Botox & Fillers

Reduce or eliminate wrinkles & fine lines

Cosmetic neurotoxins are a class of neurotoxins used in aesthetic medicine to temporarily reduce or eliminate wrinkles and fine lines. These substances work by temporarily paralyzing or relaxing the muscles responsible for creating facial wrinkles, particularly those caused by repetitive facial expressions like smiling, frowning, or squinting. Neurotoxins like Botox, Dysport, Xeomin and Jeuveau are primarily used for cosmetic purposes, but they also have medical applications, such as treating excessive sweating (hyperhidrosis), chronic migraines, and muscle spasms.

Most Common neurotoxins

When used in aesthetic procedures, the effects typically last 3–6 months, after which the treatment needs to be repeated for continued results.

Botox (Botulinum toxin type A)

This is the most well-known cosmetic neurotoxin. It works by blocking the release of acetylcholine, a neurotransmitter that signals muscles to contract. By injecting small amounts into specific muscles, Botox helps relax them, softening dynamic wrinkles, particularly those around the forehead, eyes (crow’s feet), and between the eyebrows (frown lines).

Dysport

Similar to Botox, Dysport is another botulinum toxin type A product. It works in a similar way but has a different formulation and may spread more easily in the area of injection, which can sometimes lead to a quicker onset of action.

Xeomin

Another botulinum toxin type A product, Xeomin has a slightly different composition. It does not contain the complexing proteins found in Botox and Dysport, which may reduce the risk of developing resistance to treatment over time.

Jeuveau

Also known as the “new Botox,” Jeuveau is another botulinum toxin type A injection, introduced as a competitor to Botox. It is used for similar indications, such as treating frown lines.

Botox And it's Many Uses

In addition to the approved uses of Botox to treat the fine lines and wrinkles of the forehead, glabella, and crow’s feet, I also used advanced Botox injection techniques to address other issues of the face and neck, specifically the area around the mouth, the lips, and neck.

Gummy Smile

This refers to a smile where an excessive amount of the upper gums is visible above the upper teeth. This can occur when the upper lip rises too high during smiling, or if the teeth are shorter than usual, or the gums are larger or more prominent. The gummy smile is harmless but can be very distressing to come patients. Oftentimes, this can be treated with botox injections to the upper lip to reduce its elevation with smiling so that there is less gum exposure.

Masseter Hypertrophy

This refers to the enlargement or overdevelopment of the masseter muscles, which are the muscles responsible for chewing. These muscles are located on each side of the jaw and help in the movement of the jaw during chewing and speaking. Masseter hypertrophy can lead to a square or more pronounced jawline and may cause discomfort, jaw pain, or teeth grinding (bruxism). It can also be a cosmetic concern for some individuals who wish to achieve a more tapered or softer facial appearance. It is easily treated with an injection of higher doses of Botox (25U or more) into the masseter muscle on each side to reduce the bulk and tone of the muscle, leading to a slimmer jawline.

Downturned Mouth or Marionette Lines

The depressor anguli oris (DAO) is a facial muscle that plays a key role in facial expressions, particularly in frowning or creating a sad expression. Overactivity of this muscle can make the corners of the mouth appear turned downward, which can contribute to an older or less pleasant facial appearance. I use Botox to Lift the corners of the mouth and smooth out the marionette lines. By relaxing the DAO muscle, the mouth corners naturally turn upward because the pull is reduced, creating a more youthful, neutral, or even smiling expression.

Wrinkly Chin or Chin Dimpling

This can also be referred to as a “pebbly” or “orange peel” appearance, which is typically caused by the overactivity of the mentalis muscle. This muscle is located in the chin and is responsible for movements like puckering the chin, which can lead to the formation of fine lines or dimpling when it contracts excessively. I use Botox injections to temporarily relax the mentalis muscle, smoothing out the appearance of the chin by reducing its ability to contract. This helps reduce the appearance of the small, puckered indentations and dimpling.

