What can Botox do, and what can it not do?

What it actually does

Botox works where the nerve meets the muscle. The nerve still fires and the muscle still works, but the signal between them is interrupted, so the muscle stops overcontracting and the line it was folding into the skin softens.

“The Botox is not gonna make you sick. All it does is that puts a block between your muscles and your nerves, so the nerves are still working, the muscles still working, but there's a miscommunication between the two of them.”

That is why it belongs in areas of heavy movement: between the brows, at the outer corner of the eye, and across the forehead.

Botox and filler are not the same treatment

Botox stops a muscle from creasing the skin. Filler replaces volume and structure. Patients often arrive expecting one to do the other's job.

“You may not know this. Botox and filler are completely used in different areas. Botox is used in the areas that you have a lot of muscle movement as movement is giving you frowning or a lot of wrinkles around your eyes. We use Botox to relax those muscles not to be overactive.”

How long it lasts

Around two to four months. The effect fades as the nerve signal returns, so the result is held through regular treatment.

“That usually lasts around two to four months. That's why you need to get these treatments done fairly regularly if you want to maintain the results for as long as possible.”

There is no permanent version, whatever a search result promises.

“permanent Botox is there such a thing unfortunately not”

Why some faces end up frozen

A frozen or done look is usually a placement problem. When one area is relaxed and the muscles beside it are left to pull, the face moves unevenly, and that is what people notice from across a room.

“If you can recognize someone who has done Botox from a distance, that's one that has not been done right.”

Dr. Ourian sets placement by watching the face move. He has the patient smile and frown before deciding where each injection goes, so expression is kept rather than removed.

When he says no

Experience decides who should not be treated, and he says so before treatment rather than after.

“It's experience that tells me if a patient is going to have good results right off the bat. I can tell them, You know what? You may not be a good candidate for Botox or any other procedure.”

Prevention, and the twenties

On record he ties prevention to the point where collagen and elastin start to break down, not to a particular age.

“At some point your collagen is going to break down. Your elastin starts to break down. You got to do something.”

For younger patients, his advice starts with learning your own skin before adding treatment.

“You really have to learn your skin. So, not every skin is the is the same and you have to become your own uh professor of your own skin.”