April 2, 2025 • 36 mins
In this episode of Plastic Surgery Uncensored, Dr. Rady Rahban teams up with his aesthetic nurse Charlene, the newest member of his team, to kick off an exciting new aesthetics series starting with a fan-favorite: neurotoxins. From Botox and Dysport to Daxxify and beyond, they break down how these wrinkle-smoothing injectables really work, where they’re used, the common myths, and why less is more for natural results. Whether you’re a first-timer or a seasoned Botox fan, this episode is packed with must-know insights, honest opinions, and expert tips to help you make smart, confident decisions.
Tune in, laugh a little, and learn a lot.
Tune in, laugh a little, and learn a lot.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
All right, welcome to another episode of Classic Surgery and Censored.
I'm your host, doctor Roddy Rabond, and we're going to
put together a little quick series for you. I think
you guys are going to like this upcoming series. I'm
here with Charlene, our newest member to our team. As
many of you know, and as many of you may
not know, we recently opened up what I've referred to
(00:27):
as a wellness center, a METSPA of sorts. It's called
actually Restore. And in that wellness center or met SPA,
one category is esthetics, and we're going to sort of
do a multiple part series where Charlene and I kind
of hit each of the menu of services that we
(00:48):
provide and do so in a much more expanded way
for you, so you have a much better understanding of
what each of these treatments are, what you can expect, downsides, risks, etc.
And so I hopefully you'll enjoy it. And as a result,
whether you come to our SPA or you're doing this
wherever you are, you have a good understanding of what
to ask for and what to expect. Okay, so today's
(01:10):
let's this episode is going to be about neurotoxins, neurotoxins
or neuro modulators, And essentially what that means is drugs
that we inject and as a result of injecting them,
they modulate or affect the muscles, which then affects the wrinkles.
(01:31):
And the most famous of such is botox. Actually, I
am guilty of using the term botox as a ubiquitous term,
even though we're going to talk about the different brands
there are different brands of it. We use botox just
because it seems to be the most commonly. It's a
universal term. It's kind of like using Kleenex to describe
(01:51):
tissue paper, right, all right, so Charlie, right now on
the market, there are multiple you know, Botox was the
first one to come into the market for the For
those of you who don't know, botox was originally a
drug that was invented for medicinal reasons. It was not
a cosmetic drug. It was a drug that was used,
if I'm not mistaken, in ophthalmology for blepharospasm. People would
(02:14):
get twitches in their eyes and this drug was invented
and it would help address that. And then later of
course they realized, wow, it does more, and here we
are now and it's essentially the I would say the
number one cosmetic treatment globally.
Speaker 2 (02:29):
Absolutely.
Speaker 1 (02:30):
Yeah. So aside from botox, which everyone knows, what are
the different names of neuromodulators that are out there now?
Speaker 2 (02:38):
There is a couple of different ones, and every year
I feel like there's more that are coming out. Botox
is definitely one of the most common dysport. We have, zemin, Juvo, Daxify.
There's a whole bunch of different ones coming out.
Speaker 1 (02:51):
So first thing people want to know whenever there's things
that are multiple, it's like which one's better. Yeah, And
the reality is that I would argue in this particular arena,
they're all pretty much six of one, half a dozen
the other for several reasons. Number one, the main reason
they're all the same is because the actual active drug
the drug is the same drug. It's bochelinim toxem, a derivative,
(03:11):
and so the same would be equivalent of ibuprofen, motrin,
and advil, which is better. People come to me and
they're like, oh, I only add so much better. It's
like it's the same drug.
Speaker 2 (03:22):
Yeah, That's exactly how I explain it to patients too,
and they ask me, I say, it's all about preference.
You know, sometimes you don't really know unless you try
different types. But that's exactly the same analogy. Yes, it's
like it's using a different type of ibuprofen, you know.
Speaker 1 (03:37):
Right, and so the one that so the base drug
is the same. However, where the little bit of nuances
come is in the way that the drugs are carried,
the carrier meaning inside the drug, how you and then
also how each provider reconstitutes them. In other words, you know,
(03:57):
they come in as a powdered form, you add saline,
that siline then reconstitutes it. The degree of the dilution
equals the strength. So for example, you may go to
one met SPA and you're like, well, dude, the disport
didn't work. Then I would assure you if disport didn't work,
(04:17):
it was the way they diluted it. Because Disport's going
to work, saxifies, they're all going to work. They'll work differently.
But I think a bigger issue is who's injecting you
and how they dilute it, in other words, the concentration
of the drug. We in general, Charlene and I are
partial to Disport. The reasons why I've used Disport for
(04:40):
shoot as soon as as soon as it came out,
and the reason I like it a little more again
they're all the same a little more than the other
ones is I feel that it kicks in a little quicker.
Maybe what do you think about three maybe three days
to five days we would say. I felt like Botox
took like five to seven days. Second, I feel like
(05:02):
the Disport, pound for pound, is a little stronger. So
if I put in five units of Disport, I'm sorry,
five units of botox. Technically, the way the numbers work,
it's fifteen units of Disport, but let's just say for
all intensive purposes the equivalency. I feel like the Disport
(05:24):
sort of lasted a little longer. Did you get that experience? Yeah?
Speaker 2 (05:28):
For me personally, that's how I felt about it.
Speaker 1 (05:30):
Yeah. And then the other thing I like about the
Disport was that. And this actually turned out to be
something that people hated about the Disport originally. It spreads
a little more. And so if you do reconstitute it
with too much saline, in other words, I want to
put a dot of disport here above my brow. If
(05:53):
it's too dilute, I have to put a lot of
fluid and it spreads, And initially when it first came out,
myself included I was diluting it the way I was
diluting botox, and I had some non desirable outcomes. People
immediately blamed the disport. Again, yeah, you should blame the provider.
And now that now that I use a very much
(06:15):
more concentrated form, I feel like the reason why I
like it is when you put botox, the drug goes
and it works in a very finite space. So the
space right next to it, I feel, is a bit
more abrupt, like it's on off, on off, whereas the
disport kind of like spread.
Speaker 2 (06:34):
It has like a really nice diffusion.
Speaker 1 (06:35):
A diffusion to it exactly.
Speaker 2 (06:37):
So that's how I even felt when I had it
done on me. Personally, I've had botox done the very
first time and I felt like it was very harsh. Yeah,
but with the disport it really was a soft effect,
but it gave me the exact type of results.
Speaker 1 (06:48):
Yeah, so we like, I think we both agreed on that.
In general. Again, doesn't matter if you're going to respond
they're injecting you with Daxify, as long as you like
the outcomes, and the price point is about the same.
That's really good. The next thing about these drugs is
people want to know, let's talk about where we can
use them. So we're the areas that what I would
consider the core areas that we would use the neuromodulators.
Speaker 2 (07:13):
Yeah, core areas would be the upper third of the face.
That'll help with the fore headlines, the frown lines, and
then the crow's feet.
Speaker 1 (07:19):
Yeah, so we call them the number eleven people who
do a lot of frowning. Right right in the middle
of your eyebrows. Those are the muscles, are the corrugators,
and if you see they kind of move inwards. Some
people have an additional muscle called the preserus, and it
comes it pulls down so it has a line across
the nose. There is the forehead, the frontalis, and then
(07:41):
of course the crow's feet, which are on the side.
And I think those are tried and true, and those
are areas that when people ask me like, oh, I've
never done botox before, what areas you suggest? I always
suggest those three, even if one of your three areas
is worse than the others. So I don't generally tell
people to just do their forehead or just do their corrugators.
