Botox®️ or Xeomin®️ are commonly injected into 3 main sites; the forehead to treat expressive lines, the outer sides of the eyes to treat “Crow’s Feet”, and between the eyebrows to eliminate frown lines sometimes referred to as “11s”. But did you know that botulinum can also be used to raise the eyebrows, eliminate horizontal “bunny” lines on the nose, turn up the corners of the mouth, reduce lines above the lip, get rid of chin dimpling and smooth out neck bands? Read the details below.

Eyebrow Lift

When an elevated brow is desired, botulinum injected into the upper lateral aspect of the circular eye muscle named the orbicularis oculi can achieve this. By slightly weakening this part of the muscle, the opposing muscle of the forehead literally lifts the eyebrow up. Simple!

Bunny Lines

People use their facial muscles differently. Some people develop vertical “11” lines when they frown while others also contract the muscles on the side of the nose creating a horizontal “bunny” line across the bridge of their nose. This can be easily treated with a single injection of botulinum to each side of the nose.

Mouth Frown

Do people think you look sad when you are not? Droopy mouth corners can be improved by reducing the activity of a muscle that pulls the corners of the mouth down, the depressor anguli oris. This allows the smile muscles that pull up on the corners of the mouth to function, unopposed. Easy as that.

Lip Lines & “Lip Flip”

Nothing makes one feel older than the fine lines that develop above the lip. Often incorrectly referred to as “ Smoker’s Lines”, they can develop in smokers and non-smokers alike. When low dose botulinum is placed above the lip in the circular muscle that creates puckering, the muscle relaxes, and the lines are reduced creating a more youthful look. Some people even get the added effect of a slightly wider upper lip leading to its nickname, the “lip-flip” or the “ lip-pop”.

Dimpled Chin

Chin dimpling can occur with age if the mentalis muscles become overactive. Botulinum can be used to relax these muscles thereby reducing the dimpling, giving you a smoother chin.

Masseter

Teeth clenching and teeth grinding can cause enlargement of the masseter muscle which adds fullness to the face and angulates the jaw. Botulinum into this muscle not only relieves the symptoms of teeth grinding but can have the added benefit of slimming the face.

Neck Bands

The platysma is a broad superficial muscle that spans the neck from the top of the chest to the jawline. With age, it can develop bands and cords. Botulinum into these bands relaxes them, making them less visible. The result is a smoother, more youthful neck.

So next time you are in for your Botox®️ or Xeomin®️ appointment, let me know if you are interested in treating one or more of these areas. I will evaluate your unique, expressive face, and we will decide if adding any of these sites would be a good choice for you.

(Botox®️, Xeomin®️, Dysport®️, Jeuveau®️)

Wrinkle smoothing Botulinum Toxin A injections are the most common non-invasive aesthetic procedure in the US, and while they are colloquially called “Botox”, there are actually four different FDA approved Botulinum Toxin A injectable products for cosmetic use. Each one is made by a different manufacturer and has different cost, potencies, formulas and trademarked names. Because Botox®️ was the first FDA approved neurotoxin on the market, for many people the name Botox®️ has become synonymous with Botulinum Toxin A just as Kleenex has with tissues.

All four contain the same active ingredient, a very small dose of the potent Botulinum Toxin A which has the ability to temporarily paralyze muscles for cosmetic effect thereby reducing the appearance of fine lines and wrinkles caused by facial expression.

How They Work

Botulinum Toxin A works by preventing muscle contraction. After injection into the target muscle (forehead, “elevens”, Crow’s Feet), the product travels to the junction of the motor nerve ending and the muscle. There, it attaches to the nerve ending and prevents the nerve from releasing the chemical messenger (acetyl choline) that normally travels to the muscle cell with the signal to contract or shorten. Without this signal to contract, the muscle remains relaxed, and wrinkle free.

Dosing, Duration and Side Effects

Each of the four neurotoxins have similar safety and efficacy profiles but subtle differences do exist. Dosing is similar for Botox®️, Xeomin®️, and Jeuveau®️ but Dysport®️ dosing is more than double the units per area. Onset for Botox®️and Jeuveau®️ is 3-5 days, 5-7 for Xeomin®️ and 24 hours for Dysport®️. Results last an average of 3-4 months for all four but vary for individuals. The most common side effects are redness or bruising at the injection site, headache, nausea, temporary facial weakness and, rarely botulism-type symptoms.

