Botox® and Dysport®

Why should I see a cosmetic dermatologist for BOTOX® and Dysport® injections?

It is true that today, many non-dermatologists perform procedures out of their area of specialty, in order to bite off a chunk of the cosmetic pie. However, neither dentists, nor gynecologists, family practitioners, ENT’s and other non-dermatologists have any training in treatment of the skin and of facial expressions. As a cosmetic dermatologist, I spend every day, the entire day treating patients’ skin, for both medical and cosmetic purposes. I pride myself not only on my background and training, but my sense of aesthetics, which is rooted in my background in music and art. This helps me ascertain that my patients walk out with a natural looking, yet effective treatment. The best compliment is when they come back telling me how their friends comment on their youthful looks, without knowing that they came from a bottle. I also offer treatment by the area, not counting units. This lets me avoid overtreatment the first time, alleviates the patient’s worry about having to pay for a touch-up, and add more after a week at no charge if needed. This way, my treatment results are neither over, nor under treatment, yielding a natural, pleasing look. Charging by units or other ways often result in pressure on both the patient and doctor. In my practice, this is one less thing for you to worry about.

I am worried about looking “frozen”.

That is a good point. Too much of a good thing is…too much. I personally also prefer a relaxed rather than the frozen look. For this reason, especially when I treat someone the first time, but also each time thereafter, I always recommend to start conservatively. After the BOTOX® or Dysport® takes effect, usually 5-7 days, I ask the patients to return for a touch-up. If there is any place that was under-treated, I inject more BOTOX® or Dysport® at this time. This allows me not to overdo the initial treatment, and avoid that motionless, unnatural look.

Do I have to pay for the “touch-up” treatment?

No. Unlike in many other practices, there is a one time charge per area only. Touch-up treatments are free of charge. This way, there is no pressure on me to inject too much initially, and there is no worry on the side of the patient that if they need more, it will cost them more. Over the years, this system made me and my patients very comfortable.

What is BOTOX® and Dysport®?

A treatment I like to describe as “little pain but much gain,” BOTOX® and Dysport® are so widely popular, they are considered by some to be “the aspirin of the 2000’s”. In recent years, BOTOX® and Dysport® have become the number one procedure of choice for facial rejuvenation.

BOTOX® and Dysport® are substances made from Botulinum Toxin A, and are injected in minute amounts into the skin to decrease the “angry look” that many people develop from years of frowning. BOTOX® treatments are real crowd pleasers, since they erase many years worth of unwanted lines that result from facial expressions. The treatment is easy, takes only 10-15 minutes, but that little bit of BOTOX® or Dysport® makes a huge visual impact on the appearance. BOTOX® and Dysport® injections are one of the most common cosmetic treatments in my practice, and I admit that I use it myself. It’s also the easiest way for someone considering a cosmetic treatment for the first time to get their feet wet and experience the benefits of rejuvenation the easiest way possible.

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Board Certified Dermatologist,
Dr. Hellman performs all treatments herself

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Before & After Photos

Botox® and Dysport® : Before And After Photos: Female - (frontal view)
Botox® and Dysport® : Before And After Photos: Woman - (frontal view)

*Results may vary

How does BOTOX® and Dysport® work?

BOTOX® and Dysport® have a temporary effect on the muscles in the areas injected, stopping them from moving. In turn, this eliminates the wrinkling that results from the motion of those very muscles and restores the youthful look of the face. The onset of the effect takes about 5-7 days, and lasts between 3-5 months on average.

I also consider BOTOX® and Dysport® to be a method of behavior modification for the muscles injected, since patients learn to express themselves without constantly using and overusing them. Because of this effect, as well as a small degree of weakening in the muscles causing the wrinkles due to BOTOX® and Dysport®, the time between successive treatments will get longer and longer over a period of several treatments. I have many patients who come every 6-8 months only.

Are BOTOX® and Dysport® dangerous?

BOTOX® and Dysport® Cosmetic are not considered dangerous at all. It has been approved by the FDA for treatment of the frown lines between the eyebrows, but for many years before, it has been used for neurological disorders, ophthalmologic problems and treatment of migraine headaches. There has been a lot of experience with BOTOX® and Dysport® over those years, and the FDA-approved BOTOX® and Dysport® Cosmetic has not been known to result in any serious complication. It is important, however, to have the injections by a trained MD who uses the product approved in a medical setting. BOTOX® and Dysport® parties, injections at malls and other forms of “casual” BOTOX® and Dysport® can cause unwanted complications.

