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Many people often think of Botox injections as a generic service however, "paralyzing wrinkles with a fixed quantity of toxin in predetermined areas is not how the game is played in the big cosmetic league," says Dr. Wells. For him the real beauty of Botox is in creating "balance." Facial muscles, unlike all others in the body, connect the skeleton to the skin. As such they act to allow expressions. Long before language developed, animals and primitive people used facial expressions as a principle means of communication. In fact, even today we read emotions on faces constantly. Unfortunately, expressions we commonly make strengthen those involved muscles, while other muscles less used get relatively weaker. So one can imagine that over time the relative balance of our facial muscles changes. This is why aging often results in a more sad or concerned constellation of expressions as compared to the faces of younger people.

Physicians are taught to use Botox in very defined places to diminish specific lines or creases such as the “11s” between the brow, and crow’s feet at the sides of the eye. As a long time experienced injector, Dr. Wells studies the relative strength or balance of the muscles, and strives not to paralyze muscles, but to rebalance them. This requires a much more sophisticated understanding of anatomy and a global approach to injecting the face. Done well, this Botox Balancing renders the patient much more attractive and younger appearing. This phenomenon occurs not just because an offending crease or wrinkle is ameliorated, but because the patient’s entire constellation of facial expressions are returned to a more youthful position. Think improved facial posture. In addition, certain areas of the face such as the entire brow/eyelid complex, midface, or even jowls may be lifted by diminishing overly strong muscle pull in the undesirable directions, while leaving intact muscles that pull in the desired direction.

It’s all about Balance. Great Botox results are all about youthful "Balance."

Originally published: 05/12/16

Scott Wells, MD

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