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Botox In Cosmetic Surgery Los Angeles

The popularity of Botox® Cosmetic injections in Los Angeles, as in the rest of Southern California, is unmatched by any other cosmetic surgery procedure. A tiny amount of Botox® Cosmetic, when injected into tense facial muscles, is enough to inhibit contraction of the targeted muscles, causing them to relax and impressively correcting a myriad of facial imperfections and signs of aging. Unlike microdermabrasion, cosmetic lasers, or chemical peels, which are good at fading minor fine lines, Botox® Cosmetic and its recently FDA-approved competitors, Dysport® and Xeomin®, can get to the root of the problem by relaxing muscles and releasing the overlying wrinkles for months to come. Also, unlike painful surgical procedures, these products containing botulinum toxin are successful at narrowing a wide jawline, correcting gummy smiles, or preventing excessive sweating without much pain or downtime. Furthermore, Botox® injections are found to help some patients break their habits of overusing certain muscles of expression, like the frequent forceful elevation of the eyebrows; the main cause of the appearance of deep horizontal forehead lines.

Please go to Botox® overview to learn about the products, namely Botox®, Dysport®, and Xeomin®, the procedure, preparing for the procedure, and aftercare. You may also go to the Botox® FAQ to read the answers to frequently asked questions about these popular injectable products.

It should be pointed out that injection of Botox® Cosmetic, Dysport®, and Xeomin® to the lower face involves higher risks and accordingly requires a more precise technique since lower facial muscles are involved in important functions like speech, eating, drinking, and smiling. As a consequence, doses in these areas tend to be conservative, and the results are more modest than in the upper face. Injection of the mid- and lower face and neck is best reserved for experienced injector doctors and patients who have had successful injections in the upper face. With Dr. Dishakjian’s experience of tens of thousands of Botox® injections over many years, you are reassured that you are in the best hands. The conditions commonly treated with Botox® Cosmetic by Dr. R. Dishakjian include:

Dynamic Wrinkle Reduction with Botox®

Dynamic wrinkles are those that are caused by facial expressions, such as smiling and frowning. Botox® injections are ideal to gradually reduce the appearance of these wrinkles. When used for wrinkle correction, Botox® injections are intended to weaken the targeted expression muscles to an extent that limits their movement but retains the ability to show an acceptable level of expression, not an artificial and expressionless facial appearance. The trick for successful Botox®, Dysport®, and Xeomin® applications is to make sure your muscles don’t get too relaxed and that you retain your natural ability to show emotions through facial movements. When an area has never been treated, it’s always wiser to use more conservative doses since doing a touch-up treatment is much easier than waiting for months for an excessive effect to wear off.

It should be noted that in advanced cases, wrinkles caused by expressions often become etched even at rest. In these cases, for optimal results, one has to resort to dermal fillers and laser resurfacing in addition to Botox® injections. Wrinkles and lines that are ideally suited for Botox® injections are the following:

Frown Lines – Botox® Cosmetic reduces them the best
These are the glabellar lines for which Botox® Cosmetic, Dysport®, and Xeomin® injections have received FDA approval for their use in cosmetic surgery. They develop over time between the two eyebrows as two vertical lines (known as the 11) as a consequence of repeated squinting and scowling. These lines can become particularly annoying, making us look angry or worried even when we are not. Botox® Cosmetic, when injected into the scowling (corrugator) muscles, causes them to relax and gives the individual a more relaxed and good-natured appearance. The number of units a person needs depends on the size and strength of the corrugator muscles. The average amount of Botox® used for the “11” lines between the eyebrows is around 16–22 Botox® units for a female or an equivalent unit of Dysport® or Xeomin®. Males will usually require more units (about 20 to 30 units) as their facial muscles are often thicker and stronger. It should be noted that Botox® injected between the eyebrows may often improve tension headaches and even migraines related to the repeated tightening of these muscles.