(08:04):
The reason being is that I feel, and I don't
know if you've experienced it, that when I inject one area,
I find like the other area gets a little worse
because people are trying to still animate without knowing it,
and it's just isolated and it just overcompensates.
Speaker 2 (08:20):
When you relax when area, the other area is going
to overcompensate and have a strong repult.
Speaker 1 (08:25):
Yeah. So those are the three tried and true areas.
But there's a boatload, I mean a boatload of areas
that people inject. Now, I myself, I just I've always
been more conservative and I like things that I think
are consistently awesome, not usually awesome. So the other areas
that people do I think that are effective. One. I
(08:47):
think massaters are effective, definitely. I think the problem with
massads is overinjection. Yeah, it's a muscle unique you don't
need you from the talent.
Speaker 2 (09:01):
Very common right now to do a lot of botox
and the masters because people want that cosmetic effect of
that facial swimming. But even for me in my practice,
I don't like to do that. I always I always
question the patient. I'm like is this going to be
for cosmetic reasons or therapeutic?
Speaker 1 (09:16):
Right? So why would you do Why does one do
the master? Right? Yeah?
Speaker 2 (09:21):
So for me, I like to treat the masters therapeutically.
If someone has strong massters, if they clench a lot,
if they have TMJ, if they just want a little
bit of relief from that area, doing the massaters with
botox could really relieve some of the pressure in that area.
Speaker 1 (09:36):
So we found that it affects migraines mm hmm. We
found that it affects grinding and teeth decay right, some people.
I've had patients who have broken through mouth guards. We
found that it affects TMJ, which is directly, and we
found that affects just regular garden variety headaches. So in
that regard, I think it's really effective. The problem is
(09:59):
that as you inject the massater, it's a muscle and
a will start to soften and it becomes slimmer, and actually,
in my opinion, esthetically it looks worse. The reason I
don't like it is that we do everything we can
aesthetically to create a strong jaw, and the muscle in
(10:21):
some people is a critical part of that angle of
the jaw, and I think when you over inject and
really melt that muscle down a I think that it
affects chewing, which is what the massater was designed for. Two.
I think it softens the angle so much that you
lose that transition and your mandible kind of just blends
(10:42):
into your neck. The reason it became very popular esthetically
is actually in the Asian community, right because they're one
of the only, really the only community who has a
lot of jaw angle and maybe could benefit from a
little bit of so called slimming. But that's more of
(11:03):
a Korean like, they like heart shape, not square shape.
But I would tell you ninety nine point nine percent
of times I'm aesthetically striving for an angle, So I
would caution you. I think I never inject more than
fifteen units, So it's usually ten to fifteen units. You
see most people they're dropping twenty five units per side
or more. I think you're going to get into trouble.
(11:26):
Another area that I find really effective is injecting the
chin pad, right, And why would we inject the chin pad?
Speaker 2 (11:33):
Are this little temple?
Speaker 1 (11:35):
Yeah, I call it cobblestoning or pew the orange pew,
the orange is orange peeling, and it usually occurs for
people who are straining this muscle. The mentalis muscle helps
keep the mouth shut, and some people just animate forcing
their lips together.
Speaker 2 (11:53):
It's a little overreactive, and some people don't realize that
they even tend to do.
Speaker 1 (11:57):
Ninety nine percent of times where I do chin, I
may yeah, because it's one of those things that you
only do when you speak, and when you're looking in
the mirror, you're not speaking, so you don't see it.
So then it's one of those things that I generally suggest.
The beauty of that area is it's like five units.
It's like it takes nothing. An area that's another area
(12:19):
that is effective but needs to be thought through a
little bit is neck bands. So neck bands is a
little you gotta be careful number one. It's a large muscle,
so you can drop a ton of money and a
ton of neuromodular for little gain. So for example, I
(12:42):
do it a lot of actors and actresses people that
are on camera because of the band. When they speak
and they animate, it sort of bounces and they see
I stood in people who really don't want to have surgery.
But this is the caution must be exclusively muscle, and
(13:05):
unless you're super young, I'm talking early forties or younger.
I find that as you get into your late forties
and fifties, now you're having some skin accumulation, so skin
and muscle, and then you'll inject these bands and maybe
it's a little better, maybe it's a little worse because
(13:27):
now the muscle relaxes and your skin, which needs a necklift,
becomes more prominent. So this is neck bands. I don't
think are a treatment for people who are older and
their necks starting to sag and they need a facelift
or a necklift. It's a good thing in young people
that have hyperactive or overactive necks. Yeah, I agree. We
(13:50):
have some areas that I don't love. We have the DAOs.
I'm not a fan. Some people are What is the
doos and what are they for?
Speaker 2 (14:05):
The dieos pull down the pretty much the lateral sides
in your mouth. So it's the ones that make you
frown like that, right.
Speaker 1 (14:12):
They're the muscles adjacent to your mentalis and when activated,
they're attached to the corner of the mouth and they
pull the corner of the mouth down. The idea or
the objective is that when you inject it and it
relaxes the muscle the corners of the mouth wise up.
(14:34):
My experience has been that because that area has a
cluster of different muscles, there's actually not just one muscle
there that if it's not exactly done correctly, it causes
actually animation deformity, like you're talking and your mouth is
just off and like one side's higher than the other.
And for many years I found it to be very
(14:58):
difficult to get a super smooth outcome. So I personally
have stopped doing it. I just it's just too much
of a headache for me. Do you play with it.
Speaker 2 (15:09):
Sometimes it really kind of just appends per patient, piece
by case.
Speaker 1 (15:13):
Yeah, we have actually not very effective. But people who
have what do you call it smoker's lines upper lips
Smoker lines when you pucker your lip like for a straw.
So that's a big complaint for a lot of people.
There is no perfect solution. It's a combination of things.
(15:34):
But putting in the tiniest amount of botox weakens your
obicularis and then it softens those wrinkles. But remember it
also affects your ability to speak, and it affects your
ability to pucker, and more importantly, whistle or drink from
a straw. So when I say tiny, I mean tiny.
(15:58):
What other areas are there that are sort of more
random that.
Speaker 2 (16:02):
People do the Barbie botox traps.
Speaker 1 (16:07):
Definitely, in my opinion, a disaster. Yeah, no, no, no,
no no, once you start getting to huge muscles, a
trap muscle. First of all, Like the whole point of
botox in my opinion, is because it's temporary, it has
to be cost effective. So let's say I had a
procedure for you. It was three thousand dollars in every
(16:30):
three months, you have to redo it. Like, what kind
of stupid procedure is that? So the beauty of these
other eras is they're like ten units, fifteen units, et cetera.
So the trap is huge. The idea is that it
relaxes the muscles, it causes soft kind of swimming down,
and then it's been associated with all kinds of other conditions,
(16:51):
breathing issues and things of that nature because you're now
injecting a lot of botox in critical areas and it's spreading.
So it wasn't a lady who was on a ventilator. Yeah,
on Instagram, she was literally on a ventilator because they did.
I think they trapped too much trapped. So I think
that's just again like everything people are going to be
in a spa, they're going to sell you the product,
(17:13):
you know, they want to make more money, and I
just think it's overkilled.
Speaker 2 (17:16):
And then with that too, a lot of people don't
realize that doing that much botox in that area, your
body's going to overcompensate for the lack of use of
these muscles, so then people start to get sore backs
and sores.
Speaker 1 (17:26):
Just a stupid idea in my opinion. Another area that's
kind of interesting that I found in some people really
love it and it's a tiny amount is a lar flaring.
