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Botox Is Finally Approved by FDA for Use in the Forehead Area

Article from New Beauty Blog by Tatiana Bido , Special Projects Editor | October 03, 2017

With new uses of Botox Cosmetic being explored every day (like a cure for depression, a temporary fix for a gummy smile and the unfortunately named Scrotox), it’s hard to believe the drug isn’t already approved by the U.S. Food and Drug Administration for all of its many indications. Even though the substance has been around since the '50s and '60s, it was only in 2002 that Botox Cosmetic received approval for treating frown lines and facial wrinkles (and it was just approved for use on crow’s-feet in 2013). Now, the FDA has approved the brand for use to treat forehead lines as well, making it the only neuromodulator on the market approved for use in wrinkles in three areas of the face—forehead lines, crow's-feet and glabellar lines.

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If it seems like Botox Cosmetic has been treating forehead wrinkles for a very long time, that’s because it has. Doctors have been using the drug to treat forehead lines “off-label,” meaning outside of its FDA-approved use, for decades. Once a drug obtains FDA-approval for one condition, a licensed physician can legally prescribe it for other conditions that they believe can benefit from the drug. The recent FDA-approval for the use of Botox Cosmetic in the forehead area just means that the drug has passed numerous clinical trials and is proven to do what doctors and patients around to the world already know it can, temporarily banish lines and wrinkles. 

You May Also Like: The Most Under-the-Radar Uses for Your Favorite Injectables

"As a physician, I've been using Botox Cosmetic since it was FDA-approved in 2002, but for years my patients have also inquired about how to treat forehead lines. With this latest indication for Botox Cosmetic, I have an FDA-approved product I already know and trust, that can improve the appearance of the forehead," says Boca Raton, FL, oculoplastic surgeon and lead clinical trial investigator, Steven Fagien, MD. 

According to the American Society of Plastic Surgeons, more than 7 million Botox Cosmetic treatments were administered in 2016, making it the number-one noninvasive cosmetic treatment in the country. And with younger patients turning to the injectable for preventive measures, we forsee more FDA-approved uses in the years to come for the treatment Time Magazine called “The Drug That’s Treating Everything.”

https://www.newbeauty.com/hottopic/blogpost/11409-botox-fda-approved-forehead-lines-wrinkles/

Q & A on botox & filler

1. What's the different between Botox and fillers? 

BOTOX® Cosmetic is designed to reduce the repetitive muscle contractions that cause frown lines, crow’s feet, and forehead wrinkles.  Lines and wrinkles caused by active movements or expressions are what we call dynamic wrinkles.

As the BOTOX® Cosmetic takes effect (about 5 to 7 days) you will notice a visible smoothing of your crow’s feet lines and frown lines between your brows.

Dermal filler is an injectable soft gel that acts as a volumizer, providing a subtle smoothing, plumping, volumizing effect as well as lifting areas of moderate to deeper folds or volume loss, such as smile lines, marionette lines, down turning smiles (oral commissures), lips and cheeks. 

2. When should someone start doing botox?

I will start by saying, everyone is different.  There are a lot of factors that play into facial aging and premature aging, including sun exposure, environment, diet, hydration, skin care and genetics.

The best time to start is when you are looking in a mirror and you make an expression to see the lines, then relax.  Are the lines still there?  Even faintly, can you see an impression of it?  That will only continue to increase with continue use and exposure.  It is much easier to do BOTOX® Cosmetic once a year on a preventative front, rather than coming in a few years down the road and having to do much more to correct.  Just like a healthy diet and exercise routine and lifestyle maintenance, it is never too late to start but the sooner the better the results will be.

3. What are the benefits of botox?

BOTOX® Cosmetic have some amazing benefits.  For aesthetic purposes BOTOX® Cosmetic can smooth out facial lines and wrinkles resulting in a younger, fresher-looking face.  When used on the frown lines which are the lines between the eyebrows, it softens them up so much resulting in a less angry look to the face.  When used on smile lines often referred to as "crows feet" it gives a slight lift or pulled look creating a younger face minus those deep lines and wrinkles you see every time you smile.  

