As we age, our appearance changes. Wrinkles and lines become more pronounced. The skin can sag, and the contours and profile of the face change, making lines and folds even more visible. Wrinkles and some fine lines are caused by the activity of the muscles underneath.
The strength of the muscles used in facial expression also changes, leading to changes in appearance such as fine lines around the eyes, lowering of the eyebrow, fine lines and pursing around the lips, dimpling in the chins, and downward turns of the corners of the mouth. These changes are commonly noticed as a tired, angry, or sad appearance on the face, even when you are not feeling that way.
What are neuromodulators?
Neuromodulators are prescription medications that are used to change muscle activity when injected into the muscle itself. In Canada, these products are commonly known by trade names such as Botox®, Dysport, Xeomin, and Nuceiva. Neuromodulators are used to relax the underlying muscles that are responsible for wrinkles, lines and the changes in expression.
Who will provide the neuromodulator treatments?
At our clinic in Ottawa, we provide Botox®Cosmetic treatments administered by Dr. Zhang, a licensed general surgeon. She is a certified Botox®Cosmetic provider with Allergan. Dr. Zhang is an experienced and conscientious provider. She will care for you throughout your treatment journey, from the initial consultation to the time after treatment. She will work with you to create a plan that is tailored specifically to your individual needs and concerns. Contact our clinic today to book a consultation.
What's the difference between Botox®Cosmetic and fillers?
Botox® Cosmetic is the tradename of onabotulinumtoxinA, a neuromodulator produced by Allergan. Botox® Cosmetic is a prescription medication in Canada. We are only able to provide limited information regarding prescription medications such as Botox®Cosmetic on our website in compliance with Health Canada advertising laws for prescription medications.
With regards to neuromodulators vs fillers, neuromodulators are prescription medications that relax the activity of muscles. Neuromodulators are delivered into the targeted muscle using a small needle by injection. Neuromodulators decrease the muscle activity of the targeted muscle temporarily to help decrease the appearance of lines and wrinkles.
Fillers, more specifically known as soft tissue or dermal fillers, are injectable implants approved for use by Health Canada and the United States FDA for use in creating a smoother or fuller appearance in the face by restoring some of the volume loss associated with aging. Soft tissue fillers are also approved for the augmentation of lips. Soft tissue fillers are delivered by small needle or cannula into the soft tissue planes of the face to help restore some of the volume in these areas. Soft tissue fillers do not change any muscle activity and are not a prescription medication. For more information regarding soft tissue fillers, please check out our Soft Tissue Filler section on our website. You can also contact our clinic for more information about soft tissue fillers or Botox® in Ottawa.
When should I start getting Botox®?
Botox® belongs to a class of drugs known as neuromodulators. When to start treatment with neuromodulators will depend on the concerns of the individual patient. Each person is different, and neuromodulator treatment should be planned to suit every individual’s particular concern, facial structure, and past medical history. These are all aspects that Dr. Zhang will discuss with you at your consultation. Contact our clinic if you would like to book a consultation or if you have questions regarding starting neuromodulator or Botox® treatment in Ottawa.
Frequently Asked Questions
What is it like to get neuromodulator treatment?
Neuromodulators are considered to be non-surgical, non-invasive treatment. A small needle is used to inject the neuromodulator into the skin and delivers it to the targeted muscles.
How long does the treatment take?
The procedure takes an average of 15-30 minutes, and the effects of the neuromodulator are usually noticed within 7 days after the treatment with full results noticed in 14 days. Some minor adjustments may be needed after 14 days which is why it is important for patients to follow up at that time.
The effects of neuromodulators typically last for 3-4 months. Every person is different, and the length of time may be slightly different for each individual. Repeat treatments are recommended to maintain the optimal aesthetic result.
What to expect from Botox first time?
Prior to any Botox® or other neuromodulator treatment, you will meet Dr. Zhang, and she will perform a detailed consultation with you to discuss your goals and make recommendations for the best treatment. She will discuss with you what to expect for the treatment process and the outcomes after treatment. Treatment can be performed on the same day as the consultation or on a different day.
Neuromodulator treatments typically consist of a small series of injections with a small needle. This needle is the same size used for insulin injections and is smaller than the needles used for most vaccines. The entire procedure takes about 15 to 30 minutes. The procedure is well tolerated. There is no need for local freezing. A numbing cream can be applied over the treatment area for some patients. Most patients are able to return to work or other activities after their procedure. The activities to avoid after the procedure are exercising for 24 hours after the procedure and laying down for about 4 hours after the procedure.
Who should consider Botox?
Botox® belongs to a class of drugs known as neuromodulators. In general, neuromodulators can be used safely by most patients. Women who are pregnant or breastfeeding should delay treatment until they have completed their pregnancy and are finished breastfeeding. Patients should be at least 18 years of age before beginning neuromodulator treatment. Patients who have an existing neuromuscular disorder (eg. Muscle dystrophy, Parkinson’s disease, ALS) are not candidates for cosmetic treatments with neuromodulators.
It is important to have a consultation with a medical professional who will review your past medical history to determine if you are a good candidate for neuromodulator treatments. At our clinic, we offer Botox®Cosmetic for neuromodulator treatment. We are only able to provide limited information regarding prescription medications such as Botox®Cosmetic on our website in compliance with Health Canada advertising laws for prescription medications. Please book a consultation or contact our clinic to find out more about Botox® in Ottawa.
