The key to a natural and effective treatment outcome is based on experience, judgment, and a thorough understanding of the injectable product. San Diego plastic surgeon Dr. Karam has extensive experience in advanced and innovative non-surgical facial rejuvenation techniques using BOTOX in San Diego and other injectables. He is considered to be among the best BOTOX authorities in the San Diego area, La Jolla, and beyond. One of the benefits of Botox treatments is that there is no recovery time.

Botox treatments are short and relatively painless, allowing you to stop in, get your treatment, and be on your way. Because of this, Botox is popularly known as a “lunchtime” procedure--the treatment only takes about half an hour. You may notice small red bumps just after your treatment. Not all patients experience this, but if you do see them, they will disappear in about 30 minutes. We recommend not exercising, drinking alcohol, or massaging the treated area for 24 hours after your treatment.

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How Long is the Recovery Time After a Botox Treatment?

One of the benefits of Botox treatments is that there is no recovery time. Botox treatments are short and relatively painless, allowing you to stop in, get your treatment, and be on your way. Because of this, Botox is popularly known as a “lunchtime” procedure--the treatment only takes about half an hour. You may notice small red bumps just after your treatment. Not all patients experience this, but if you do see them, they will disappear in about 30 minutes. We recommend not exercising, drinking alcohol, or massaging the treated area for 24 hours after your treatment.

Before & After

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How Does Botox Work?

Our BOTOX in the La Jolla procedure works by decreasing the strength of muscle contraction. Essentially, when BOTOX is injected into a muscle, the muscle weakens. So how is BOTOX used to enhance your appearance and to slow the aging process? To understand this, we first need to understand how a wrinkle is formed. Anatomically, our facial muscles exist under the facial skin. When the muscle contracts during facial expression, the skin moves and a crease is formed. Normally this is not a problem, but as we age, the skin thins and its elasticity diminishes. So with each expression, a line starts to form that gets deeper and deeper with time. This is the evolution of a wrinkle. The upper face is the best example of this process, as most of the wrinkles in this region occur as a direct result of muscle contraction.

Normally this is not a problem, but as we age, the skin thins and its elasticity diminishes. So with each expression, a line starts to form that gets deeper and deeper with time. This is the evolution of a wrinkle.

The upper face is the best example of this process, as most of the wrinkles in this region occur as a direct result of muscle contraction. This preventative process has been well established in an identical twin study.

One twin received BOTOX starting in her mid-thirties while the other did not. 13 years later, there was an obvious difference in the presence of wrinkles between the twins, confirming the preventative value of BOTOX.

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How Fast Can I Expect to See Results?

If you have had Botox before, the results may be seen within the day. If this is your first time getting a Botox treatment, it may take some time to begin to take effect.

Most patients notice a difference anywhere between three days to a little more than a week. Each day, the effect will be stronger.

The full results will be realized in about two weeks. It takes time for the Botox to get the nerves and muscles to relax.

By the time two weeks have passed, the messages from the nerves to the muscles telling them to contract will be fully inhibited, and your skin will be smooth and wrinkle-free.

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List of Areas BOTOX Can Be Used On

Botox has a variety of medical uses in different parts of the body and can be enormously beneficial in that regard. For cosmetic purposes, Botox is used to treat the face. It can address the following areas:

  • Forehead lines
  • Crow’s feet
  • The “11s” (the area between the eyebrows)
  • Upper eyebrow area
  • Lines around the nose
  • Wrinkles at the corners of the mouth or smile
  • Dimpled chin

Botox can be applied to any or all of these areas, creating the desired Botox effect of erasing the lines and wrinkles, and leaving your skin smoother and younger-looking. Almost any facial wrinkles can be targeted and treated with Botox.

FAQ

If I inject BOTOX, will I look frozen or expressionless?

Where can BOTOX be injected?

How long does it take for BOTOX to start working?

How long does BOTOX last?

What are the side effects of BOTOX?

If I inject BOTOX, will I look frozen or expressionless?

The answer is no. If BOTOX is injected in a well-thought-out way by an experienced injector, the dose and distribution can be controlled so you get a softening of the expression but not a complete loss. This is the real goal of advanced BOTOX injections. When done well, no one will even know that BOTOX has been injected.

Where can BOTOX be injected?

Glabella: Our BOTOX in San Diego is FDA-approved for injection in the glabella (the vertical lines between the brows that appear when you frown). This is perhaps the most common area of injection. When this area is injected with BOTOX, the expression appears more relaxed, calm, and pleasant.

