Xeomin

Now what we are going to do is inject her frown lines here, and what we are going to do is use a little bit of a botulinum toxin just to relax this. Basically in the face there is one muscle here that pulls everything up, and everything else pulls it down. So by relaxing this set of muscles here and here – we will be able to relax the muscles that pull down as she should get a little bit of an eyebrow lift and that will look really nice. Sometimes we go ahead and combine that with a little bit of injection out here, and again that allows us to relax the muscle that pulls it down here giving you a lift, so botulinum toxins are all opposite when you relax the muscle that goes down you get an elevation and when you relax the muscles here that hold the eyebrow and eye lid up you get a droop. So a lot of times I will see people that come from other places, and what they have done is had injections through here to try and get rid of these lines, and unfortunately what that will do is drop you so what we will do is go ahead and start. Go ahead and frown, give it a little pinch. What we like to use here are these very, very small microscopic needles to place the protein perfectly where it belongs. Pinch – it also decrease the discomfort and we have a few other things that we do here that make it much more comfortable for the patient. In general, no matter which product we are using we try and do about 5 or 6 injection sites and that gives us a very nice pattern. How are you doing? Good! So you can see it is a fairly simply injection and what we are doing is using these imported needles from Japan and they are so small you can barely see them. We go through a lot of these, the other thing is that sometimes we will use our insulin syringes again because they are very small very comfortable. Minimal, minimal bruising. You will see a little bit of fluid there and you will see just 5 little fluid bumps and what that is, is this saline or salt water that we use to reconstitute or mix up the toxins, and most of the ones that are available today are similar in that respect. Some of the newer ones will come pre- mixed. Raise your eye brows for me? So again this is one muscle here called the frontalis that is pulling everything up. In her it is giving these lines, but they are not that deep and we don’t really want to every go below the bottom third. If we go below here and she will get an eyelid heaviness. So go ahead reach up, lift up for me, little pinch sorry – and so in contrast with some of the other injections we do. What I am doing here is spreading the protein out evenly with tiny, tiny, tiny injections. So we are not going to get every single line but we are going to clean up the neighborhood, and make her look a little bit more relaxed and less stressed. How are we doing? Good. So I am taking my time here and going along and trying to make sure that the body of the muscles relaxed and that she still has something that works to hold her eyebrow up. Trying to make it as symmetric as possible, and again that is a pretty easy injection. Are you okay? Mhmm. So that is how we treat the frontalis or forehead muscles and that is how we do the frown lines or glabella but very, very easy to do the only thing is you have to know where you are going and use the right amount of product. There are many different products available today from Botox to Dysport to Jeuveau to Xeomin and they are pretty interchangeable to some degree. You just have to understand the difference between them and correct for some dosage. There are some subtle differences that we will also talk about in the next part. So you should be perfect for that!