Dr. Sanjay Parashar is an expert in Botox (Botulinum Toxin) injections. He has been performing this procedure since 1998. He has been a trainer and instructor for several medical professionals. He is trained and experienced in both basic and advanced Botox injections. He has conducted courses for Kaya clinics, Association of Plastic Surgeons of India, ICAAM, DCAAM, Allergan Company etc.

Botulinum Toxin Injections popularly known as “Botox” is also called onabotulinum toxin A. There is another similar product called Abobotulinum toxin A and is marketed as “Dysport”. Both are FDA approved products.
Botox injections are basically used to relax muscles. It has been used since many decades for muscular spasm around eye globes, neck and other areas.

FDA approval s for Botulinum toxin type A

  • In 2002 FDA approved botox as a treatment for facial wrinkles.
  • In 2004 it was approved for severe axillary hyperhidrosis (excessive sweating)
  • In 2010 Botox was approved for migraine treatment.

How does the botox work for face?

Botox is used for face for following :

  • Wrinkle reduction:
    Forehead wrinkles or worry lines:  Botulinum toxin in microdoses are injected into the forehead muscle called frontalis . Forehead hyperactivity leads to deep lines and creases called worry lines. Botox injected strategically relaxes the muscles and prevents bunching of the muscle.Frown Lines or Glabellar lines:  Frown lines occurs due to constant straining and frowning that leads to formation of  “Number 11” in the frown area. This makes one look angry even if they are not. Small injections of botox are used in three or four places that relaxes the muscle and prevents deep furrowing.

    Smile Lines or Crows feet:  These are formed besides the eyes  because of hyperactivity of orbicularis oculi muscles.  Injection of botox reduces the smile lines and prevents from formation of permanent crows feet.

  • Brow Lift:  Botox can be injected in the forehead strategically to allow mild lift of outer brow. But this happens at the expense of leaving some part of fraontalis intact that may continue to wrinkle.  It is very selectively used in patients based on doctors judgement and patients muscle condition.
  • Neck bands or Neck lift  Botox can be used in two different ways in the neck region.
  • Standard dose of botox is injected in the platysmal bands of neck. It removes or reduces the bands and partially lifts the neck skin. Microbotox is highly diluted botox that can be injected all along the neck skin. This relaxes the musculofibrous connection of neck skin and helps in overall skin lifting.
  • Advanced use of Botox
    1. Lift angle of mouth
    2. Reduce masseter muscle hypertrophy- this reduces the flare of the angle of face
    3. Reduce nasal flaring
    4. Reduce gummy smile
    5. Reduce smokers lines
    6. Microbotox to whole face can help improve texture of skin and give a skin lift.

Botox for Migraine:

Botox is  also used to reduce headache in patients suffering from Migraine. It can reduce the severity of headache, frequency of migraine attack and thus reduction on dosage of medications.

Botox for Sweating:

Botulinum toxin is injected in the underarms, palms and soles to reduce perspiration. Underarm injections are very common and it significantly reduces sweating/ perspiration. The effect may last from 6-8 months depending upon the severity.

How long does the Botox last?

It lasts average 4-6 months, but it varies from person to person and areas of injections. For facial wrinkles, it is important to achieve a natural result. To achieve that, we control the dosage of botox. Lesser amount gives more natural outcome but may not last very long.

Is it painful?

Needles do hurt, but that can be reduced by applying topical anaesthetic cream (Emla), applying ice and off course using tiny needle (32 G) and gently injecting the areas.