Nuances

Conclusion

Botulinum Toxin in its natural form is considered one of the most lethal substances known to man. I marvel that scientists have been able to harness, purify and dilute Botulinum Toxin A to create a product that is both safe and aesthetically useful.

Ideal Facial Dimensions

The concept of ideal facial dimensions has existed for thousands of years and remains relevant in modern times. And although we all know a beautiful face when we see it, attempts to quantify the ideal facial proportions can be downright humorous. For example, did you know that the ideal face should be equal to the length of three noses, and that the space between the eyes should be the width of one eye? Additionally, according to BBC News, the distance between a woman’s eyes and her mouth should be over a third of the overall length of her face. Who knew?

The Triangle of Youth

The youthful face has specific dimensions and proportions too, particularly when compared to the older face. Commonly referred to as the Triangle of Youth, the weight of the youthful face is at the top of the face, with full cheeks, high cheek bones, and full temples. These pleasing youthful proportions can change over the years leading to an Inverted Triangle with the weight of the face at the bottom rather than the top. Many factors contribute to this including the effects of gravity on muscle and skin, loss of collagen and elastin, and, what we will address below, loss of fat pads, particularly in the cheeks and temples. But what can be done?

Treating the Hollow

Dermal fillers can be used to add volume to the temples and midface and restore the Triangle of Youth. Restoring volume to these areas can eliminate hollow temples, accentuate cheek bones, and lift the face thereby reducing wrinkles and folds even in the lower face.

Safety Consideration

Dermal fillers can be safely added to the temples and cheeks in the office. The procedure can usually be performed with minimal discomfort after the application of a topical anesthetic and typically takes less than 30 minutes. Use of a blunt cannula in the temple region can reduce the risk of bleeding or bruising. Results are immediate and can last up to two years if a long-lasting hyaluronic acid filler such as Juvéderm Voluma®️ is used.

So, if you have lost volume in your cheeks, or your temples appear a bit hollow, a little dermal filler can help restore an attractive, aesthetic proportion to your face and help create a more youthful you!

1. Smile, Often!

Forget about aging gracefully! Age youthfully! Individuals in a study on the aging face were asked to guess the age of models with various facial expressions. Neutral expressions led to the most accurate estimates of age. Fearful expressions led to subjects being rated older than they were, and happy smiling faces were rated as younger than they really were. So, smile and take years off your appearance!

2. Take Care of Your Skin.

A simple skincare routine which includes a daily facial cleanser, toner, serum (particularly those with Vitamin A or C) and a hydrating cream is essential for healthy looking skin. Adding a weekly polish will help remove dead skin cells and promote skin cell turn-over. Taking time for a monthly HydraFacial©️ can help keep your skin radiant and bright. As always, drink plenty of water and keep fruits such as grapes, berries, plums and pears in your diet. They contain sorbitol which is a humectant, or substance that attracts water. And lastly, protect your skin from damaging UV rays. The best choice in sunscreens is one that is mineral based rather than chemical based. Mineral based sunscreens like Colorescience®️ provide a physical barrier to UV rays and are not absorbed by the skin.

3. Touch Up Your Hair.

As we age, our hair changes in color, texture and fullness. In addition to highlights and lowlights, consider the routine application of conditioner. If hair loss is a problem, Platelet Rich Plasma (PRP) is a non-surgical way to improve hair growth. It can be safely performed in a doctor’s office or medispa and can be highly effective.

4. Exercise Four Times per Week.

Pick something you like, whether it is walking the Galveston beach, jogging with friends, playing tennis or golf, or just keeping up with the grandchildren. Try combining cardiovascular for heart and lungs with resistance exercise for muscles and stretching for flexibility and healthy joints. Staying active will help you move more gracefully, fend off muscle loss, and help you sleep better.

5. Give Yourself Permission to Get a Little Help.

Often, I have clients who tell me that their significant others are opposed to them getting Botox or filler. Interestingly, these are often the same clients who are getting the occasional Botox or filler! The men don’t know, they just think their wife or girlfriend just looks great! If done well, Botox and filler should neither make you look fake nor over-done like a Hollywood actress or Washington politician.