Nefertiti Lift

This is a non-surgical cosmetic procedure where I use Botox injections to lift and contour the lower face, especially the jawline and neck. This procedure was named after Queen Nefertiti, the ancient Egyptian queen known for her graceful and defined jawline. During this lift, I inject Botox into the platysma muscle (the muscle that runs along the sides of the neck) and the depressor anguli oris (DAO) muscle, which is responsible for pulling down the corners of the mouth. A Nefertiti lift does not take the place of a standard face and neck lift.

By relaxing these muscles, the treatment can:

1. Lift the jawline: By relaxing the muscles that pull the jaw downward, the Botox allows the muscles responsible for lifting the jawline to become more prominent, resulting in a firmer, more youthful jaw contour.

2. Smooth neck bands: Botox injections can reduce the appearance of vertical neck bands or “turkey neck” by relaxing the platysma muscles, leading to a smoother, more sculpted neck.

3. Reduce sagging: The treatment can help reduce the appearance of sagging skin around the lower face and neck, creating a more defined and youthful look.

Plastysmal Banding

This occurs when the plastyma muscle, a large flat muscle that originates from the clavicle and inserts onto the lower jaw, contracts and creates vertical bands of tissue and muscle. Relaxing these bands with Botox can lead to a more sculpted neck and jawline.

Lip Flip

This is a procedure where I use small amounts of Botox into the orbicularis oris muscle to create the appearance of a fuller, more defined upper lip. This muscle controls lip and mouth movement and by relaxing it near the border of the lip, it allows the lip to “flip” outward, subtly enhancing the lip shape and giving it a more youthful, pouty appearance.

What to Expect

My approach is honest and realistic—I focus on achieving natural, balanced results without overselling expectations.

I love using Botox because it is safe and effective and temporary (for better or for worse). It has so many uses beyond the FDA-approved labels, which are still safe. There is virtually no downtime and the procedure can be done quickly in the office with minimal side effects. Like any procedure, however, it is important to go to an experienced injector especially for the more advanced and off-label techniques. I take the time to ensure that you are an ideal candidate for Botox injections, carefully tailoring the dosage to suit your unique anatomy. Though rare, the unwanted adverse effects of Botox injection is relaxing an unintended muscle, which can lead to asymmetry, eyelid drop, changes in smile, among others. Even though Botox injections are generally short procedures, it is important to talk to your injector about the risks and expected outcomes.

Schedule Consultation

Turn your dreams into reality

Get in-depth personal consultation where I will review your goals, anatomy, and medical history to formulate a plan that is specific to you.

I am located in a beautiful and classic San Francisco neighborhood called Pacific Heights.

Directions: Apple | Google

Phone: 415-981-3911

FAQs

Frequently Asked Questions

Can I build immunity to Botox to the point where it no longer works?

Yes. This has been described in the scientific literature or you may have heard of or know someone who has experienced this. Rare cases of antibody development to the protein in the formulation of the product may reduce its therapeutic effect. We cannot predict who will develop immunity. The good news is that there are several formulations and brands of neurotoxins that can be used if Botox no longer works for you.

Can Botox be reversed?

No, there is no reversal agent for Botox. It is temporary, and muscle action will return after 3-6 months, sometimes sooner in areas where there is more muscle movement like the eyelids and lips or mouth. Eyelid drooping from Botox is treated with special eye drops that help stimulate one of the small muscles (Mueller’s muscle) in your eyelid that help elevate it. Eyelid drooping after glabellar injection (11’s) is extremely rare but can happen to very experienced injectors.

My Approach

I am committed to the highest standards of patient care and plastic surgery. I believe in developing a strong relationship with my patients in order to best serve their needs and desires.

Furthemore, I am committed to the art and science of plastic surgery and believe that the best results come from a combination of technique, knowledge of patient anatomy, and artistry. My goal is to achieve excellence with a natural aesthetic and elegance while matching the patients’ desires to what is surgically possible so that they can radiate from the inside out. I look forward to meeting you.

Patient Testimonials