So some people when they speak or they talk, their nostril,
the roundness of their nostrils flares. It's it's a muscle
we use for deep breathing, like if I ran a marathon,
at the end, I bet and my nostrils. But some
(17:49):
people just do that in conversation and it takes like
it's painful as hell.
Speaker 2 (17:53):
It's painful. I've tried it and it's very painful.
Speaker 1 (17:57):
It takes a dog, but it is.
Speaker 2 (17:59):
It's just a tiny drop and it does make a
nice difference depending on the person that's you know, it
makes a difference.
Speaker 1 (18:04):
There's the flip lip, yet another one of those that
I don't love, but I know that you had dabbled
in it, and you do it here and there, the
idea being.
Speaker 2 (18:12):
Yeah, And even with that, I'm very selective on the
patients I like to do it on. I really like
to do it on patients who when they smile their
lip upper lip really curves in or have a gummy smile,
because it does relax the upper lip enough where you know,
it doesn't show.
Speaker 1 (18:26):
Gummy smile is a different story.
Speaker 2 (18:28):
Yeah, I'm just doing a tiny little I think.
Speaker 1 (18:30):
Gummy smile is a phenomenal use for it. So what
is so? There are people when they smile just regular,
their upper lip gets pulled up so high that in
addition to their teeth, they see a lot of gum
and it's generally not a very attractive look. And by
dropping a tiny amount of botox in the upper portions
(18:50):
right of the pure forms where the nasalabia folds are,
it softens up muscles so that you don't retract it
up as high. And I have actually found that in
some people it's very very effective. The next thing is
in general, and this is one of the reasons why
Charlie now is in our SPA with us is philosophically.
(19:12):
I have for twenty years been injecting half the dose
that is normally injected everywhere. So I want you to
just want you to listen to me here. Recently, I
just love all these stupid marketing names. They call it
baby botox, and it's like baby botox, What the fuck
is baby dough botox. We're not injecting babies. So what
(19:34):
it is is they realize for me, when I came
out of training, there's the sort of guidelines, right, and
when I interviewed a bunch of nurses, it was obvious
to me that they're all trained with these stupid guidelines.
Who makes the guidelines the companies that sell the product.
And the idea is that like a forehead is twenty units,
let's just use that as an idea. Between the eyes
(19:56):
is twenty units each. I for the crow feed is
ten and ten, which is twenty units. So the average
patient who goes and gets these products gets fifty to
sixty units. I inject for twenty years, twenty to twenty
five units, the occasional thirty unit. And when I interviewed
(20:19):
a bunch of people, I had them come in, and
I had the one easy way to just check check
their preferences was to ask them. They'd walk in, I'd
be like, all right, here's Gael. Gale's my patient. How
much did you inject? And they're like, oh, fifty five units,
And like I'd open up Gale's chart, I'd be like, look,
Gale's been coming to me for fifteen years. Every single
one of these is twenty twenty two, twenty five, twenty two,
(20:41):
twenty two, twenty five. And the reason is that people
in general want to look natural. What makes you look
not natural is it's just too strong. Yeah, and you
get frozen forehead, your brows drop, you animate weirdly when
you smile, like nothing moves, but some like muscle way
back where So this idea of baby botox is ridiculous.
(21:05):
It just means injecting the correct amount. And ironically, in men,
I inject less botox than I do in women, yet
they have stronger muscles. Do you know why?
Speaker 2 (21:20):
So that it doesn't freeze the area and it looks
a lot more natural.
Speaker 1 (21:23):
Guys look ridiculous, ridiculous. When frozen women, we have a
different esthetic for a woman. It's more glossy, it's more polished,
it's more smooth. Men, the reason we do botox is
to just slow down the wrinkle formation. So number one
reason why I inject less in men than women is
they just look odd sort of, that whole masculine element
(21:46):
of them goes away. The second reason is because in
general men's brows, a man's browseits lower than a woman's brow.
So often if you meet a guy and you're like, hey,
have you tried botox? Oh no, no, no, I'm never
doing that again. Well what happened? All my brows were
so heavy? And I well, that's because you went to someone.
They injected you with botox. They relaxed the muscle and
(22:07):
it dropped your brows, and as a result, you hated
your experience, and now you stay clear of botox, when
in reality you should be staying clear of that injected Okay,
So that's that another thing that I'm we need to
clarify about, which I hear almost every day, which I
don't hear anymore because you hear it now, But is
(22:28):
the idea is like, hey, doctor Rabond, Can you put
some botox right here on the outer brow? Why would
you want me to inject you there? I want my
eyebrows to go up. So wait, you want me to
put botox in the corner of your eyebrows, so your
eyebrow goes up. You do know that if I put
botox in the corner of your eyebrow, your eyebrow will
(22:48):
go down. Right? Wait, what do you mean? So let's
talk about this idea of browlifts. So when you put botox,
and again we're using botox as a global term, anywhere
it paralyzes that muscle, then that muscle doesn't work. Then
(23:09):
what that muscle was doing, it doesn't do anymore. So
your forehead muscle lifts up your brow. So anywhere you
inject it drops the brow. Yeah, so how do we
get a browlift? Then it's certainly not from putting the
botox where you want it lifted, right, So tell me
how we get a browlift.
Speaker 2 (23:28):
Then I do a little bit on the ubiculous orus,
because that is a muscle that does do a little
bit of a depression. So remember, botox is the opposite
of what it is supposed to do. So oftentimes if
you do a tiny drop there and it'll just give
a little eye opening effect.
Speaker 1 (23:42):
Right. So the two ways that you can raise the
brows that can be done individually or together is one
knock out the obicularis which is the crow's feet, which
then relaxes right, relaxes, and that lets the brow free
and goes up and or inject the middle of the
(24:03):
forehead and not the outer part. And that allows the
middle not to move and the outer to move, which
will then lead it to lift higher. So it's a dial.
In some people, that's exactly what they don't want, and
that's exactly what they tell me they want to avoid,
is that spock. Look, I don't want my eyebrows in
(24:23):
the eye up in the air. And in some people
their brows are super flat, and that's what they're begging for.
So that's why your provider needs to say, hey, you're
a bad candidate for raising brows, and you're a great
candidate for raising brows.
Speaker 2 (24:37):
I've had I've had inchectors want to raise my brows
every time, and I'm like, do you see these browsies
are natural? Like, I do not need a brows lift whatsoever.
Please do not touch.
Speaker 1 (24:45):
That it's gonna look, I'm gonna definitely look. Yeah, all right, son,
So let's go over what is the when when a
patient comes in they're having botux done for the first time,
what is the recovery so to speak, Because like, oh,
there's been so many things about what I can do
and I can't do whatever, So what do you tell
them is their recovery?
Speaker 2 (25:06):
Recovery is very mild with botox. You know, you could
come in and do it takes about five ten minutes
to do, and afterwards, you know, you might have a
little bit of some tiny, little pinpoint bleeding in the
areas that were injected, very tiny, maybe a little swelling
from the bowtox itself, but those bubbles will go down
in about twenty minutes. Other than that, the rest of
the day you're pretty free. I just recommend patients don't
(25:28):
go to the gym right afterwards. No hot tubs on
the steam rooms, lay up right for about three to
four hours, but pretty wild. Can you turn to your
normal activities the next day?
Speaker 1 (25:38):
Yeah, So here are the things that Number one, it's
if done correctly, you should come in, inject, go back
to work within thirty minutes. Number two usually I would say,
in all the bowtox I've done in twenty years, maybe
one percent of people get bruising. Yeah, very little, It's
very unlikely. Number Three, you can resume everything you were doing.
(26:02):
Oh I heard, I can't do this. No, I can't.