We also use BOTOX® Cosmetic and Dysport for Hyperhydrosis (excessive underarm sweating). 

I personally undergo this treatment and it is not painful. I do not even use numbing cream. The effects are amazing.  I have nearly a 100% reduction in underarm sweating and am able to wear some of my favorite silk tops, even in the Miami summer!  The results last for just over 6 months.

BOTOX® Cosmetic to treat hyperhydrosis is a great option for those who don't want sweat stains or don't like using deodorant.  It is a very popular treatment all year round in Miami due to the high humidity and the big social scene and designer outfits.  Celebrities often go for Hyperhydrosis treatments before the red carpet events.

4. How can someone avoid that "frozen" look with botox?

Go light - if you go light though, expect it not to hold as long and may require you to come in more frequently

Or rotate the areas - don’t do all 3 at once

Also, some people like the frozen look – they prefer the stoic, poised and unnerved appearance that it can provide.  I find this more in people who are very emotionally expressive.  In the sense there is little buffer or filter between the thoughts in their head and the expression on their face.  They appreciate the veil that botox can provide.

At smith & popov we are very conservative and always prefer to provide a natural look to the face.  We focus on smoothing out the wrinkles but allow movement so it doesn't look like you have had botox.  It simply looks as if you look youthful and refreshed.  We do get some requests from our clients who want to have a "frozen" tighter and smoother look and some benefits include a more awake wide eyed look and as well as a subtle brow lift appearance.  After we spend time discussing the options we always work together to get the results our clients want without going too extreme.

5. Fillers...what do they do exactly?

Simply put, fillers fill.  They add volume where volume needs to be added, either to restore or enhance.

Volume is super important as we age because we tend to lose it in our face resulting in a hollow, drawn and droopy look.  By using dermal filler injectables you can really build the face back up to look youthful and plumped.  Aside from age prevention, fillers are amazing for those who do not have the features that they want.  We can create those features for them.  Whether it is a full, plump lip or high contoured cheekbones.  We can add volume to various areas of the face to fix almost any superficial imperfection.

6. What are your dos and dont's of fillers, especially at a young age (25-30)

In today's media and with reality shows glamourizing botox and fillers on younger girls who happen to look really good and have great results the do's are to go slow and spend time talking to the specialist to make sure that the look you are requesting is right for you.  So just because your favorite celebrity has va va voom lips it may not necessarily be the right look for you.  Be realistic with your goals and what you want to achieve.

Do: Educate yourself – this is something that we pride ourselves on at smith & popov.  We welcome questions and consultations.

Do: Keep it natural. Do things in stages and not too much at once. If someone is advising you to do more than you are comfortable with in the first treatment, you may want to get a second opinion or do more homework.

Do: Your homework on your provider.  The least or most expensive deal in town is not necessarily the best. 

In Florida you want to look for providers that are Nurse Practitioners (ARNP, NP), Physician Assistant’s (PA), Medical Doctor (MD), Doctor of Osteopathic Medicine (DO), or Dentist (DMD). 

Not all botox is created equal. 

Do: Make sure you are getting US Allergan BOTOX® Cosmetic from a verified provider.  You can check https://www.botoxcosmetic.com to make sure your provider is registered under “find a provider.

Do: Follow provider pre and post treatment instructions and follow up recommendations.

Do: Maintain your investment – take care of yourself and your skin

- use your sunscreen, wash your face, remove your make up at night, eat a balanced healthy diet, workout regularly, drinks lots of water, don’t smoke, and limit excessive alcohol.

7. How often do these procedures need to be touched up?

When first starting with a patient, I tell them to expect to come in for a touch up.  It takes building a relationship with the patient to get to know what they like and to see how the products work for them.  I much prefer to be conservative to start and then add on whatever additional is needed for a touch up.   After that, it's very infrequent.

7. Add On - What does a maintenance plan look like?

It depends on each patient and how far along they are in the aging cycle. 

If you have moderate to severe wrinkles I would recommend staying on top of your BOTOX® Cosmetic cycle with consistency at every 3 to 4 months.