What is exfoliation and why bother?

Let’s cut to the chase. Would you rather run your fingers over a smooth silk pillow or across a burlap sack? Exfoliate!
Exfoliation involves the removal of dead skin cells from the skin’s outer layers and is performed to promote healthy skin and to prevent breakouts. New skin cells are formed in the deeper layers, pushing the dead cells to the surface. If these dead cells are not removed, they can build up causing a dull appearance and rough texture. (Remember the burlap?) Adding exfoliation to your routine will not only brighten your face but will also improve tone and texture allowing products and makeup to go on “as smooth as silk”.

What are the different types of exfoliators?

It can be fun to find an exfoliation process that you enjoy and that works for you and your skin type. Some can be done at home and some require specialized equipment like the HydraFacial©️.

Physical exfoliation often involves the use of a granular scrub that abrades or buffs the skin’s surface removing dead cells. Common granules include salt, sugar, magnesium crystals, grains, jojoba beads and even ground nuts. For daily use, the ZO®️ Exfoliating Cleanser with jojoba beads is gentle and effective. A more aggressive product that is great for a weekly buff is the ZO®️ Exfoliating Polish with its abrasive magnesium crystals.

Chemical exfoliators usually involve gentle acids and enzymes that dissolve the protein bonds that exist between dead skin cells allowing for cell removal.

Mechanical exfoliation employs a product or tool that rubs, scrubs or vacuums. This includes brushes, loofahs, abrasive tips and others.

Can I use more than one of the different exfoliating techniques?

Combining various options can be fun and can lead to healthy, vibrant looking skin as long as you are careful not to over-exfoliate. Treat yourself to a monthly facial with the patented HydraFacial©️ machine! It provides a gentle chemical exfoliation (with glycolic acid and salicylic acid) and physical exfoliation with its specifically designed HydraFacial tip and fluid enhanced suction. Your skin will glow! In between facials, enjoy your home skincare regime.

If you are not already exfoliating, try adding it to your skin care regime and say good-bye to rough uneven skin and hello to smooth silky skin you will love!

What can Retinoids do for me? 

Vitamin A derivatives (commonly referred to as retinoids) can do wonders for your skin. Naturally abundant in carrots, eggs and sweet potatoes, synthetic retinoids are a gold standard ingredient in skin care because they alter the behavior of aging cells to act more youthful. They improve the appearance of the skin by reducing fine lines and wrinkles, increasing exfoliation, improving skin tone and texture, and reducing hyperpigmentation. They accomplish all this by first causing the outer layer of keratinocytes to shed off, leaving the skin smoother and more evenly pigmented. Next, Vitamin A derivatives effect the epidermal cells which start replicating faster, causing the skin to look and feel softer and healthier. This amazing vitamin also shrinks dilated pores and improves cell turnover within the pores so that they are less likely to clog and become blackheads or whiteheads.

How often can I use Vitamin-A products on my face and how soon will I see results?

Most people will notice improvement in their skin after 2-3 weeks of using a product with Vitamin A, but sometimes it can be as long as 6 weeks, depending on the skin type and concentration. Retinoids can be strong and often cause peeling and redness as well as irritation. It is best to apply the product sparingly all over the face, skipping days or adhering to a schedule of application every three days. After your skin gets acclimated to the product, you can increase the frequency of use.

Are Retinoid, Retinol and Retin-A all names for the same thing, and which ZO® Skin Health Products contain them?

Retinoid is the general category of synthetic Vitamin A derivatives. The over-the-counter version is called Retinol and is milder than the prescription version known as Retin-A or Tretinoin. Retinol is a powerful ingredient in Dr. Obagi’s ZO® Skin Health ‘Prevent and Correct’ line. A partial list of products that contain it are Wrinkle and Texture RepairRetinol Skin BrightenerRenewal Crème and Daily Power Defense. If you decide to add Retinol to your skincare regime, we will look at your specific skin type and needs to select the best corrective ZO® Skin Health product for you.

Are there any down-sides to using Vitamin-A derivatives in my face care regime? 