You can do everything. The only thing we suggest, and
this is really more of a suggestion, is we just
injected you with this drug that is sort of going
to attach to something. It's going to attach the muscle.
So we highly suggest you don't do things that make
you sweat a boat load early on right away. So
(26:23):
exactly I wouldn't go and do like a major cardio class.
I wouldn't go in a sauna, steam shower, jacuzi whatever,
because you're heating up. What can I do tomorrow? Everything?
The only other thing I also tell you is don't
do the injection and then go lay on a massage
table with your face in a table, point down, pressure
on your face for three hours that same night. So
other than that, go to a dinner, go to a movie,
(26:44):
put on makeup, whatever. So it's really actually a very
simple and easy recovery. How often do I need to
get the boattox?
Speaker 2 (26:55):
Usually three to four months on auverage.
Speaker 1 (26:57):
So I want you guys to listen to this concept
because it's very important for you understand that I can
inject you with a boatload of bowtox and it will
last six months. So you come in twice a year
and you'll be frozen, like for the first two and
a half months, you'll be frozen. Or I can inject
you with less bowtox more often, in which case you'll
look natural. At the end of the year, you will
(27:18):
have spent the same amount of money. So it is
the idea is less more often than more less often,
and the less I inject more often, the more natural
you will look. So we have found that that happy
place where I'm not in here every three weeks and
I'm not coming in every six months is three to
(27:40):
four months. Right around three months, it'll start giving way,
so that when you get to four months, you're due
and there's probably ten to fifteen percent of it's still left,
and you kind of just pit it again and let
it go, and hit it again and let it go.
So that's usually the timeframe that we would suggest, which
is at best three times a year is really what
it takes. Let's talk quickly about complications, So complications, you know,
(28:08):
what could go terribly.
Speaker 2 (28:10):
Wrong, honestly, really bruising if you can bruise for a
couple of days. But again, like you said, that's going
to be very minimal. Other than that, I mean if
unless you have a severe allergy. I haven't really seen
any complications unless it's overly injected.
Speaker 1 (28:24):
Yeah, so that Yeah, the things that can go wrong
are very very minimal. You have to remember something about
this drug. This drug has been around for now thirty
forty I don't know many many years, and it's been
injected in over billions of people. So let's take any
(28:44):
drug and let's say the complication rate of a drug
is I don't know, one percent. I make it up.
That is a lot of complications. Yeah, right, you would.
It would be on the internet, it'd be everywhere. So
the reality is like point zero something. The thing are
very The things that are inject your driven are someone
(29:07):
can overinject your brows and then your brows drop and
now you're like, god, damn it, my brow is so heavy.
Hey doctor Bond, I need you to fix this. There
ain't no fixing it. Yeah. There is a drug that
was recently discussed where it can reverse botox, but I don't.
(29:28):
I don't think it's made to the market. So for
now and has been forever, you own it for three
to four months. The second thing that can happen, which
is ten times worse than dropping your brow, is you
can drop your eyelid. Then you're really pissed, which means
the muscle that keeps your eyelid open, the levador, is
(29:50):
right underneath your eyebrow. So if someone injects you right
over your eyelid and it's too much or it spreads,
it'll drop into your eyelid and then it'll knock your
eyelid out, and then your eyelid will be droopy and
you'll be really annoyed for a couple of months. That's
the next thing it happened. It's pretty bulletproof. Pretty bulletproof. Yes.
(30:15):
Bruising is usually if you're a bruised and you're like,
every time I go, I'm hella bruise. Something's not right.
Either you have a bleeding disorder or your injector's a hack.
But it should be boom boom boom boom in out
and you go about your business.
Speaker 2 (30:28):
But yeah, other than that, I say, majority of the times.
Even if you absolutely hate the boatox, it'll wear off
in three to four months everything goes back to normal.
Speaker 1 (30:36):
So yeah, yeah, I mean the the one beauty of
botox is that it's one hundred percent reversible. And so
if you have a bad experience, and my suggestion to
you is if you had if you did botox and
you add a bad experience, you should just go to
another provider, not eliminate botox. It's just too valuabullet tool
(30:57):
to help you maintain a overall beautiful esthetic. So here
is my philosophy about botox, and I think this is
really important for you to understand. Who should do botox? Everyone? Wait,
come on, doctor ravon everyone? Everyone at what age? Mid twenties? Yeah? What?
(31:19):
So here's the basic principle. Botox is misnamed as preventative.
Preventative means I do something and it prevents something from happening.
It is not preventative. It is delayative. It delays something
from happening that will happen. So we know for a
fact that every human being after one million, two hundred
(31:41):
forty seven thousand, two hundred and four animations meaning moving
my eyebrow smiling, then makes a wrinkle that is temporary.
Like my son makes wrinkles when he smiles, and then
when he's not smiling, he's porcelain smooth. At the age
of thirty seven or whatever, that wrinkle he has will
(32:01):
become permanent. He'll not smile. You're just standing here and
there it is. Look at that wrinkle in your forehead,
and then after a certain period of time it's etched in.
It's actually a scar. It is a embedded in your dermiss.
So if there's a treatment that's relatively affordable, relatively low risk,
(32:23):
easy to do that eliminates or slows down the progression
of these wrinkles, why on earth wouldn't you do it?
And so the reality is, the sooner you start, the
longer it takes for those wrinkles to become permanent and irreversible.
(32:44):
If you show up in my office at sixty and
you've never done it before, I cannot get you to
a place where you're gonna be like, oh my god,
that's beautiful. The botox will help a little bit. Then
I got to resurface your skin. Then I got to
inject the wrinkles with thiller. However, if you come here
and you're young, and I don't need it exactly precisely,
(33:05):
you don't need it. You're not doing it because you
need it. You're doing it because you will need it.
So the difference is when my niece or my young
patients come in, I put an eight tiny amount, tiny
tiny like fifteen units, and when someone comes in and
they need it, I put in still very little, but more.
(33:26):
The idea being I put less in people who don't
need as much of it because I'm trying to just
slow down the progression. So I'm a big, big, big,
big fan of neuromodulators. I think that the key to
our success mine and now yours is the number one
key to neuromodulators is less is more. That's all you
(33:51):
need to do. Literally, Oh my god, doctor b I'll
go nowhere else. You're incredible. And I keep telling them
it's just I'm really concerned. And so when you're conservative,
it looks great. Why aren't other people doing it that way?
They make money? Listen, it's very simple. They're bias. If
(34:13):
I inject you with fifteen to twenty units for a
unit of time, I'm here, you're standing in front of me.
I'm injecting you with fifteen twenty units or forty to
sixty units, which is better for me. That is the
answer of why people are frozen across this country, because
people are just getting over injected with botox. And we'll
(34:34):
be talking about filler on our next episode. And this
is the same shit there too. The whole duck effect
occurred because I make money injecting you. Holy shit, all
of a sudden, now you need two syringes instead of one.
I think that's really about it. I'm I think we
hit all the key points. I don't think there's anything else.
Is there anything else? On the normodulators? All right, guys?
(34:55):
I mean I hope you like that tutorial, that basic intro,
that basic if you will overview on neuromodulators, come and
check us out. Come to our new restore by Rabon MD.
I refer to it as a wellness center because in
addition to all the esthetic treatments that we offer, which
is botox, fillers, micro needling, lasers, prp skincare. In addition
(35:21):
to all those things, we're going to hopefully be adding
wellness and ad drapes, vitamins, things of that nature. So
all right, that's a rap. As always, if you like
our show, do me two favors. One go write up
great reviews. Say oh my god, this new nurse Charlie
and she's wonderful. I love her, Doctor Bond, you're the best.