Forehead lines – Botox® Cosmetic injections reduce them the best
These are the horizontal lines on the forehead that appear when we raise our eyebrows in surprise. Botox® Cosmetic can be injected into certain points in the forehead to relax these lines. Typically, 10–15 units are injected, depending on the size of the muscles in the forehead, the patient’s gender, and the severity of the lines. Many patients report significant improvement in tension and migraine headaches following injections in this area. Forehead injections should be used with caution in patients older than 65 to avoid droopiness of the eyebrows.

Crow’s Feet – Botox® Cosmetic injections reduce them the best
These lines radiating from the outer edge of the eyes resemble crow’s feet, particularly during smiling and forceful eye closure. They are caused by the contraction of the orbicularis oculi muscle, a thin and circular muscle that surrounds the eye. Botox® Cosmetic, Dysport®, or Xeomin® can be used to diminish these crow’s feet-like lines by relaxing this muscle. Typically, 10–18 units of Botox® Cosmetic are needed per side.


Bunny lines – Botox® Cosmetic reduces them the best
These are fine lines that show up on either side of the nasal bridge. They are caused by repeated squinting, smiling, and sniffing. Around 5 units of Botox® Cosmetic or the equivalent units of Dysport® or Xeomin® on either side of the nasal bridge will allow these muscles to relax.

Smokers’ lines
These refer to the vertical lines that appear on the skin part of the lip. They are common but not necessarily associated with smoking. Ideal patients for Botox® injections have a few large but not highly etched-in wrinkles. It should be noted that Botox® should only be administered in conservative doses (0.5–1 U per wrinkle) to minimize weakness in this area, as lips have an essential role in critical facial functions. Combination treatment with fillers like Juvederm or Restylane may be required for optimal results in these patients. Even when used in appropriate doses, Botox® injections in this area may sometimes prevent patients from being able to drink through a straw or whistle. For very deep lines or numerous very fine lines, deep laser resurfacing will be the treatment of choice for effective, long-term results.

Wrinkled and dimpled chin
Also known as peau D’orange chin, this is a chin that gets wrinkled up during talking, smiling, and eating. It can be easily corrected by injecting 5–10 units of Botox® Cosmetic into several points at the base of the chin. Wrinkles smooth out as the underlying muscles relax.

Chest rejuvenation
Some women may exhibit wrinkling of the central mid-chest (décolleté) with aging. Botox® injections can successfully reduce these wrinkles.

Corners of the mouth

This treatment intends to straighten the downward-turning corners of the mouth that are sometimes more accentuated with aging, giving the person a depressed appearance. Around 5 units of Botox® Cosmetic injected into the muscles that pull the angle of the mouth excessively downward (the Depressor Anguli Oris or DOA muscle) will allow the corners of the mouth to turn upward.

Brow lift or brow balance

Botox® Cosmetic, when injected at the lateral sides of the eyebrows, can sculpt the brow and provide a beautiful lateral lift, a “chemical eyelift.” Although not typically performed, strategically and carefully placed Botox® injections will contour the position of the eyebrows, create a pleasing arch, and give a rested and more alert appearance to the eyes. The procedure can also be applied to even out asymmetric eyebrows, for example, if one eyebrow is higher than the other. 2–5 Botox® units are usually used in this area.

Nasal flare

Refers to the aesthetically unappealing flaring up of nostrils in situations such as anger, emotional upset, and also as a habit. A unit of Botox® Cosmetic administered to each side of the nostrils in the region of the levator alae nasi will usually stop these unattractive nasal flares.

Other applications of Botox in cosmetic surgery

There are several less common applications of Botox® in cosmetic surgery that, when performed professionally by an expert surgeon, can replace invasive surgical methods and render excellent results. These include:

Click Botox®, Dysport, or Xeomin – FAQs to find the answers to questions you may have on the use, effectiveness, and safety of these products.

Questions about Botox® treatments or the cost?

You may reach our Los Angeles medical spa and clinic by clicking the “Contact” button or by calling 818-832-4500. Our receptionist will be delighted to assist you with any inquiries regarding cost, additional information, or scheduling a consultation session with Dr. Dishakjian, a cosmetic surgeon and phlebologist. Consultations with the doctor are free with the purchase of any service. We charge a nominal, refundable consultation fee for the first office visit only. This fee is fully credited towards a subsequently purchased service.

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