Skin Rejuvenation

Everyone deals with wrinkles differently. One of the first signs of maturity are lines on cheeks and eyelids, which are accentuated by smiling or frowning and become progressively deeper with increasing age. For some, wrinkles are distinguished and part of who they are. For others, looking youthful is appealing because of a competing work environment or just wanting to look healthier.

About Dr. Bourget
Dr. Louis A. Bourget has been practicing oral and facial cosmetic surgery for the past 15 years. His clinics are scattered around the east coast, with the Atlantic Facial Reconstruction Centre in Bathurst, N.B., and his new practice, Renu Cosmetic and Reconstructive Surgery, in Halifax, as well as a satellite practice in Newfoundland. Bourget finds oral and facial the most challenging out of all surgeries.  “It is the most demanding,” he says. “People can’t hide it and therefore it becomes more of a challenge and reward and instant gratification.”

Botox is a treatment where wrinkles can be long gone and turning back time on your skin can happen. Bourget has been administering Botox for 10 years and he says there have been many improvements with the treatment. With medical advancements, Botox is now offered in fewer amounts but with better results being achieved.  

What is Botox?
Botox, a prescription medication, is purified protein produced by the clostridium botulinum bacteria that is injected into certain areas and work specifically on those areas. “The Botox itself relaxes the muscle,” says Bourget. Botox blocks the release of acetylcholine, which transmits messages from the nerves to the muscles to make them contract and move. Once acetylcholine is blocked, the muscles relax, providing relief to patients with dynamic muscles (muscles used by movement).  

Depending on what types of wrinkles you have, the doctor will suggest either Botox or cosmetic fillers. The types of wrinkles that usually appear are dynamic and static wrinkles.  Botox would be the right treatment to correct dynamic wrinkles, which are caused by the contraction of muscles. Every muscle movement causes the skin to bunch together which weakens the overlying skin. Botox gets rid of these dynamic wrinkles by being injected into the most commonly found areas between the eyebrows, across the forehead and at the crow’s feet (above the cheeks, near the outer corners of the eyes).  

While Botox erases wrinkles by relaxing muscles, cosmetic fillers smooth and correct hollow lines by restoring fullness. It is used for static wrinkles, which stay the same and are visible regardless of movement from facial muscles.  Cosmetic fillers fill this hole or void that is seen around the lips and mouth area. Bourget compares cosmetic fillers and static wrinkles to a balloon.  “We are blown up when we’re younger and we slowly deplete by losing baby fat and using our muscles,” says Bourget.  “As we get older we want to get back to the youthful appearance with a more full facial area.”

“TOO MUCH BOTOX IS NOT PRETTY IN GENERAL... TO LOOK YOUTHFUL AND NATURAL, YOU NEED BOTOX ON A REGULAR BASIS IN THE RIGHT PLACES — THAT'S THE KEY.”

The Treatment
Botox is a very quick procedure – within 10 minutes the treatment is done. The injections are very small doses with .1, .3 or .5 cc’s and a patient may have around 50 units of them. Each unit costs $10 and Bourget recommends doing the treatment on a regular basis rather than once or twice a year.

He says that if a patient starts off at 50 units and waits a year, they’ll receive another 50 units.  However, if the patient comes in every three months and has 5 to 15 units in certain areas, there won’t be such a drastic change in appearance. “You will maintain a youthful look year-round, rather than going from being very tired to very refreshed,” he says.
 
A Temporary Solution
“It is not an instantaneous effect, but a progressive one,” says Bourget. A patient will have to wait five to 14 days to see results and Botox injections will last on average three to six months, depending on where the injection happens and the activity of the muscle.  

Because it is temporary, Bourget says that it does turn people away from getting it. “But again it’s a double-edged sword,” he says. “People try it because it is temporary and people don’t try it because it is temporary.”

Botox is a good alternative to erase wrinkles compared to undergoing major surgery like eyelid surgery, which is very expensive, takes hours to do and months to heal from. “If you are 30 to 40 years old and not at the stage for a forehead or facelift, Botox is the best choice,” says Bourget.  

Will It Hurt? The Misconceptions of Botox
One of the reasons why people may be hesitant to receive Botox is because it’s a protein and it’s an injection.  But, Bourget says it is ultimately just a medication and like other medications, if you have too much, it can be harmful.  The biggest side effect Botox can have, says Bourget, is what a mosquito bite would look like.  “There can be a little bit of redness, but that’s fairly rare,” he says.  

What about a frozen face? Many of us hear horror stories that people will not be able to move their face if they get Botox. Bourget says that with too much Botox everywhere, there’s no question there would be no expression. “Too much Botox is not pretty in general,” he says. “To look youthful and natural, you need Botox on a regular basis in the right places – that’s the key,” he says.  

What is the prime age for Botox? According to Bourget, there is no right age. He says most of his patients are women from 30 to 50 and men from 40 to 50 years old.
 
The future of Botox
Bourget says the demand for Botox keeps growing and he doesn’t see it slowing down anytime soon.  For Botox, there has always been a higher percentage of women choosing to do it, but the amount of men getting it has taken off. “It was a taboo for men back then,” Bourget says. “But more men are feeling the pressure, especially at work with younger employees being hired… They want to keep their age and age gracefully.” •