While using a Vitamin-A product, it may be best to avoid certain irritating skin care products such as those containing lactic acid, salicylic acid, or glycolic acid. On the other hand, using fragrance-free moisturizers and hydrating creams is encouraged and can sooth the Vitamin-A treated skin. Allow the Retinol product to absorb into the skin for 10-15 minutes before applying a moisturizer. Additionally, it is imperative that you use sunscreen daily while using Retinol as your skin will become very sensitive to the sun.A Fountain of Youth? Probably not, but Retinoids are the gold standard skincare ingredient that help the aging skin cells act young again.

Electronics and Your Skin

You are probably aware that blue light from digital devices has the potential to cause eye damage, but did you know that blue light from your computer and cell phone screens can also cause skin damage?
Blue light is a high energy, short-wavelength light emitted by the computer screen, cell phone, other digital devices and the sun. In the age of the pandemic when we are all spending so much more time on our devices, blue light skin exposure and skin damage is on the rise.

How Blue Light Causes Skin Damage

Blue light stimulates the production of free radicals in the skin which accelerates the appearance of aging. The effects are cumulative and can lead to increased pigmentation, redness and swelling. In addition, your skin’s regenerative cycle can get thrown out of whack causing more skin damage over time.

How to Minimize the Damage

Reducing your time on the phone, computer or other electronic devices is unlikely to happen in this time of social distancing and need for alternate forms of communication. However, there are a few simple things you can do to lower your exposure. When possible, keep your phone a minimum of 12 inches away from your skin. Placing your calls on speaker, rather than hugging it to your cheek, is a practical measure you can implement. You can also reduce the brightness on your screen by 50% or enable the “Night Shift” setting to limit the blue light emitted.

Do Any Products Protect Skin Against Blue Light?

Skincare manufacturers are quickly getting on board with products that block high energy blue light in addition to UVA and UVB light. Colorescience®️ is ahead of the curve. They offer an array of skin protection products that guard against blue light as well as traditional UVA and UVB lights, pollution and infrared radiation. Colorescience®️ uses minerals and antioxidants to promote healthy skin by preventing damage and speeding up repair. Offering a wide variety of cosmetic-like products,Colorescience®️ can protect your skin with its transparent Sunforgettable®️ sunscreen, or its lightly pigmented All Calm®️ and Even Up®️ which double as a natural looking light base. Additionally, the popular Sunforgettable®️ Total Protection Brush is made for easy transportation in your purse or console for mess free touch ups throughout the day. Don’t forget, SPF protection only lasts about 2 hours so it is important to reapply throughout the day. Completing the line is the Colorescience®️ Lip Shine and Total Eye™️ 3-in-1 Renewal Therapy.

So, remember. Protect your skin as well as your eyes from damaging short-waves emitted by your devices. Make certain your sunscreen products protect you against blue light!

– Dr. Tara Wegryn

We all know that a facial is a lovely way to pamper yourself and a great way to look and feel fresh. But are there any true health benefits to this pleasant procedure? The answer, of course, is yes.

Firstly, a facial can help relieve stress by activating your sympathetic nervous system, reducing anxiety and improving your mood. In addition, a HydraFacial provides a thorough cleansing of your face which reduces the total bacterial count, preventing break-outs, whiteheads and blackheads.

With a facial, skin rejuvenation is enhanced by its effect on improving circulation through massage and by opening up and cleaning out the pores. Your skin is continuously remaking itself by producing new skin cells daily. The old skin cells die and tend to pile up on the surface of your face, making your skin dry and rough. Exfoliation during a facial removes the build-up of dead cells leaving your skin smoother and softer and allowing for easier pore extraction. Gentle acids such as salicylic acid and glycolic acid aid in both the removal of dead cells and the cleaning of the pores.

A good HydraFacial will leave your skin healthier with reduced bacterial numbers, fewer layers of dead skin cells, and pores that are free of debris and exudates. Your fresh, healthy face will now be able to absorb nutrients and therapeutic agents. Antioxidants can be applied to help reverse the aging process. Hyaluronic acid and growth factors promote collagen formation and reduce wrinkles, and skin lighteners/brighteners reverse the synergistic effects of UV light on melanocytes which causes skin darkening and age spots.

Lastly, just the process of having your face touched and manipulated during your facial improves lymphatic drainage which allows your body to remove by-products and impurities while reducing swelling.

