Botox & Juvederm Demonstration

View this video to see Dr. Irwin demonstrate BOTOX® Cosmetic and Juvederm™

Botox relaxes the muscles that contract under the skin of the face and that cause the skin to wrinkle. So Botox helps to smooth out wrinkles and lines in the face.

Juvederm is a type of natural sugar that lifts out wrinkles and can also be used to give full lips.

Note that this demonstration is edited and does not attempt to convey all aspects of a treatment, such as consultation, informed consent, pre-treatment processes, and post-treatment care and communication. We have posted this subject to our Terms of Use.

Link to Guide to Botox for Frown Lines, Forehead Lines, Crows Feet and more

Video Transcription:

Dr. Irwin: I’m Dr. Brandith Irwin at Madison Skin and Laser Center in Seattle and we’re demonstrating today Botox and Juvederm which is a hylauronic acid filler on Andrea who is so kindly consented to come today and be the person that we demonstrate with. This is Rita, who is the nurse that I work with everyday, she’s wonderful, she’s an RN and she’ll be helping Andrea and I. Andrea, this is your first time for anything, so let me give you a mirror, let’s talk a little about what you’re thinking and I’ll tell you what I see and then we can wipe that googy stuff off too. We have some numbing goo on Andrea, so that she’ll be comfortable for the injections, its really nice to have that because it makes it not painless, but almost. Okay, so show me in your forehead what you were thinking about and what’s been been bothering you.

Andrea: The lines right in between my eyes.

Dr. Irwin: Okay, so frown hard for me, so you’re getting that just a little bit aren’t you? But not too much.

Andrea: And then the lines (points to forehead)

Dr. Irwin: More across that, I see those a little bit more actually than I see a little tension through there but not so much in the way still of lines. Raise your eyebrows for me too, lets see. So maybe these lines up in here are starting to bother you. How about the lines around your eyes?

Andrea: Yes, the crows feet. I noticed that over the last year they really started to spread

Dr. Irwin: How old are you now?

Andrea: 40.

Dr. Irwin: Aw, that’s a good age though.

Andrea: It is.

Dr. Irwin: Give me a big smile, I just want to see how strong your muscles are there, its kinda hard to smile with that numbing stuff on.

Andrea: It is.

Dr. Irwin: And then around there in here, are you kinda thinking mostly through those parentheses lines around your mouth? Kinda pulls down just a little bit, I’ll fix that too. Okay, that sounds good. So lets get you ready. I think I’d like to drape a gown around you too. Its just a little makeup pencil it comes off easily so I’m going to have you frown hard again for me. And again, I’m not putting too much up in your forehead, go ahead and relax that cause I think you’re really more of a scruncher than you are a frowner so what I see more is that you’re scrunching a little bit. And raise your eyebrows one more time. And again, I’m wiling to go very lightly in your forehead for this first time, go ahead and let that relax, and just put a bit little in because we can always add a little bit more later and I don’t want to bring your forehead down too much or relax it so much that your eyebrows come down or that your forehead feels heavy to you. So I’d rather underdo it a little the first time it the first time a little bit cause we can always do more at a second treatment. And then I’m just marking your eye area too.

Okay, so is your head really comfortable there for me? That’s perfect! Okay, so again I’m just gonna just going to put a little in here not very much so I think your less of a frowner and more of a scruncher so I’m not really trying not to put a whole lot in your frown lines. And then I’m going to put, a little tiny bit, this is on the side of your nose, just a tiny little drop in that bunny line that is coming down there. Botox can be used in many diff ways and it is very easy to customize it for an individual to get a very natural relaxed look and Good Botox should be undetectable and just make you look more rested, a little bit more relaxed. I’m just kinda of going very gently, I really like a natural look, I really don’t like that face doesn’t move, deer in the headlights look. Dr. Irwin: How are you feeling comfort wise? Not too bad.

Andrea: I feel great

Dr. Irwin: going to have you turn toward the window for me, that’s perfect. And then raise your eyebrows really hard for me, okay, good let that go. Just trying to make sure your eyebrows wont pull up too much there, cause you want a little lift, you just don’t want it so much that you look kinda cronically surprised. Okay, im going to have you turn toward Rita just a little bit, that’s perfect. With Andrea, we’ll check in with her by phone in about 5 days when the Botox takes effect. Its takes about 5-7 days to see the full effect of Botox and then we’ll check in with her we’ll see how she’s doing particularly this first time.  If we need to, we can bring her back and adjust it a little bit, although  usually we don’t need to. And then Ill have her follow up with me in about 3 months. Usually, maintanence,  most of my patients who have been coming for Botox, coming every 6 months, about every 5 or 6 months. But in the beginning, there’s a cumulative effect and it takes the muscles a little while to relax. So usually, Ill have my patient if their new like Andrea come back in 3 months, and then after that maybe 3 ½ and then after that 4 months and then as you can see gradually kinda extend the interval out.

Okay, lets start the Juvederm. Juvederm is a hyaluronic acid filler like Restylane. They’re very similar, I tell my patients its like comparing apples to apples. There’s some expert injectors that love and prefer Restylane and there’s some expert injectors that love and prefer Juvederm. I like to be conservative when I start I think its easy to add later, it’s a little bit harder with fillers to take it out, although with Juvederm and Restylane you can if there’s a lump or a bump that just doesn’t go away, it can be easily removed. Okay, so you got your head all comfy, there that’s perfect. I’m going to go in right in this area, you’re going to feel just a little bit of a pinch. There that’s just perfect. Botox is something that relaxes hyper active facial muscles like a frown line for example or frown muscles and Juvederm fills  lines or in some cases we use it to fill in cheek bones or a scar that has occurred as a result of an accident. So I like to work side to side, Andrea so ill do a little bit on one side and we’ll kinda move over and ice it for comfort. How are you feeling?

Andrea: I feel fine.

Dr. Irwin: Good so not so bad. I’m going to start just trying to lift the corners of your mouth up a little bit, I’m going to have you open and  just a little bit, not quite that much  just a little more, a hair more. It’s hard to feel, isn’t it? Im going to go in the corner there, it feels kinda strange. You might feel that a little on the inside of your mouth temporarily, that’ll go away though after a little while. I like to see peoples faces moving in motion and at rest cause sometimes what looks good at rest doesn’t always. Say, “ the rain in Spain falls mainly in the plane”

Andrea: The rain in Spain falls mainly in the plane.

Dr. Irwin: Good okay, you just need a little drop more over there. That’s perfect. Now smile for me, just want to make sure you’re smile is nice and symmetric. That looks great. And again usually when I do my first  treatment, I’m not trying to correct everything in one treatment, I think its nice to go slowly. Andrea can always let that settle in for a couple of weeks and if she wants me she can always call me and come back in and we’ll do a bit more. Or she might feel that’s just perfect and ill see her probably in about 4 months. Kinda fun, huh?

Andrea: Yes, I can feel it in the corners of my mouth.

Dr. Irwin: That’ll go away in a couple of days, just be complete, I want you to know that we’re just showing a segment of this and the consent form and talking to her about all the benefits and risks and possible complications were all done ahead, prior to the video and then we’re also we’re talking to her after the video about what to watch for, what she should expect, going over what she should do afterwards or not do, all those things are being done off camera.

Just so you know that was just a sample just so you could see how the procedure goes. This is Dr. Brandith Irwin at Madison Skin and Laser. There is much more information on our website, If you want more information about this procedure.

Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin, and I believe that consumers need and deserve a medically trained and unbiased skincare advocate.

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