The Three D’s Of Aging

As we get older, the natural aging process results in less collagen, elastin and hyaluronic acid production due to declining hormones, stress, and environmental influences and oxidative damage to the skin cells. Hormonal imbalances (androgen excess) in the perimenopausal years may lead to excess sebum production with acne breakouts, dark facial hair (hirsuitismand even thinning of the scalp.


Which twin is the smoker? To view the myriad ways that smoking accelerates the aging process, see
Ways-Smoking-Affects-Looks *Individual Effects Will Vary


  • Thinning, dry skin with fine lines and wrinkles.
  • Uneven brown pigmentation, texture changes such as coarse pores.
  • Accelerated by sun tanning, stress, and exposure to toxins such as cigarette smoke. Some lines are the direct result of habitual expressions, (frowning, squinting, scowling, wrinkling the nose, pursing the lips) and are known as dynamic lines.

These are best addressed by the use of muscle relaxing agents such as Botox CosmeticTM


  • Shrinkage of the deep fat compartments in the mid face and temples.


Sagging of the face and neck, which manifests in deep folds, jowls and loose neck tissue.

This is best addressed by the use of volumizing fillers such as Juvederm, Radiesse and Sculptra

(see: “SoftLift”-Voluma, RadiesseThe V -Effect, and Sculptra).

In later years., the shrinkage of the deep supportive fat compartments is compounded by muscle atrophy and bone resorption, especially around the eye sockets and the upper jawline (maxilla), appearing as deep hollows around the eyes and flattening and lengthening of the skin between the nose and upper lip, which can lead to inversion and a virtual disappearance of the lips.

These signs can be tricky to address, but sometimes the use of autologous Platelet-Rich Fibrin Matrix (Selphyl) can be used to thicken the infraorbital skin, minimising hollows. Prudent use of hyaluronic acid fillers such as Juvederm can reconstruct lips.


Botox™ Cosmetic

A purified preparation of neurotoxin A produced by the bacterium Clostridium Botulinus. This neurotoxin has been studied and used for medical indications since the 1970’s and has been used extensively for cosmetic uses since 2001.

The bacterium produces 7 different neurotoxins, of which Neurotoxin A and B are used in cosmetic medicine. In Canada, 3 preparations of the neurotoxin A are available: Botox, Dysport and Xeomin. Neurotoxin B is available under the trade name MyoBloc. There are subtle differences in the pharmacology of each preparation, but all are approved by Health Canada.

Botox ™ (Onabotulinumtoxin A) works by interfering with the release of acetylcholine from the pre synaptic nerve terminal, thus blocking the transmission of the nerve impulse that controls movement in the specific parts of the muscle into which it is injected. The end result:

No Muscle Contraction

No Movement Of The Skin Overlying The Muscle

No Wrinkling

Botox Improves Dynamic Lines

  • Lines that are caused by muscle activity (eg frown lines, horizontal lines in the forehead and crow’s feet). It makes no difference to folds caused by sagging or loss of volume (eg. jowls and nasolabial folds).
  • As one gets older, the skin loses its collagen and elasticity, dynamic lines become deeper or appear as fine pink striae (a groove on a surface), which will not disappear completely when the skin is stretched. Botox will not completely remove these lines. Further improvement may only be obtained through resurfacing lasers, or dermal fillers.
  • Precise knowledge of facial anatomy is needed when injecting Botox, so as to avoid a spillover effect into neighbouring muscles. The better understanding the injector has of the complex interaction of facial muscles, the better the results will be.
  • Onset is in 1-2 days following treatment, although it takes 7-10 days for the maximal clinical effect. The results of Botox will last an average of 4 months, some will get more or less time than others.
  • Expert injectors avoid a frozen or overdone look. It is better to retain some ability of expressive and to aim at a rested refreshed look.