And number two, share this information with people you love.
(35:44):
At the end of the day, the purpose of this
podcast is educational and you just simply don't know who
knows what and who doesn't. So share this with your friends,
download and subscribe. All right, guys, that's a rap. We
will see you next week on Plastic Surgery Uncensored, Always
your host, Doctor Roddie Rabon,
All right, welcome to another episode of Classic Surgery and Censored.
I'm your host, doctor Roddy Rabond, and we're going to
put together a little quick series for you. I think
you guys are going to like this upcoming series. I'm
here with Charlene, our newest member to our team. As
many of you know, and as many of you may
not know, we recently opened up what I've referred to
(00:27):
as a wellness center, a METSPA of sorts. It's called
actually Restore. And in that wellness center or met SPA,
one category is esthetics, and we're going to sort of
do a multiple part series where Charlene and I kind
of hit each of the menu of services that we
(00:48):
provide and do so in a much more expanded way
for you, so you have a much better understanding of
what each of these treatments are, what you can expect, downsides, risks, etc.
And so I hopefully you'll enjoy it. And as a result,
whether you come to our SPA or you're doing this
wherever you are, you have a good understanding of what
to ask for and what to expect. Okay, so today's
(01:10):
let's this episode is going to be about neurotoxins, neurotoxins
or neuro modulators, And essentially what that means is drugs
that we inject and as a result of injecting them,
they modulate or affect the muscles, which then affects the wrinkles.
(01:31):
And the most famous of such is botox. Actually, I
am guilty of using the term botox as a ubiquitous term,
even though we're going to talk about the different brands
there are different brands of it. We use botox just
because it seems to be the most commonly. It's a
universal term. It's kind of like using Kleenex to describe
(01:51):
tissue paper, right, all right, so Charlie, right now on
the market, there are multiple you know, Botox was the
first one to come into the market for the For
those of you who don't know, botox was originally a
drug that was invented for medicinal reasons. It was not
a cosmetic drug. It was a drug that was used,
if I'm not mistaken, in ophthalmology for blepharospasm. People would
(02:14):
get twitches in their eyes and this drug was invented
and it would help address that. And then later of
course they realized, wow, it does more, and here we
are now and it's essentially the I would say the
number one cosmetic treatment globally.
Speaker 2 (02:29):
Absolutely.
Speaker 1 (02:30):
Yeah. So aside from botox, which everyone knows, what are
the different names of neuromodulators that are out there now?
Speaker 2 (02:38):
There is a couple of different ones, and every year
I feel like there's more that are coming out. Botox
is definitely one of the most common dysport. We have, zemin, Juvo, Daxify.
There's a whole bunch of different ones coming out.
Speaker 1 (02:51):
So first thing people want to know whenever there's things
that are multiple, it's like which one's better. Yeah, And
the reality is that I would argue in this particular arena,
they're all pretty much six of one, half a dozen
the other for several reasons. Number one, the main reason
they're all the same is because the actual active drug
the drug is the same drug. It's bochelinim toxem, a derivative,
(03:11):
and so the same would be equivalent of ibuprofen, motrin,
and advil, which is better. People come to me and
they're like, oh, I only add so much better. It's
like it's the same drug.
Speaker 2 (03:22):
Yeah, That's exactly how I explain it to patients too,
and they ask me, I say, it's all about preference.
You know, sometimes you don't really know unless you try
different types. But that's exactly the same analogy. Yes, it's
like it's using a different type of ibuprofen, you know.
Speaker 1 (03:37):
Right, and so the one that so the base drug
is the same. However, where the little bit of nuances
come is in the way that the drugs are carried,
the carrier meaning inside the drug, how you and then
also how each provider reconstitutes them. In other words, you know,
(03:57):
they come in as a powdered form, you add saline,
that siline then reconstitutes it. The degree of the dilution
equals the strength. So for example, you may go to
one met SPA and you're like, well, dude, the disport
didn't work. Then I would assure you if disport didn't work,
(04:17):
it was the way they diluted it. Because Disport's going
to work, saxifies, they're all going to work. They'll work differently.
But I think a bigger issue is who's injecting you
and how they dilute it, in other words, the concentration
of the drug. We in general, Charlene and I are
partial to Disport. The reasons why I've used Disport for
(04:40):
shoot as soon as as soon as it came out,
and the reason I like it a little more again
they're all the same a little more than the other
ones is I feel that it kicks in a little quicker.
Maybe what do you think about three maybe three days
to five days we would say. I felt like Botox
took like five to seven days. Second, I feel like
(05:02):
the Disport, pound for pound, is a little stronger. So
if I put in five units of Disport, I'm sorry,
five units of botox. Technically, the way the numbers work,
it's fifteen units of Disport, but let's just say for
all intensive purposes the equivalency. I feel like the Disport
(05:24):
sort of lasted a little longer. Did you get that experience? Yeah?
Speaker 2 (05:28):
For me personally, that's how I felt about it.
Speaker 1 (05:30):
Yeah. And then the other thing I like about the
Disport was that. And this actually turned out to be
something that people hated about the Disport originally. It spreads
a little more. And so if you do reconstitute it
with too much saline, in other words, I want to
put a dot of disport here above my brow. If
(05:53):
it's too dilute, I have to put a lot of
fluid and it spreads, And initially when it first came out,
myself included I was diluting it the way I was
diluting botox, and I had some non desirable outcomes. People
immediately blamed the disport. Again, yeah, you should blame the provider.
And now that now that I use a very much
(06:15):
more concentrated form, I feel like the reason why I
like it is when you put botox, the drug goes
and it works in a very finite space. So the
space right next to it, I feel, is a bit
more abrupt, like it's on off, on off, whereas the
disport kind of like spread.
Speaker 2 (06:34):
It has like a really nice diffusion.
Speaker 1 (06:35):
A diffusion to it exactly.
Speaker 2 (06:37):
So that's how I even felt when I had it
done on me. Personally, I've had botox done the very
first time and I felt like it was very harsh. Yeah,
but with the disport it really was a soft effect,
but it gave me the exact type of results.
Speaker 1 (06:48):
Yeah, so we like, I think we both agreed on that.
In general. Again, doesn't matter if you're going to respond
they're injecting you with Daxify, as long as you like
the outcomes, and the price point is about the same.
That's really good. The next thing about these drugs is
people want to know, let's talk about where we can
use them. So we're the areas that what I would
consider the core areas that we would use the neuromodulators.
Speaker 2 (07:13):
Yeah, core areas would be the upper third of the face.
That'll help with the fore headlines, the frown lines, and
then the crow's feet.
Speaker 1 (07:19):
Yeah, so we call them the number eleven people who
do a lot of frowning. Right right in the middle
of your eyebrows. Those are the muscles, are the corrugators,
and if you see they kind of move inwards. Some
people have an additional muscle called the preserus, and it
comes it pulls down so it has a line across
the nose. There is the forehead, the frontalis, and then
(07:41):
of course the crow's feet, which are on the side.
And I think those are tried and true, and those
are areas that when people ask me like, oh, I've
never done botox before, what areas you suggest? I always
suggest those three, even if one of your three areas
is worse than the others. So I don't generally tell
people to just do their forehead or just do their corrugators.
(08:04):
The reason being is that I feel, and I don't
know if you've experienced it, that when I inject one area,
I find like the other area gets a little worse
because people are trying to still animate without knowing it,
and it's just isolated and it just overcompensates.
Speaker 2 (08:20):
When you relax when area, the other area is going
to overcompensate and have a strong repult.
Speaker 1 (08:25):
Yeah. So those are the three tried and true areas.