Forehead: When you raise your eyebrows, you see horizontal lines running across the forehead. This muscle, the frontalis, is the only muscle that lifts your eyebrows. BOTOX injections here need to be done with caution to avoid eyebrow droop. This is prevented by proper BOTOX injection techniques and by choosing the right dose. If high doses are used, the brows and eyelids may feel heavy.

When BOTOX is injected well, the horizontal lines that run across the forehead will soften and in most cases disappear while allowing you to still move your eyebrows.

Crow’s feet: These are the smile lines that form around the corners of your eyes. They are caused by the contraction of the obilcularis oculi muscle. Repeated contraction of this muscle leads to fine lines and wrinkles along the lower eyelid and around the corners of the eye. When treated with BOTOX, the lines and wrinkles are softened and the transition to permanent lines and wrinkles around the eyes is prevented.

Brow lift: A small area along the end of the eyebrow has a muscle that pulls the end of the eyebrow down. When this segment is injected with BOTOX, the tail of the brow can raise 2-4 mm, giving the appearance of a brow lift.

Neckbands: Some forms of neckbands are caused by strong muscle contraction. These may appear as vertical bands that run down the neck. They can appear tense. In these cases, when BOTOX is injected, the bands can relax, improving the contour and shape of the neck. Great care needs to be taken during this injection, as the neck has many important structures.

Downward turning corners of the mouth: A small muscle that inserts into the corner of the mouth called the depressor anguli oris muscle is partly responsible for turning down the corners of the mouth. A small amount of BOTOX into this muscle can help turn the corners up, decreasing the sad look caused by this muscle.

Facial asymmetries: Patients suffering from facial nerve disorders resulting from tumors or Bell’s Palsy can be helped by strategically treating different facial muscles to improve the balance of the face.

BOTOX treatment of migraines: Certain varieties of migraines and headaches have been shown to improve with the proper placement of BOTOX in certain muscle groups.

How long does it take for BOTOX to start working?

BOTOX takes anywhere from 1-3 days to start working and takes approximately 2 weeks to reach peak activity.

How long does BOTOX last?

The typical duration of our BOTOX in La Jolla injections is between 3-5 months. The duration of BOTOX is dependent on 2 primary variables: 1) The strength of the muscle and 2) the dose used during the injection.

Simply, the stronger the muscle or the lower the dose, the shorter it will last. Conversely, the higher the dose (to a point) and the weaker the muscle the longer it will last.

Each patient has a specific dose that is ideal to achieve the desired effect. Some of our patients who are in front of the camera or are public speakers will get lighter doses more frequently so that they can look natural yet still get the beneficial anti-aging properties.

What are the side effects of BOTOX?

Like anything, BOTOX has potential side effects. Each prospective patient needs to review these in detail with their physician and understand the potential issues.

Having said that, the cosmetic uses of BOTOX have been shown to be very safe when injected by experienced hands. Common side effects such as eyelid ptosis (the most common side effect), brow droop, or asymmetries are typically related to injection technique and can be minimized by an experienced injector.

Reviews

Francine M.

"I had a vertical restore at age 65 with Dr Amir Karam. It has been a little over a year and I am delighted with the results. Some of my friends have not even noticed - I just look rested. Dr Karam will provide you with all the information and supplements that you need to make the procedure and the recovery time as comfortable as possible. I usually bruise very easily but with the supplements that were given to me prior to my procedure and afterwards, my bruises were gone within a week."

"I highly recommend Dr. Karam and would go back to him for anything I might want done in the future. I totally trust his approach and recommendations. You won't be disappointed!"

Kris R.

"I'm one month out from a Vertical Restore with Dr Karam. Dr Karam is an incredibly talented Surgeon. I can barely see my scars already. I also did a laser peel, within 8 days I was wearing makeup and admiring my new jawline and neck. I'm 65 this month and so happy I chose him. He is the best there is. His staff are fun, caring and kind. They made my entire experience so easy. I would not hesitate or even think about going anywhere else. Check out his Instagram account. He does all his content himself. Extremely informative, with many before and after photos. I decided on Dr Karam after researching his Instagram and had made my decision before we had even met."

Janice S.

"Dr Karam is a great surgeon, a true artist and a wonderful human being. He has done 2 procedures on me over the last 3 years. Both with excellent results. His fat transfer and his lip lift technique are extraordinary. I wouldn't think of going to anyone else and I would highly recommend him to anyone who is looking for the best."

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