When you have deeper lines that we are working to correct, I advise my patients not to wait for the wrinkles come back, but to come in when they start seeing the movement return.  Don’t wait for the lines to fully form again. That’s how we stay ahead of them. 

If you are more of a preventative case, you can get away with doing BOTOX® Cosmetic once every 6 months to a year.

8. Is there a way to get these done without looking "fake" going for a more natural look?

Absolutely, it is all about finding the right provider who values that natural look as well.  It is always best to start low and go slow.  Dip your toe in, try it out, add it on slowly.  You can always ask to see your provider’s “before and after” photos to get a sense of their injecting style.

Keep it to 1 to 2 syringes per treatment with filler then go back after the product has settled.

Danielle Smith’s philosophy is to be conservative and natural.  We are committed to giving our clients the results they want.  We work with first timers, individuals on a budget and those high profile "perfectionists" who have very little down time and rely on the natural look for their careers.  There is simply no rush.  Starting slow and evaluating as you go is the way we work.  We create relationships with our patients where they have access to us 24/7 if needed and at smith & popov we only offer private one on one appointments where we spend time educating and discussing options.

9. How to decide if either of these are right for you.

The best way is to inform yourself.  Go and visit your provider.  At smith & popov we are big on educating our patients.  We offer complementary consultations and welcome the questions.  We want our patients to understand exactly what they are looking for and what their options are.  If someone is uncertain or hesitant, I will give them a list of educational resources or other referrals to help them gain more information and knowledge.

 

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all about that boo-tox

Miami Aesthetic Nurse Practitioner Danielle Smith uses Botox Cosmetic for wrinkle elimination in areas such as crows feet, between the eyes - glabella (aka the 11's), smoker-lines or lip wrinkles, laugh lines, neck wrinkles (bands) and many others.  Danielle Smith NP will also use botox to decrease the contractility of certain facial muscles in order to “open” specific areas.  The best example is using botox injections to open the eyes.  Click here to read more about eyelid rejuvenation.  

Crows Feet

Eyes are the windows to the soul and often the first place to show signs of aging.  Botox Cosmetic is used around the eye to smooth out and soften both superficial and deep lines; creating a youthful, refreshed and rejuvenated appearance.

Frown Lines

The vertical lines and grooves between the eye brows can create a constant angry look.  Botox Cosmetic is used to target and relax muscle activity in this area to visibly smooth the lines resulting in a younger, softer-looking appearance.

Forehead lines

With constant movement and facial expressions, such as raising our eyebrows, we tend to form lines and wrinkles on our forehead.  Botox Cosmetic relaxes muscle activity to smooth out lines and wrinkles for a more lifted, refreshed look.

Bunny Lines

Bunny Lines are winkles that form at the sides and top of the nose when you smile, laugh, scrunch and squint.  Botox Cosmetic is a quick fix to subtly soften, smooth and prevent these lines from becoming deeper. 

Brow Lift

Danielle Smith NP uses Botox Cosmetic to target the muscle that depresses the brows relaxing them in an uplifted part of the face for a more vibrant and rejuvenated overall look. 

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my wrinkles

Fun Fact ▪️I used to require 70units of botox to tame this forehead and frown lines. It took me 2 years of injecting 70 units of botox every 4months to get it under control. Now I simply maintain with 15-20units every 4months. ▪️Can you believe I was 21 in this photo? ▪️
I often get asked, "When is a good time to start doing botox?" Most people would think 21 is way too young to start until you see this forehead... Each patient is different, but my general rule is 1) if you make the expression and then relax, can you see the lines at rest? If yes, (even faintly)... it's time. ▪️Without botox the lines will only continue to set and get deeper. Which then requires more units, and more time to correct them. 2) sooner is always better than later. ▪️even if it's once, or once a year, the smallest amount of botox prevention can make a huge difference. ▪️The GOAL 🥅: to be able to use the least amount of botox overtime. By starting early, we can stay in prevention phase longer and then maintain with less. I like to call this ▪️BABY BOTOX ▪️it optimizes movement and expression while suppressing wrinkles and lines to give the most natural results possible. ▪️▪️▪️get the magic @smithand_co