But there's a boatload, I mean a boatload of areas
that people inject. Now, I myself, I just I've always
been more conservative and I like things that I think
are consistently awesome, not usually awesome. So the other areas
that people do I think that are effective. One. I
(08:47):
think massaters are effective, definitely. I think the problem with
massads is overinjection. Yeah, it's a muscle unique you don't
need you from the talent.
Speaker 2 (09:01):
Very common right now to do a lot of botox
and the masters because people want that cosmetic effect of
that facial swimming. But even for me in my practice,
I don't like to do that. I always I always
question the patient. I'm like is this going to be
for cosmetic reasons or therapeutic?
Speaker 1 (09:16):
Right? So why would you do Why does one do
the master? Right? Yeah?
Speaker 2 (09:21):
So for me, I like to treat the masters therapeutically.
If someone has strong massters, if they clench a lot,
if they have TMJ, if they just want a little
bit of relief from that area, doing the massaters with
botox could really relieve some of the pressure in that area.
Speaker 1 (09:36):
So we found that it affects migraines mm hmm. We
found that it affects grinding and teeth decay right, some people.
I've had patients who have broken through mouth guards. We
found that it affects TMJ, which is directly, and we
found that affects just regular garden variety headaches. So in
that regard, I think it's really effective. The problem is
(09:59):
that as you inject the massater, it's a muscle and
a will start to soften and it becomes slimmer, and actually,
in my opinion, esthetically it looks worse. The reason I
don't like it is that we do everything we can
aesthetically to create a strong jaw, and the muscle in
(10:21):
some people is a critical part of that angle of
the jaw, and I think when you over inject and
really melt that muscle down a I think that it
affects chewing, which is what the massater was designed for. Two.
I think it softens the angle so much that you
lose that transition and your mandible kind of just blends
(10:42):
into your neck. The reason it became very popular esthetically
is actually in the Asian community, right because they're one
of the only, really the only community who has a
lot of jaw angle and maybe could benefit from a
little bit of so called slimming. But that's more of
(11:03):
a Korean like, they like heart shape, not square shape.
But I would tell you ninety nine point nine percent
of times I'm aesthetically striving for an angle, So I
would caution you. I think I never inject more than
fifteen units, So it's usually ten to fifteen units. You
see most people they're dropping twenty five units per side
or more. I think you're going to get into trouble.
(11:26):
Another area that I find really effective is injecting the
chin pad, right, And why would we inject the chin pad?
Speaker 2 (11:33):
Are this little temple?
Speaker 1 (11:35):
Yeah, I call it cobblestoning or pew the orange pew,
the orange is orange peeling, and it usually occurs for
people who are straining this muscle. The mentalis muscle helps
keep the mouth shut, and some people just animate forcing
their lips together.
Speaker 2 (11:53):
It's a little overreactive, and some people don't realize that
they even tend to do.
Speaker 1 (11:57):
Ninety nine percent of times where I do chin, I
may yeah, because it's one of those things that you
only do when you speak, and when you're looking in
the mirror, you're not speaking, so you don't see it.
So then it's one of those things that I generally suggest.
The beauty of that area is it's like five units.
It's like it takes nothing. An area that's another area
(12:19):
that is effective but needs to be thought through a
little bit is neck bands. So neck bands is a
little you gotta be careful number one. It's a large muscle,
so you can drop a ton of money and a
ton of neuromodular for little gain. So for example, I
(12:42):
do it a lot of actors and actresses people that
are on camera because of the band. When they speak
and they animate, it sort of bounces and they see
I stood in people who really don't want to have surgery.
But this is the caution must be exclusively muscle, and
(13:05):
unless you're super young, I'm talking early forties or younger.
I find that as you get into your late forties
and fifties, now you're having some skin accumulation, so skin
and muscle, and then you'll inject these bands and maybe
it's a little better, maybe it's a little worse because
(13:27):
now the muscle relaxes and your skin, which needs a necklift,
becomes more prominent. So this is neck bands. I don't
think are a treatment for people who are older and
their necks starting to sag and they need a facelift
or a necklift. It's a good thing in young people
that have hyperactive or overactive necks. Yeah, I agree. We
(13:50):
have some areas that I don't love. We have the DAOs.
I'm not a fan. Some people are What is the
doos and what are they for?
Speaker 2 (14:05):
The dieos pull down the pretty much the lateral sides
in your mouth. So it's the ones that make you
frown like that, right.
Speaker 1 (14:12):
They're the muscles adjacent to your mentalis and when activated,
they're attached to the corner of the mouth and they
pull the corner of the mouth down. The idea or
the objective is that when you inject it and it
relaxes the muscle the corners of the mouth wise up.
(14:34):
My experience has been that because that area has a
cluster of different muscles, there's actually not just one muscle
there that if it's not exactly done correctly, it causes
actually animation deformity, like you're talking and your mouth is
just off and like one side's higher than the other.
And for many years I found it to be very
(14:58):
difficult to get a super smooth outcome. So I personally
have stopped doing it. I just it's just too much
of a headache for me. Do you play with it.
Speaker 2 (15:09):
Sometimes it really kind of just appends per patient, piece
by case.
Speaker 1 (15:13):
Yeah, we have actually not very effective. But people who
have what do you call it smoker's lines upper lips
Smoker lines when you pucker your lip like for a straw.
So that's a big complaint for a lot of people.
There is no perfect solution. It's a combination of things.
(15:34):
But putting in the tiniest amount of botox weakens your
obicularis and then it softens those wrinkles. But remember it
also affects your ability to speak, and it affects your
ability to pucker, and more importantly, whistle or drink from
a straw. So when I say tiny, I mean tiny.
(15:58):
What other areas are there that are sort of more
random that.
Speaker 2 (16:02):
People do the Barbie botox traps.
Speaker 1 (16:07):
Definitely, in my opinion, a disaster. Yeah, no, no, no,
no no, once you start getting to huge muscles, a
trap muscle. First of all, Like the whole point of
botox in my opinion, is because it's temporary, it has
to be cost effective. So let's say I had a
procedure for you. It was three thousand dollars in every
(16:30):
three months, you have to redo it. Like, what kind
of stupid procedure is that? So the beauty of these
other eras is they're like ten units, fifteen units, et cetera.
So the trap is huge. The idea is that it
relaxes the muscles, it causes soft kind of swimming down,
and then it's been associated with all kinds of other conditions,
(16:51):
breathing issues and things of that nature because you're now
injecting a lot of botox in critical areas and it's spreading.
So it wasn't a lady who was on a ventilator. Yeah,
on Instagram, she was literally on a ventilator because they did.
I think they trapped too much trapped. So I think
that's just again like everything people are going to be
in a spa, they're going to sell you the product,
(17:13):
you know, they want to make more money, and I
just think it's overkilled.
Speaker 2 (17:16):
And then with that too, a lot of people don't
realize that doing that much botox in that area, your
body's going to overcompensate for the lack of use of
these muscles, so then people start to get sore backs
and sores.
Speaker 1 (17:26):
Just a stupid idea in my opinion. Another area that's
kind of interesting that I found in some people really
love it and it's a tiny amount is a lar flaring.
So some people when they speak or they talk, their nostril,
the roundness of their nostrils flares. It's it's a muscle
we use for deep breathing, like if I ran a marathon,
at the end, I bet and my nostrils. But some
(17:49):
people just do that in conversation and it takes like
it's painful as hell.
Speaker 2 (17:53):
It's painful. I've tried it and it's very painful.
Speaker 1 (17:57):
It takes a dog, but it is.
