Everything You Ever Wanted To Know About Botox


You know you’ve been thinking about it…it’s all you can see when your mask is on. The forehead lines, brow lines, crow’s feet…how can you get them to go away?

Botox helps prevent muscles from making creases. It is technically a toxin, but there is no need to worry because it is completely safe in the doses used. The three FDA-approved areas for Botox are the frontalis (horizontal lines across the forehead when you raise your brows), the glabella (vertical lines between your brows when you make an angry  face), and the crows feet.

Treating these areas is safe, effective, and can actually be preventative. I use a special technique I have coined “Nanobotox”, which gives you the most natural results possible. I use several small aliquots of product rather than larger boluses, placed in anatomically strategic locations. This allows for a nice, even spread, and avoids the dreaded eyelid droop or “Spock” brows.

Does Botox Hurt?

There are ways to go the extra mile to make sure your treatment is as comfortable as possible. Your injector can use the smallest possible needles and have you apply an ice pack prior to treatment to minimize pain.

While we can never guarantee a bruise-free treatment, bruising is highly  avoidable. Examining your forehead for visible blood vessels, using cold packs and smaller needles, and having an overall gentle touch really does minimize your risk. Additionally, if possible, being off of all blood thinning agents like aspirin, ibuprofen, Motrin, or Aleve for about 10 days prior to your treatment greatly reduces your risk of bruising.

What Can I Expect?

Botox is an art, not an algorithm. It should feel like your provider is customizing your treatment to you. I adjust the product concentration depending on which area I am working on. I also have my clients dynamically move wrinkles prior to treating so I can mentally map out the custom plan nad keep careful records of exactly what has and has not worked for the client in the past.

How Much Does Botox Cost?

Different places will price differently. I, like many other board-certified plastic surgeons, choose to price treatments per area. This does a few things: 1. It takes away the importance of number of units and rather allows for focus to be on quality of treatment. 2. It allows for a dynamic shift of your focus as your muscles and anatomy change over time. 3. It builds in physician responsibility—I offer a completely complimentary touch up at the 7-10 day mark meaning I own my treatment, and do everything I can to nail it the first time.

Botox can vary in price, but the universal truth to purchasing applies—you get what you pay for. If the price seems to good to be true, it likely is, and you can likely bet that you’ll be sorry in about a week.

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Ann Jayaram is a board certified ophthalmologist and fellowship trained oculoplastic surgeon. She has completed an ophthalmology residency in all types of eye care and surgeries including comprehensive eye exams, cataract surgery, glaucoma procedures, and laser treatments, and then went on to complete an intensive fellowship in eyelid surgery which encompassed facial trauma, cosmetic procedures, cancerous lesion management, tearing procedures, droopy lid surgery, facial injectables, and laser therapy. Over the years, Dr. Jayaram has performed over 5,000 eyelid and ocular procedures making her a true expert in this very specific area.


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