Botox in Manhattan and New Jersey

Botox With a Plastic Surgeon

I love Botox^R . It is an absolutely terrific drug. It works as expected and there are amazingly few problems with it. I’ve injected so much Botox over the last decade that I recently gave the Botox lecture to the plastic surgery residents at the Cornell/Columbia plastic surgery residency program. Probably closing in on ten thousand patients. I inject Botox at my Park Avenue office in Manhattan and at my office in Franklin Park, New Jersey. If you want to see me inject Botox, check out my video on Oprah.com

Botox paralyzes muscles with a very potent toxin. It is not infectious...you can't get botulism from Botox.  Botox is used to soften wrinkles between the eyebrows, the horizontal lines of the forehead, the crow's feet area, and the "bunny lines" on the nose. I use it to smooth out dimples in the chin and sometimes to hide a "gummy" smile. I can even soften the bands of the neck with Botox and decrease underarm sweating!

How Long Botox Lasts

Botox lasts between 2 and 6 months. The wrinkle softening is a gradual process, taking months to occur. Contrary to advertisements, it is not an overnight phenomenon. And no - there's no "Botox cream" that even has a chance of working. That's either pure fantasy....or even fraud.

The longterm use of Botox may progressively weaken muscles. That's a good thing if you want to get rid of wrinkles. I have patients who, after 3-4 years of continuous Botox, have significantly longer lasting effects.

Botox is also useful for reducing sweating of the underarms and hands (painful!). Some plastic surgeons use it to decrease wrinkle lines around the lips, but it is very difficult to weaken without paralyzing and causing drooling and speech problems.

I use it very sparingly around the mouth - reminds me of Joan Rivers saying it's  more important to look good than to speak properly...

Botox can reshape the face! Injected into the masseter muscle in people who clench their teeth and developed square faces, it can improve your appearance and may even reduce wear and tear on your teeth.

Is Botox Safe?

You may have heard about 16 deaths in the last decade due to Botox. Another example of the media just getting it wrong. In fact, 15 of these deaths were due to the use of massive doses of Botox (sometimes 300 times the cosmetic dose!) injected into spastic neck muscles. This causes difficulty swallowing and has resulted in aspiration pneumonia and death. One death occurred in a cosmetic case. Presumably, the neck muscles were injected to reduce the bands of the neck.

For cosmetic reasons, Botox is extremely safe. Of course, there are potential problems with any drug. Botox injections can cause bruising and can even result in the drooping of eyebrows or even eyelids. And it can give you a funny appearance (think "Spock"). That's where experience comes in. And an artistic approach to Botox. Beware of storefronts employing people with giant diplomas they obtained at a 2 hour course!  

New types of “Botox” are called "Jeuveau^TM", “Xeomin^TM” and “Dysport^TM”. These are basically the same chemicals and no company has proven their product is superior to the others. I use them interchangeably. Botox should not be used in people with neurologic disorders, pregnant women, or people with various medical conditions.