Speaker 2 (17:59):
It's just a tiny drop and it does make a
nice difference depending on the person that's you know, it
makes a difference.
Speaker 1 (18:04):
There's the flip lip, yet another one of those that
I don't love, but I know that you had dabbled
in it, and you do it here and there, the
idea being.
Speaker 2 (18:12):
Yeah, And even with that, I'm very selective on the
patients I like to do it on. I really like
to do it on patients who when they smile their
lip upper lip really curves in or have a gummy smile,
because it does relax the upper lip enough where you know,
it doesn't show.
Speaker 1 (18:26):
Gummy smile is a different story.
Speaker 2 (18:28):
Yeah, I'm just doing a tiny little I think.
Speaker 1 (18:30):
Gummy smile is a phenomenal use for it. So what
is so? There are people when they smile just regular,
their upper lip gets pulled up so high that in
addition to their teeth, they see a lot of gum
and it's generally not a very attractive look. And by
dropping a tiny amount of botox in the upper portions
(18:50):
right of the pure forms where the nasalabia folds are,
it softens up muscles so that you don't retract it
up as high. And I have actually found that in
some people it's very very effective. The next thing is
in general, and this is one of the reasons why
Charlie now is in our SPA with us is philosophically.
(19:12):
I have for twenty years been injecting half the dose
that is normally injected everywhere. So I want you to
just want you to listen to me here. Recently, I
just love all these stupid marketing names. They call it
baby botox, and it's like baby botox, What the fuck
is baby dough botox. We're not injecting babies. So what
(19:34):
it is is they realize for me, when I came
out of training, there's the sort of guidelines, right, and
when I interviewed a bunch of nurses, it was obvious
to me that they're all trained with these stupid guidelines.
Who makes the guidelines the companies that sell the product.
And the idea is that like a forehead is twenty units,
let's just use that as an idea. Between the eyes
(19:56):
is twenty units each. I for the crow feed is
ten and ten, which is twenty units. So the average
patient who goes and gets these products gets fifty to
sixty units. I inject for twenty years, twenty to twenty
five units, the occasional thirty unit. And when I interviewed
(20:19):
a bunch of people, I had them come in, and
I had the one easy way to just check check
their preferences was to ask them. They'd walk in, I'd
be like, all right, here's Gael. Gale's my patient. How
much did you inject? And they're like, oh, fifty five units,
And like I'd open up Gale's chart, I'd be like, look,
Gale's been coming to me for fifteen years. Every single
one of these is twenty twenty two, twenty five, twenty two,
(20:41):
twenty two, twenty five. And the reason is that people
in general want to look natural. What makes you look
not natural is it's just too strong. Yeah, and you
get frozen forehead, your brows drop, you animate weirdly when
you smile, like nothing moves, but some like muscle way
back where So this idea of baby botox is ridiculous.
(21:05):
It just means injecting the correct amount. And ironically, in men,
I inject less botox than I do in women, yet
they have stronger muscles. Do you know why?
Speaker 2 (21:20):
So that it doesn't freeze the area and it looks
a lot more natural.
Speaker 1 (21:23):
Guys look ridiculous, ridiculous. When frozen women, we have a
different esthetic for a woman. It's more glossy, it's more polished,
it's more smooth. Men, the reason we do botox is
to just slow down the wrinkle formation. So number one
reason why I inject less in men than women is
they just look odd sort of, that whole masculine element
(21:46):
of them goes away. The second reason is because in
general men's brows, a man's browseits lower than a woman's brow.
So often if you meet a guy and you're like, hey,
have you tried botox? Oh no, no, no, I'm never
doing that again. Well what happened? All my brows were
so heavy? And I well, that's because you went to someone.
They injected you with botox. They relaxed the muscle and
(22:07):
it dropped your brows, and as a result, you hated
your experience, and now you stay clear of botox, when
in reality you should be staying clear of that injected Okay,
So that's that another thing that I'm we need to
clarify about, which I hear almost every day, which I
don't hear anymore because you hear it now, But is
(22:28):
the idea is like, hey, doctor Rabond, Can you put
some botox right here on the outer brow? Why would
you want me to inject you there? I want my
eyebrows to go up. So wait, you want me to
put botox in the corner of your eyebrows, so your
eyebrow goes up. You do know that if I put
botox in the corner of your eyebrow, your eyebrow will
(22:48):
go down. Right? Wait, what do you mean? So let's
talk about this idea of browlifts. So when you put botox,
and again we're using botox as a global term, anywhere
it paralyzes that muscle, then that muscle doesn't work. Then
(23:09):
what that muscle was doing, it doesn't do anymore. So
your forehead muscle lifts up your brow. So anywhere you
inject it drops the brow. Yeah, so how do we
get a browlift? Then it's certainly not from putting the
botox where you want it lifted, right, So tell me
how we get a browlift.
Speaker 2 (23:28):
Then I do a little bit on the ubiculous orus,
because that is a muscle that does do a little
bit of a depression. So remember, botox is the opposite
of what it is supposed to do. So oftentimes if
you do a tiny drop there and it'll just give
a little eye opening effect.
Speaker 1 (23:42):
Right. So the two ways that you can raise the
brows that can be done individually or together is one
knock out the obicularis which is the crow's feet, which
then relaxes right, relaxes, and that lets the brow free
and goes up and or inject the middle of the
(24:03):
forehead and not the outer part. And that allows the
middle not to move and the outer to move, which
will then lead it to lift higher. So it's a dial.
In some people, that's exactly what they don't want, and
that's exactly what they tell me they want to avoid,
is that spock. Look, I don't want my eyebrows in
(24:23):
the eye up in the air. And in some people
their brows are super flat, and that's what they're begging for.
So that's why your provider needs to say, hey, you're
a bad candidate for raising brows, and you're a great
candidate for raising brows.
Speaker 2 (24:37):
I've had I've had inchectors want to raise my brows
every time, and I'm like, do you see these browsies
are natural? Like, I do not need a brows lift whatsoever.
Please do not touch.
Speaker 1 (24:45):
That it's gonna look, I'm gonna definitely look. Yeah, all right, son,
So let's go over what is the when when a
patient comes in they're having botux done for the first time,
what is the recovery so to speak, Because like, oh,
there's been so many things about what I can do
and I can't do whatever, So what do you tell
them is their recovery?
Speaker 2 (25:06):
Recovery is very mild with botox. You know, you could
come in and do it takes about five ten minutes
to do, and afterwards, you know, you might have a
little bit of some tiny, little pinpoint bleeding in the
areas that were injected, very tiny, maybe a little swelling
from the bowtox itself, but those bubbles will go down
in about twenty minutes. Other than that, the rest of
the day you're pretty free. I just recommend patients don't
(25:28):
go to the gym right afterwards. No hot tubs on
the steam rooms, lay up right for about three to
four hours, but pretty wild. Can you turn to your
normal activities the next day?
Speaker 1 (25:38):
Yeah, So here are the things that Number one, it's
if done correctly, you should come in, inject, go back
to work within thirty minutes. Number two usually I would say,
in all the bowtox I've done in twenty years, maybe
one percent of people get bruising. Yeah, very little, It's
very unlikely. Number Three, you can resume everything you were doing.
(26:02):
Oh I heard, I can't do this. No, I can't.
You can do everything. The only thing we suggest, and
this is really more of a suggestion, is we just
injected you with this drug that is sort of going
to attach to something. It's going to attach the muscle.
So we highly suggest you don't do things that make
you sweat a boat load early on right away. So
(26:23):
exactly I wouldn't go and do like a major cardio class.
I wouldn't go in a sauna, steam shower, jacuzi whatever,
because you're heating up. What can I do tomorrow? Everything?
