Botox Injection Technique for Wrinkle Reduction in Virginia
Board Certified Facial Plastic Surgeon in Northern Virginia, Dr. Naderi, discusses and demonstrates his injection technique for Botox. Botox is injected to the forehead, crows feet, lower eyelid and frown lines of a young female to PREVENT formation of lines and wrinkles. A very conservative 30 units of Botox is used for all three areas (Cost 0). This can be repeated about 3 times / year.
Thank you very much for the kind comment. Glad it worked out well for you.
I am soooooo calling you on Monday!!!
Thinking of taking the dive and getting botox so I can share with on my site what I think about it
Looks like you know your stuff
Doc,
excellent technique! Are your dilutions 1:1 or 2:1 ?
how many units did you place in the corrugators?
GREAT VIDEO send me more!
@bigal01771
Thanks! I use a 2cc reconstitution. Typically I use 20 units to the glabella which I divide between the Procerus, Depressor supercili, corrugators and lateral portion of Orbicularid Oculi. I place 2 injection sites into the corrugators for a total of about 5-10 units.
Dr Naderi,
Thanks for the quick response. I appreciate it……. 5-10 units into each corrugator, does that depend on size of the muscle and previous result from prior injections? How many units for the three injection in the orbicularis oculi and frontalis. I hope you don’t mind my questions as I adopted you as my new mentor.
Sincerely, Dr. Al, DDS
@bigal01771
My pleasure Doc. Depends on size, strength, sex and the desired results. I place very little in the Orbicularis – about 2 units or so. For the Frontalis, I do less than 10 to keep the brows nicely arched and mobile. I don’t like a heavy, frozen look and feel.
Ur videos r awesome!! Very well explained, very informative…many thanks…
@batwings24
Thank you!
Dr Naderi; once Botox is reconstituted, can it be stored and used for a later time or does it have to be used within a certain amount of time or days before the efficacy wears off??
@batwings24
Good question! Once reconstituted you may keep it in the fridge for 3-5 days or in the freezer for 2-3 weeks. It should not be kept at room temperature. You should use sterile technique by wiping the top with alcohol and using sterile one time use needles. For Therapeutic Botox (which is exactly the same as Botox Cosmetic but with a different label for medical use) the company recommends using one vial per patient and a one time use. There are no clear guidelines.
nice vid ! but doctor im afraid they say botox can be sometimes dangerous for some reasons ! can you explain it please ? thank you xx
@mssuperblondie
Botox is a medication so it should be handled and injected by trained medical professionals. Too many hair salons and spas and non trained people are injecting it these days. However, if used properly, it is relatively very safe. It has been FDA approved in the U.S.A. since 1989 for eyelid spasm and it is used for various medical problems. in cosmetic use bruising and temporary eyelid drooping are the main risks. Eyelid droop should not occur in trained hands though.
i had this done today it hurt like hell
@isisbenny404
Pain is very subjective. The exact same procedure causing a certain pain level may have one person calling it “hurt like hell” while another person calls it “didn’t hurt much at all.”
With that said, injection technique is also very important. Two doctors don’t inject the same way and one may hurt more than another. Having a “gentle smooth touch” is important in making it not “hurt like hell.”
Nice job, Dr. N. How many units per cc is your dilution? Do you put 1.5 NaCl in the powder?
@bonmom
Thank you. I like to use 2cc per 100 Unit vial. I have some use as much as 4cc. That is too much extra saline just swooshing around and can increase risk of Botox migration and adverse brow or eyelid ptosis. In the last 10 years, I have not had even a single brow or eyelid drop (knock on wood). I have seen some use 1 or 1.5cc. Thats fine but it does not give you enough volume for contouring and you will waste lots of botox in the needle hub or at the bottom of the bottle that way
Good educational video
@lovethenewyou
Thank you
Hi Dr. Naderi: I absolutely LOVE your video, very clear & concise. I’m always so worried about injecting in the midpupilary region, close to the brow. Is there any risk in injecting the lateral portion of the orbicularis oculi? I assume a 4cc dilution would be too much volume in this area? My boss likes using the 4cc mix & I’m trying to convince her to use 2cc.
Thanks
@Zandercott
Thank you. I actually do inject the lateral portion of the Orbicularis Oculi muscle in patients that do not want a higher arched brow and in ones who notice glabellar movement despite relaxed Corrugators. These patients recruit muscle fibers from over active lateral O.O. muscle. You have to be VERY conservative and careful and simply sub cutaneous and not very deep and only 2 units of Botox. I am not a fan of 4cc dilution because of the risk of excess travel.
Thank you so much for your prompt response.I’m an RN,actually worked in critical care for many years(at Inova Fairfax back in 1997 in EP lab),moved to San Diego& by chance ended up in this field.I’ve only had botox training through Aesthetic Enhancement Institute& feel those techniques may be outdated, especially after watching your technique.I’ve tried to study the facial muscles& by trial& error have learned along the way.Any suggestions for lifting brows in pt. w/excess movement in forehead?
@Zandercott
My pleasure. The way to do it is to relax all of the “depressors” of the brows while leaving the lateral elevators un touched. They will see some lines laterally over the brow but most patients who desire higher arched brows will choose the higher brow over the completely smooth forehead. There are ways of doing it very naturally and without a tell tale sign of “having botox.”
I think I need to just fly out there for a short internship w/you. =) You’re an awesome teacher….yes, it’s those lateral lines that bug me, especially when they look “rounded” at the lateral aspect of the brow. Any way to avoid this? Also,how do u avoid a spock look on a narrow forehead with many wrinkles? Back to injecting the lateral portion of the obicularis oculi….would injecting this area still allow for some brow lift or will this cause a more horizontal brow? thanks for your help!
@Zandercott
I actually do have a course for doctors and nurses:
botoxfillerinjectiontraining (.com)
The class looks awesome, you’ll be seeing me after the new year I hope. Thanks for all the tips!