Mrs. DC America Gets Botox Smile Injections in Chevy Chase by Dr Naderi

Good morning. We're doing another video series in the Botox and Filler Injection instructional series. And we have a beauty pageant winner, Mrs. District of Columbia from 2012, who's volunteered to do some Botox with us and get a little bit of benefit from it. Obviously, she's young. It's really for prevention. I've kept talking about, about prevention being the most important thing about Botox. Most people think of Botox as needing Botox once you hit your 40s and 50s. But really the most important thing is understanding that if you're expressive, if you're forming expression lines in the 20s and 30s, you should start doing Botox to prevent lines from forming. Because once the lines form, then we have to think about chemical field and lasers and other various techniques and filters. So in this case, obviously, a beautiful pageant winner doesn't need a whole lot of work. But the prevention is in areas that everybody performs certain lines. We're talking about crow's feet lines and some forehead lines. And I want to talk about the anatomy of this. I've talked to Erica about this. Basically, the forehead lines do bother her, but when we discuss what's realistically possible, we've chosen to stay away from it. And I'll tell you why. So I want you to raise your eyebrows me. And you can see as she raises her eyebrows to blow dry her hair or put eyeshadow, things like that, she notices these lines getting worse. You can do some Botox to help those lines, but as you Botox the muscles, she can't lift her eyebrows, and she prefers to have that arch. She prefers to have the higher eyebrow. And I can certainly smooth out her forehead with Botox. But then what's going to happen? The brow will feel heavy and lower, and that's not something she's interested in. If she wanted to do something like that. And about five to 10 years later, then she can think about lasers and brow lift and upper blepharoplasty. But at this point, we're just going to leave it alone for now until it gets to the point that she definitely chooses to do some Botox over the position of the eyebrows. She does form some smile lines. Not that aggressive. Go ahead and smile for me. And you can see that the eyes tend to close up a little bit. Again, it's not terrible. She has nice volume to her face, but it's really to prevent these lines from getting deeper and starting and forming those permanent indentations that we want to avoid. So we're just going to do a very conservative Botox and you've seen me in the past when I do Botox through the crow's feet, I usually have four spots below the eyebrow to keep the eyebrow arched. Lateral canthus, crow's feet area, the inferior portion, and then I come to the lower eyelid area. And that's a very well known thing that I do with most of my patients. I'd probably say about 95% of my patients get that lower eyelid injection. But we're going to avoid that for her because she's really not forming lines there. And she does have a little bit of a tear trough here that can make that worse. So until we take care of the tear trough and do some volume with resting for her, we're going to leave that Botox alone. So it really will be just three spots. And I'm going to show you how I'm going to do that. You ready? All right, so we're going to start and we talked about the three points that I'm going to do on her. The first one is about a centimeter and a half away from the lateral canthus. This is really important. You just want to just put the tip of the needle under the skin, barely penetrating, and then create a bleb. You can see that bleb. And that's the Botox. If you go deep, you're going to hit blood vessels and you're going to get bruises. But if you stay very superficial, you don't get that. The second one is underneath the brow, and you really want to lift the eyebrow to pull it out of the orbit and you go below the brow because again, you want to create a little bit of a lift to the brow and it goes right there. The third one, you're creating a V shape fashion. The third one is going to be in this area. And again, just the head of the needle goes in and you create this little bleb. And you can see the bleb get elevated and that's it. Those are the three spots. And I'm going to have her bring her left hand up and hold pressure here while I go to the other side and put her all the way up to the eyebrow as well. For me, Erica. Okay, come closer. We're going to do the same thing here. Again, about a centimeter and a half just ahead of the needles going in. I'm raising this bleb. You can see this bled and barely the head of the needle went in. That's where you want to do it. Around this area. I lift the brow up, I go underneath it, place a little drop right there. And then I come down, create a V, place another drop here. That's essentially it. That's all she needed. I'm going to have you hold this for me. So basically, that's all that we did about 20 units of Botox that are crow's feet. I didn't do the lower lids for her. She didn't need it. You have to individualize every treatment. Not every person needs the exact same Botox. Not in the same locations. There are different places you can put it even underneath the eyebrow. Sometimes I place a little bit more medially underneath the lateral arch. Sometimes it's more laterally underneath the head of the eyebrow. And again, you have to examine your patients and see what their face looks like and what their expressions look like. Thanks. And thank you. Before botox, after botox.