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Remarkable facial rejuvenation begins with BOTOX

Today’s cosmetic patient expects the highest level of care and treatment outcomes. Rightfully, people want results that are both natural and enhancing. We have dedicated ourselves to meeting this demand by not only providing excellent care, but also leading the way with innovative applications and teaching others in our specialty, with the ultimate goal of advancing the entire field.

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 considered to be among the best BOTOX authorities in the San Diego area, La Jolla, and beyond.

Dr. Karam is frequently invited to lecture at national training courses on the latest uses of injectable products and is a speaker and national trainer for Allergan, the makers of BOTOX, Juvederm, and Latisse. He frequently trains physicians and other health professionals around the country on the safe and effective use of non-surgical injectable approaches to facial rejuvenation.

Dr. Karam has become the trusted source for excellent and consistent outcomes, with patients consisting of other cosmetic professionals, physicians and industry leaders. His patients travel from throughout the country for their treatments.

Carmel Valley Facial Plastic Surgery, located in San Diego California, is among the highest volume providers of cosmetic injectable treatments, earning the Platinum Provider status from Allergan.


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Commonly asked questions about BOTOX in San Diego California:


1) If I inject BOTOX, will I look frozen or expression-less?

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.

2) 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 disappears 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.

Neck bands: Some forms of neck bands 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.

3) 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 are 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 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.

Before & After

Dr. Karam, who is board certified by the American Board of Facial Plastic and Reconstructive Surgery and American Board of Otolaryngology, offers services in San Diego County including San Diego, Del Mar, Carlsbad, Carmel Valley, Encinitas, Rancho Bernardo and La Jolla in Southern California.

If you are ready to schedule an appointment with Dr. Karam, contact us today.

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