So, the next time you treat yourself or a loved one to a HydraFacial you can rest assured that, in addition to enjoying a relaxing, pleasant respite, you are truly doing something for your health by creating a cleaner, purer you.

– Dr. Tara Wegryn

A common problem for many women as they age is the dreaded ‘turkey neck’, or loose, sagging skin under the chin and jawline. ‘Turkey neck’ can be caused by a number of factors including aging and weight change, while genetics also plays a big role. Until recently, the most common treatment for the sagging skin was a surgical lift or other painful procedures to remove or tighten the skin. Fortunately, advances in medicine and technology have brought us an exciting, non-invasive treatment for this condition, eMatrix Radio Frequency, which can be done in the office with minimal pain and downtime.

eMatrix delivers radio frequency energy precisely into the skin via a small grid. Perceived as an injury by the body, new collagen and elastin is deposited and remodeled. This healing process is accelerated by the healthy skin surrounding the grid pattern. This causes the dermis to contract and the skin to tighten, giving you a fresher, more youthful look. Radio frequency continues to cause skin tightening for up to 6 weeks after a single treatment, although a series of 3 to 4 is usually recommended. These can be performed at 3 to 6 week intervals.

The treatment itself takes less than 30 minutes but you will want to allow about an hour for your visit which will include time for the topical anesthetic to numb the area. You can expect your skin at the treatment site to be red for 1 to 2 days and for the area to feel warm, like a sunburn. Ice packs and Tylenol are all that is usually required in the first day or two. Many clients tell me they felt well enough to go out the same day or the next. The grid pattern may be visible for 3 to 4 days but is easily covered with Colorescience®️ or makeup.

eMatrix is also very effective in treating stretch marks, acne scars and skin laxity on the face and body, but that is a topic for another day.

You have probably taken the time and measures to ensure your face is aging gracefully. Now may be the time to get rid of the turkey neck and have your neck look as bright and fresh as your face! We hope you and your family have a wonderful Thanksgiving!

Have a great day and I hope you continue to “Look Fresh and Feel Confident”.

– Dr. Tara Wegryn

Many of you are now familiar with Hydrafacial’s patented approach to skin care which combines gentle suction, a rotary motion and a series of carefully formulated solutions to clean and refresh your face and decollete.

The three basic steps of the Hydrafacial©️ are to cleanse and peel, to extract and hydrate, and lastly to fuse and protect.  The first step is accomplished with a glucosamine containing solution and a gentle salicylic/glycolic acid peel that removes the rough top layers of your skin uncovering the fresher, healthier deeper layers.  Step two which involves extraction and hydration, relies on gentle suction and a moisturizing solution containing exotic compounds such as willow bark to remove debris and nourish your skin.  In the final step, your skin is saturated in antioxidants and peptides to create a healthy glow.

You can also tailor your Hydrafacial©️ treatment by adding serums that address your specific skin concerns.  Lucky for us, Hydrafacial©️ has partnered with Dr. Obagi’s skin care line, ZO®️ Skin Health, and made available several serums that pair perfectly with the ZO®️ Skin Health correction line for home use in-between Hydrafacial©️ appointments.

The Growth Factor serum minimizes the appearance of fine lines and wrinkles to restore skin health and vitality.  It pairs beautifully with ZO®️ Growth Factor serum which is applied daily in-between treatments.  Alternatively, if uneven skin tones are a concern, a Brightalive Booster serum can be applied to the skin to lighten the skin, reduce color variation and block the production of pigment.  Paired with a ZO®️ daily skin brightener, you will definitely see sustained results.

brightalive

All boosters and serums are applied after step two in the Hydrafacial©️ process when your skin is clean and the serums can be absorbed by your newly resurfaced skin.

Additionally, in this unique time of COVID when many of us are wearing face masks or shields, adding Red or Blue LED light to the Hydrafacial©️ can kill bacteria, sooth irritated areas and reduce breakouts.

Lastly, you don’t have to ask for any particular serum or treatment when you make your Hydrafacial©️ appointment. This is not a quiz!  When you come in, we will discuss your goals, concerns and options.  I will make suggestions based on our conversation, and we will go from there.

Sometimes, the patented three step Hydrafacial©️ without the bells and whistles is just what the doctor ordered.

– Dr. Tara Wegryn

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