What are the possible side effects of neuromodulators such as Botox?
There are 2 main ways side effects can happen from neuromodulators.
- Neuromodulators need to be injected into specific muscles, and therefore side effects can occur from the injection process. These side effects can include but are not limited to:
- Pain at the injection site – this typically resolves quickly within minutes to hours
- Redness at the injection site – this typically resolves quickly within minutes to hours
- Swelling at the injection site – this typically resolves quickly within the next 24 hours
- Infection – a rare side effect, characterized by ongoing pain, swelling, and redness at the injection site
- Bruising – The skin has many small surface blood vessels. These small vessels may be punctured during the course of an injection. If this happens, a small amount of bleeding can occur under the skin, causing a bruise. The bruises typically will resolve within 7-10 days.
- Side effects can arise from the neuromodulator itself. These side effects can include but are not limited to:
- Allergy – a rare occurrence. Some patients have known allergies that make them at higher risk for allergies to neuromodulators. It is important to have a thorough consultation with the doctor providing neuromodulators services to discuss your risks.
- Weakness/Droopiness – Careful injection of neuromodulators only affects the muscles that are targeted. Rarely, neuromodulators can spread into surrounding muscles. When this happens, there is decreased muscle activity in these areas as well. This can lead to weakness in these muscles. Depending on the area of the injection, patients may experience this as:
- Droopiness of the eyebrow
- Droopiness of the eyelid
- Asymmetry in the position of the lips
Because neuromodulators wear off over time, these effects are temporary as well.
What are some common areas treated with neuromodulators?
These are some commonly treated areas using neuromodulators. Everyone’s face is unique, and therefore, the treatment dose and result may vary by individual. During a consultation, Dr. Zhang will be able to give you a detailed understanding of the product, the dosing needed to achieve your desired results, and what to expect during and after the procedure. Results do vary, and risks are possible. Not everyone is a candidate for neuromodulator treatment. A consultation is necessary before starting treatment. Treatment can be performed the same day as the consultation. Please contact our clinic if you would like more information or to book a consultation.
- Frown lines – These are the lines, sometimes known as “11” lines between the eyebrows. These lines occur due to the activity of the muscles situated around the eyebrows. These lines can give the impression of anger, unhappiness, or stress to the face. For some people, these lines can give an “intense” look to the face. Treating this area with neuromodulators can decrease the appearance of the lines, increase the distance between the eyebrows, and result in a more relaxed, happier appearance.
- Forehead lines – These are the multiple horizontal lines seen above the eyebrows along the forehead. These lines are most noticeable when raising the eyebrows. For some people, these lines continue to be visible even when the eyebrows are not raised. These lines occur due to the activity of the muscles along the forehead. These lines pull attention away from the eyes and can give a tired, weary, or stressed appearance to the face. Treating this area with neuromodulators can decrease the appearance of the lines and result in a smoother appearance of skin in the area. Removing the appearance of these lines allow the eyes to become more visible, creating a more open and engaging appearance.
- Crow’s feet lines – These are the lines surrounding the outer corners of the eyes. These lines are commonly described as a crinkle around the eyes and are most noticeable when smiling. For some people, these lines are present at rest. These lines also pull attention away from the eyes, creating the visual effect of smaller eyes, tired-looking eyes, and aging eyes. These creases and lines form due to the activity of the muscle (orbicularis oculi) that works to close the eyelid. Neuromodulators can be used to relax this muscle slightly to remove the appearance of the lines while still allowing enough activity to close the eyelid.
- Marionette lines – These are the lines that extend downwards from the corners of the mouth. These lines accentuate the downturn look of the lips, which can give the face an appearance of disappointment, sadness, or dissatisfaction, even when these emotions are not present. These lines can be due to the activity of the muscles of the lower face around the lips. Relaxing these muscles can help raise the corners of the mouth and correct the downturn.
- Lip lines/Mouth lines – These are the vertical lines seen around the lips. These lines typically extend outwards from the lip and are due to constant activity of the muscle (orbicularis oris) around the lips. Common movements of the lip that contribute to these lines include drinking through straws, puckering, pursing of the lips, or just simply regular lip activity during talking, drinking, and eating. These vertical lines around the lip can give an appearance of anger or unhappiness and can cause someone to look older than they actually are. Precise injection of neuromodulators into the muscle around the lips helps relax the muscle, smooth out the lines, without typically affecting normal lip movements. In this area, neuromodulators and soft tissue fillers can be combined for a better effect. The soft tissue fillers are used to fill in the deeper lines which can still be present after neuromodulator treatment.
- Chin – The chin is constantly being pulled upwards by the mentalis muscle. Over time, this results in a dimpled appearance with divots and lines, even when the face is at rest. This effect can cause an overall look of stress or unhappiness in the face. The continued pull upwards of the mentalis muscle also decreases the projection of the chin, which can take away from the proportions of the lower face, and cause an aged appearance. The activity of the mentalis muscle can be decreased with careful injection of neuromodulators. This treatment will help decrease the dimples formed by the contraction of the mentalis muscle. Treatment with soft tissue fillers can also be combined with neuromodulators in this area to give structure and projection back to the lower face.