But I heard that BOTOX® and Dysport® are toxin’s, isn’t that dangerous to inject?

No. The word toxin may sound scary, but the BOTOX® and Dysport® Cosmetic product is carefully purified, and the amounts injected are simply tiny, just enough for the small muscles of facial expression. Additionally, BOTOX® and Dysport® only works on those muscles in that very small area of injection, and is not capable of traveling long distances to impact other organs and systems in the body. No serious complications have occurred from using BOTOX® and Dysport® Cosmetic for facial muscles as described above.

Who is a candidate for BOTOX® and Dysport®?

Anyone with wrinkles resulting from facial expression is a candidate. I treat not only women, but also a lot of men. The typical ages range from early to mid 30’s and into the 70’s and beyond. Occasionally people have hereditary wrinkles which develop very early on. I have treated such patients in their 20’s, and helped restore the youthful look they were missing.

Which wrinkles respond to BOTOX® and Dysport®?

BOTOX® and Dysport® are most commonly used to soften the frown lines (the so called 11’s) between the eyebrows, eliminating the “angry” look. It can also be used for the horizontal lines of the forehead, the crow’s feet around the eyes, the “bands” on the neck, and can help turn up the corners of the mouth from their downward position as a result of aging. It also works on vertical lines on the upper lips that are common in smokers, and has even been used to lift the tip of the nose

What about the nasolabial folds and other wrinkles?

The nasolabial folds and in general most of the lower face wrinkles are a result of gravity and loss of elasticity, not dynamic muscle movement. Therefore, they don’t respond to BOTOX® and Dysport®; rather, those can be treated by injecting fillers, such as Restylane, Perlane, Radiesse or others. You can read about the different fillers in a separate section.

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QuestionIs the treatment painful?


BOTOX® and Dysport® are injected with a tiny, thin needle. Many of my patients have no trouble tolerating it without numbing. However, for the ones who hate the idea of pain, I offer topical numbing cream, which is applied in the office for about one hour, and which makes the treatment virtually unnoticeable.

QuestionHow will I look after the treatment?


Right after the treatment, there is only a minute amount of redness and perhaps a tiny “bump” where the needle enters the skin. On very rare occasions, there can be a bit of bruising, which can be covered up by make-up, and resolves over a period of a week. At first, BOTOX® and Dyport produces no visible change. However, over the course of 5-7 days, the injection “kicks in”, and you will suddenly realize that the muscles injected are not moving very much. This effect is the one which lasts and gradually wears off after 3-5 months. Generally, I recommend for the BOTOX® and Dysport® treatment to be timed about 2-3 weeks before a big event such as weddings, etc, so that there is time for it to take hold and for any possible marks to be gone. This also leaves enough time for the touch-up treatment if needed.

QuestionWill I look worse if I don’t continue with BOTOX® and Dysport® treatments?


No, in fact often the contrary is true. If you stop the treatments, the skin will simply return to the natural look you had prior to the treatments. Often, there is a natural improvement of the original wrinkles, due to decreased muscle use while the BOTOX® and Dysport® is effective, as well as due to the behavior modification effect I wrote about above.

QuestionAre BOTOX® and Dysport® expensive?


The material used in BOTOX® and Dysport® is costly, and once a bottle is opened, it will have to be discarded if not used. The initial cost of the 1st area covers the cost of the material; additional areas carry a greatly reduced charge. Generally, pricing by area is more advantageous for the patient, since pricing by unit, as practiced by many doctors, is usually more expensive per treatment.

QuestionWhat about the creams I see advertised that are supposed to be as good as BOTOX® and Dysport®?


If there was anything living up to that promise, BOTOX® Cosmetic (and Allergan who makes it) and Dysport® would be out of business already. False claims made often prompt people to purchase topical creams, which only result in disappointment. Don’t be naive or gullible – check out any claims made before you put your faith and money into a product. Think about the ads for pills that promise miracle weight loss of many pounds virtually overnight without exercise or dieting…would you believe in those products delivering what they promise?….Now, just apply the same thinking to “just like BOTOX® and Dysport®” topical products. If I made my point, you can put that money to better use for seeing a good movie, or saving it up for a genuine BOTOX® and Dysport® treatment that will restore the look of youth you are looking for.

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