Botox™ For The Upper Face

Common uses are:

  • Treatment of Frown Lines (between the brows)
  • Treatment of Horizontal Forehead Lines
  • Treatment of Crow’s Feet
  • Treatment of Bunny Lines (lines on the bridge and sides of the nose caused by crinkling the nose when smiling)
  • Treatment of the lower eyelid
  • Treatment of Lifting The Brows

See  Illustrations Below

Botox for Forehead Lines

Botox for Forehead Lines * Individual Results May Vary


* Individual Results May Vary

Botox™ For The Lower Face & Neck

Botox in DAO Muscle

Botox in DAO Muscle * Individual Results May Vary

  • Treatment of Smoker’s Lines (vertical lines above/below the lips)
  • Treatment for down turning of the corners of the mouth (DAO muscle)
  • Treatment of excessive crinkling of the chin leading to lines in the lower face (mentalis muscle)
  • Treatment of excessive gums that show when smiling (gummy smile)

Botox™ Is Also Used for Square Faces or Tooth Grinding (TMJ dysfunction)

Injections into the masseter muscle will elongate a square shaped face, making it more oval in shape. This muscle is more commonly treated to relieve tooth grinding (bruxism) or symptoms of TMJ dysfunction and as such, may be covered by some insurance plans

Botox For Lower Neck

Botox For Lower Neck * Individual Results May Vary

Botox™ in the Neck

There are 2 uses for Botox in the neck

  • Treatment of Horizontal Neck Rings

Botox may be a helpful adjunct in association with laser resurfacing, or Selphyl (Platelet-rich Fibrin Matrix)- see feature Rejuvenate your Neck

  • Treatment of Platysmal Bands (Nefertiti Jaw Lift)
Nefertiti Jaw Lift (Botox)

Nefertiti Jaw Lift (Botox) * Individual Results May Vary

These bands are caused by bunching of the sheet-like muscle-the platysma- which covers the front of the neck. As we get older, the muscle may bunch into tight cords or bands that are cosmetically displeasing, pulling the lower face down, exaggerating jowls, and pulling the neck tissue forward. Strategic injections of Botox along the jawline and in the bands themselves rebalances the muscle and leads to a firmer, more youthful neck profile.



  • sweaty-businessmanExcessive underarm sweating or clammy hands. Botox injections offer a practical, non-invasive alternative to surgical thoracic sympathectomy or excision of axillary sweat glands. Botulinus toxin interferes with the release of acetylcholine from the nerve terminal, thus interrupting the sympathetic nerve signal to the eccrine (sweat) gland. In studies, 95% of participants have had an average reduction in sweating of 83%.The average duration of relief is 7 months, in 30% of patients, the effect will last longer than a year.

We treat axillary, palmar, and craniofacial hyperhidrosis.
Treatments are reimbursable by most insurance plans.

A number of medical conditions may cause excessive sweating; therefore a medical consultation is required before treatment is undertaken. For a full discussion of hyperhidrosis, its possible causes, other treatment options, and potential side-effects of Botox see website section Skin–Hyperhidrosis

Botox For Migraine Headaches

Recent studies have demonstrated the effectiveness of Botox in reducing the frequency of headaches in persons suffering from chronic migraines (eg. with 15 or more days per month of headaches lasting 4 hrs or longer). The recommended protocol involves injecting muscle groups in the brow and forehead area, the temples, the back of the head and back of the neck. Usually treatments are given every 12 weeks and will be reimbursed by most insurance companies.

A medical consultation is required before commencing treatment.

Botox For Cervical Dystonia

Neck pain caused by spasm of the paracervical muscles, associated with abnormal head positions, otherwise known as torticollis arising spontaneously or from strain or injury. The affected muscles, usually the scalenes, splenius capitus, levator scapulae and trapezius, are injected on the affected side, giving relief for about 4 months.

Following a whiplash injury, I was in constant pain – I tried muscle relaxants, massage, and even acupuncture-then my doctor suggested Botox. This is the first time in 4 years that I’ve been pain-free! K.G. – Laser Room Patient  

  *individual results may vary

Disclaimer: We are producing this section of the website as an informational tool for existing patients, so that they may have a basic understanding of their treatment; not as an advertisement for a specific formulation of Botulinus Toxin. It is not intended to be all-encompassing; the specifics of your planned injection protocol, potential side-effects of the drug etc, will be discussed at your consultation with Dr. Hyland.