Botulinum Toxin Injections

Cosmetic Botulinum injections can prevent or improve wrinkles. Areas treated for this patient were the forehead, the glabella (between the eyebrows), the crow's feet, masseter (jawline slimming), and Botulinum lip flip to add volume to the lips. In total, 70 units were used. The treatment is customized to help each patient achieve the desired result.

• What are neurotoxins and what can they treat?

  Rhytids (wrinkles) can be dynamic (present only during a certain facial expression) or static (present with the face at rest). Dynamic rhytids (such as ’crow’s feet’ visible near the outer portion of the eyelids during smiling) can be improved with neurotoxin injections (i.e. Botulinum). Neurotoxin injections may also have beneficial effects on certain static rhytids (such as horizontal forehead lines). Neurotoxins weaken muscles, thus resulting in decreased wrinkles that are caused by muscle contraction. Regular neurotoxin injections help prevent the formation of wrinkles. It takes up to two weeks to see the full results from the injection though you may start to notice some changes within a few days. Results typically last around 3 months, though there is some variability from patient to patient. 

• Am I a candidate for injections?

  Age is not a factor in determining candidacy for neurotoxin injections. Each patient is unique and has different needs and desires. The best treatment plan to address your concerns will be discussed after evaluation by Dr. Mettu. If you have active inflammatory conditions affecting the face, Dr. Mettu may recommend avoiding elective cosmetic injections. If you have a neurological disorder that causes weakness (such as Myasthenia gravis), neurotoxin injections may be contraindicated. Finally, if there is any known allergy to any of the substances used for injections, you may not be a candidate.

• What are the risks of neurotoxin injections?

  Risks essentially stem from too much medication given at a certain location or from the medicine affecting an unintended muscle. Since neurotoxins weaken muscles, the risks include double vision, droopy eyelids, droopy eyebrows, and dry eye syndrome. Dr. Mettu is an ophthalmologist with subspecialty training in Oculofacial Plastic Surgery and Neuro-Ophthalmology. He has an extensive knowledge of eye, facial, and neuro anatomy. With mastery of the anatomy and the use of skilled technique, Dr. Mettu is able to decrease the likelihood of these potential risks.

• How are the neurotoxin injections given?

  Topical anesthetic cream can be applied before the procedure to help with comfort. The areas treated are customized for each patient. A small needle is used to give the injections. The small size of the needle minimizes discomfort. All injections are performed by Dr. Mettu.

• What can I expect after neurotoxin injections?

  After neurotoxin injections, there will be small ‘bumps’ in the location where the injection was given. These will go down over the course of a few hours. Do not massage the area as that may cause the medication to be distributed to an unintended area and increase the risk of complications such as double vision or a droopy eyelid. It may take up to two weeks to see the full effect of the neurotoxin. With the exception of avoiding pressure to the face for 24 hours, you may resume normal activity after the injections.

• Have more questions?

  Send us an email at hello@raleigheyeandface.sprucecare.com