BOTOX®, but you only got 10 units – and paid $20 per unit of BOTOX®! Plus you aren’t going to get the same cosmetic result in terms of wrinkle reduction because you got less than half the recommended number of units of BOTOX®.
Charging by Area of BOTOX®
Let’s say a doctor is charging you by the area treated with BOTOX®. You can fall victim to the same problem – you just don’t know how many units of BOTOX® you are getting. If the doctor charges you, for example, $200 for the forehead area – they may give you just 10 units of BOTOX®. So you end up paying $20 per unit of Botox and are also getting a suboptimal BOTOX® treatment.
The Bottom Line on BOTOX® Pricing and Dilution
The only consistent factor between BOTOX® treatments is the number of units you are getting. One unit of BOTOX® in one office is the same as it is in any other office. And 25 units of BOTOX® is the same as it is in any other office. But one syringe of Botox is not. And one area of BOTOX® means something different in each office. So take care to choose a BOTOX® practitioner who will charge you based on the number of units of Botox you get.
BOTOX® Pricing and Financing
Dr. Hilinski is dedicated to personalized treatment for each patient and never takes a one-size-fits-all approach. The cost of BOTOX® will vary depending on amount being injected, which will be determined based on your aesthetic needs and goals and will be discussed during your consultation appointment.
We offer several financing options to help you fit BOTOX® into your budget. Learn more about payment options.
Brilliant Distinctions is a program offered by Allergan, the maker of BOTOX® Cosmetic and JUVÉDERM® products, to help loyal patients stay abreast of specials and exclusive invitations. To learn more about Allergan’s Brilliant Distinctions program click here.
FAQ – Frequently Asked Questions About BOTOX® Cosmetic
Do BOTOX® injections hurt?
Each individual may have a different experience, but patients typically report that BOTOX® injections are not painful, although there may be a pinching or brief stinging sensation. A topical anesthetic can be applied to the skin thirty to forty-five minutes before injections, along with a cold compress used just prior to treatment, to minimize any discomfort.
How long does BOTOX® last?
Optimal BOTOX® results typically last 3-4 months, but the time frame can vary depending on the strength of the muscle that is targeted, and the dose of BOTOX® that is used.
Do men get BOTOX®?
Yes! Dr. Hilinski’s understanding of the subtle difference between men’s and women’s facial muscles allows him to perform BOTOX® for men in a way that can restore a youthful look while still preserving a masculine appearance. Learn more about “brotox”.
Is BOTOX® right for me?
Good candidates for treatment include men and women who have unwanted wrinkles which appear with animation and emotional expression. Termed hyperdynamic lines, these wrinkles are the result of underlying muscle contraction in areas of dynamic movement.
Get Non-Surgical Facial Rejuvenation with BOTOX®
We’re happy to answer any other questions, or provide additional information about BOTOX®, other non-surgical cosmetic treatments, or facial plastic surgery. Contact us to schedule your consultation or BOTOX® appointment at our San Diego office.
Dr. John Hilinski has either authored or reviewed and approved this content.