Botox at Westport Facial Plastic Surgery

Botox™ (Botulinum Toxin) does not have to be done the conventional way! We all see people who have obvious looking Botox™, and it typically is distracting to see, or even unpleasant to look at. Typically, this look can include a centrally sloping brow (like Spock), horizontal lines over the outside of the brow, and a flat, frozen, shiny look to the center of the forehead, and possibly depression of the central brow. This is not an accident, unfortunately, but is due to the conventional application technique. It neither looks aesthetically pleasing nor provides long-term satisfaction to observers or patients. This look is completely avoidable, using un-conventional, and smarter techniques. We first described this technique in a scholarly article for physicians in 2003 (New procedures in facial plastic surgery using botulinum toxin A HD Stupak, CS Maas – Facial plastic surgery clinics of North America, 2003). The technique has been further refined and has even more practical value today, where people seek a natural look that makes it impossible to tell what has been done to the observer.

Botox by Dr. Stupak

To understand the technique, an anatomy review is required, and a root cause analysis of how the brow and upper eyelid age. First, the youthful brow is suspended in its position like a curtain by the main forehead muscle call the frontalis muscle, which causes the horizontal lines of the forehead. The upper orbicularis muscle and the corrugator muscle are embedded below the skin of the eyebrow and are the depressors of the brow, and become more active with age, stress, and repeated frowning. The elevator muscle (frontalis) and the depressors enter a state of equilibrium with the strength of each muscle group determining the brow position. In other words, strong depressor muscles and weak frontalis results in a droopy eyebrow and glabella (area between eyebrows), and a strong frontalis and weak depressor muscle result in ideal female brow position with the brow in an elevated, curved or arched pattern. So…botox to the frontalis muscle or the horizontal muscles of the brow should never be done at all! Instead, concentrated doses can be delivered to the entire upper orbicularis and glabella, resulting in a browlift! The goal should not be to improve lines, but to improve brow position and brightness of the upper face. The published risk of droopy lids from injecting around the eyebrow is actually not true, but is due to staying too far from the brow and excessively injecting the frontalis. In my opinion and experience, the theoretic travelling of the botox to the eyelid elevator muscle or the levator is not a real phenomenon if one stays on the outer rim of the eye socket. The non-surgical browlift can be beneficial in any age group from 30-90 with of course individualized results. In can also be done in conjunction with upper and lower blepharoplasty and even surgical brow-lift if necessary.

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