The only other thing I also tell you is don't
do the injection and then go lay on a massage
table with your face in a table, point down, pressure
on your face for three hours that same night. So
other than that, go to a dinner, go to a movie,
(26:44):
put on makeup, whatever. So it's really actually a very
simple and easy recovery. How often do I need to
get the boattox?
Speaker 2 (26:55):
Usually three to four months on auverage.
Speaker 1 (26:57):
So I want you guys to listen to this concept
because it's very important for you understand that I can
inject you with a boatload of bowtox and it will
last six months. So you come in twice a year
and you'll be frozen, like for the first two and
a half months, you'll be frozen. Or I can inject
you with less bowtox more often, in which case you'll
look natural. At the end of the year, you will
(27:18):
have spent the same amount of money. So it is
the idea is less more often than more less often,
and the less I inject more often, the more natural
you will look. So we have found that that happy
place where I'm not in here every three weeks and
I'm not coming in every six months is three to
(27:40):
four months. Right around three months, it'll start giving way,
so that when you get to four months, you're due
and there's probably ten to fifteen percent of it's still left,
and you kind of just pit it again and let
it go, and hit it again and let it go.
So that's usually the timeframe that we would suggest, which
is at best three times a year is really what
it takes. Let's talk quickly about complications, So complications, you know,
(28:08):
what could go terribly.
Speaker 2 (28:10):
Wrong, honestly, really bruising if you can bruise for a
couple of days. But again, like you said, that's going
to be very minimal. Other than that, I mean if
unless you have a severe allergy. I haven't really seen
any complications unless it's overly injected.
Speaker 1 (28:24):
Yeah, so that Yeah, the things that can go wrong
are very very minimal. You have to remember something about
this drug. This drug has been around for now thirty
forty I don't know many many years, and it's been
injected in over billions of people. So let's take any
(28:44):
drug and let's say the complication rate of a drug
is I don't know, one percent. I make it up.
That is a lot of complications. Yeah, right, you would.
It would be on the internet, it'd be everywhere. So
the reality is like point zero something. The thing are
very The things that are inject your driven are someone
(29:07):
can overinject your brows and then your brows drop and
now you're like, god, damn it, my brow is so heavy.
Hey doctor Bond, I need you to fix this. There
ain't no fixing it. Yeah. There is a drug that
was recently discussed where it can reverse botox, but I don't.
(29:28):
I don't think it's made to the market. So for
now and has been forever, you own it for three
to four months. The second thing that can happen, which
is ten times worse than dropping your brow, is you
can drop your eyelid. Then you're really pissed, which means
the muscle that keeps your eyelid open, the levador, is
(29:50):
right underneath your eyebrow. So if someone injects you right
over your eyelid and it's too much or it spreads,
it'll drop into your eyelid and then it'll knock your
eyelid out, and then your eyelid will be droopy and
you'll be really annoyed for a couple of months. That's
the next thing it happened. It's pretty bulletproof. Pretty bulletproof. Yes.
(30:15):
Bruising is usually if you're a bruised and you're like,
every time I go, I'm hella bruise. Something's not right.
Either you have a bleeding disorder or your injector's a hack.
But it should be boom boom boom boom in out
and you go about your business.
Speaker 2 (30:28):
But yeah, other than that, I say, majority of the times.
Even if you absolutely hate the boatox, it'll wear off
in three to four months everything goes back to normal.
Speaker 1 (30:36):
So yeah, yeah, I mean the the one beauty of
botox is that it's one hundred percent reversible. And so
if you have a bad experience, and my suggestion to
you is if you had if you did botox and
you add a bad experience, you should just go to
another provider, not eliminate botox. It's just too valuabullet tool
(30:57):
to help you maintain a overall beautiful esthetic. So here
is my philosophy about botox, and I think this is
really important for you to understand. Who should do botox? Everyone? Wait,
come on, doctor ravon everyone? Everyone at what age? Mid twenties? Yeah? What?
(31:19):
So here's the basic principle. Botox is misnamed as preventative.
Preventative means I do something and it prevents something from happening.
It is not preventative. It is delayative. It delays something
from happening that will happen. So we know for a
fact that every human being after one million, two hundred
(31:41):
forty seven thousand, two hundred and four animations meaning moving
my eyebrow smiling, then makes a wrinkle that is temporary.
Like my son makes wrinkles when he smiles, and then
when he's not smiling, he's porcelain smooth. At the age
of thirty seven or whatever, that wrinkle he has will
(32:01):
become permanent. He'll not smile. You're just standing here and
there it is. Look at that wrinkle in your forehead,
and then after a certain period of time it's etched in.
It's actually a scar. It is a embedded in your dermiss.
So if there's a treatment that's relatively affordable, relatively low risk,
(32:23):
easy to do that eliminates or slows down the progression
of these wrinkles, why on earth wouldn't you do it?
And so the reality is, the sooner you start, the
longer it takes for those wrinkles to become permanent and irreversible.
(32:44):
If you show up in my office at sixty and
you've never done it before, I cannot get you to
a place where you're gonna be like, oh my god,
that's beautiful. The botox will help a little bit. Then
I got to resurface your skin. Then I got to
inject the wrinkles with thiller. However, if you come here
and you're young, and I don't need it exactly precisely,
(33:05):
you don't need it. You're not doing it because you
need it. You're doing it because you will need it.
So the difference is when my niece or my young
patients come in, I put an eight tiny amount, tiny
tiny like fifteen units, and when someone comes in and
they need it, I put in still very little, but more.
(33:26):
The idea being I put less in people who don't
need as much of it because I'm trying to just
slow down the progression. So I'm a big, big, big,
big fan of neuromodulators. I think that the key to
our success mine and now yours is the number one
key to neuromodulators is less is more. That's all you
(33:51):
need to do. Literally, Oh my god, doctor b I'll
go nowhere else. You're incredible. And I keep telling them
it's just I'm really concerned. And so when you're conservative,
it looks great. Why aren't other people doing it that way?
They make money? Listen, it's very simple. They're bias. If
(34:13):
I inject you with fifteen to twenty units for a
unit of time, I'm here, you're standing in front of me.
I'm injecting you with fifteen twenty units or forty to
sixty units, which is better for me. That is the
answer of why people are frozen across this country, because
people are just getting over injected with botox. And we'll
(34:34):
be talking about filler on our next episode. And this
is the same shit there too. The whole duck effect
occurred because I make money injecting you. Holy shit, all
of a sudden, now you need two syringes instead of one.
I think that's really about it. I'm I think we
hit all the key points. I don't think there's anything else.
Is there anything else? On the normodulators? All right, guys?
(34:55):
I mean I hope you like that tutorial, that basic intro,
that basic if you will overview on neuromodulators, come and
check us out. Come to our new restore by Rabon MD.
I refer to it as a wellness center because in
addition to all the esthetic treatments that we offer, which
is botox, fillers, micro needling, lasers, prp skincare. In addition
(35:21):
to all those things, we're going to hopefully be adding
wellness and ad drapes, vitamins, things of that nature. So
all right, that's a rap. As always, if you like
our show, do me two favors. One go write up
great reviews. Say oh my god, this new nurse Charlie
and she's wonderful. I love her, Doctor Bond, you're the best.
And number two, share this information with people you love.
(35:44):
At the end of the day, the purpose of this
podcast is educational and you just simply don't know who
knows what and who doesn't. So share this with your friends,
download and subscribe. All right, guys, that's a rap. We
will see you next week on Plastic Surgery Uncensored, Always
your host, Doctor Roddie Rabon,
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