Schedule A Consultation

Botox in New Jersey

Botox Before & After Photo. Procedure by Dr. Baljeet K. Purewal (Oculoplastic Surgeon) in New Jersey.



Botox in New Jersey with Dr. Purewal

For years, BOTOX Cosmetic has been used to treat facial creases and wrinkles. These injections are used for addressing the signs of aging on the face and the neck. At Fresh Face & Eye, in Chatham, New Jersey, Expert Injector and board-certified Oculoplastics and Reconstructive Surgeon, Dr. Baljeet K. Purewal, uses this nonsurgical, quick and convenient facial rejuvenation treatment to help her patients look more refreshed.

Are BOTOX Injections in New Jersey Safe?

Yes. Initially, the Food and Drug Administration (FDA) approved onabotulinumtoxin A to treat eye and muscle spasms. However, once the benefits of using BOTOX for the treatment of cosmetic-related issues were realized, the FDA approved it for use in smoothing wrinkles and creases on the face and the neck. This product is ideal for treating the wrinkles and the creases that result from muscle contractions.

Strategically placed injections block the nerve impulses responsible for causing specific muscles to contract, thus, blocking the signal from the nerve to the muscle and preventing that contraction from ever taking place. This lack of signal temporarily eliminates the moderate to severe lines and furrows that result from muscle contractions.

Where Does the Bacterium Used to Create BOTOX Cosmetic Come From?

Clostridium botulinum is present in a variety of natural settings, including lakes, soil and even in the intestinal tracts of fish and mammals.

While the naturally occurring bacteria and its spores are usually harmless, once the spores transform and cell population increases, the bacteria start producing the botulinum toxin, which is the neurotoxin responsible for causing botulism.

Commercial Versions of BOTOX

Using extremely small doses of the purified protein complex of Bacterium Clostridium botulism, manufacturers create BOTOX, a prescription drug that is designed to temporarily paralyze muscles.

Commercial versions include:

  • Botox (onabotulinumtoxin A).
  • Xeomin (incobotulinumtoxin A).
  • Dysport (abobotulinumtoxin A).
  • Jeuveau (prabotulinumtoxin A).

Despite the fact that the name ‘BOTOX’ is a registered trademark of the Allergan company, people tend to use this term interchangeably when referring to any of the commercial products listed above. Although the results achieved with each of these products can vary, all of these formulations work in a similar manner.

How Popular is Using Onabotulinumtoxin A for Cosmetic Reasons?

In the United States, injections with onabotulinumtoxin A have become one of the most popular nonsurgical cosmetic procedures performed.

What Facial Issues Can BOTOX in New Jersey Be Used to Address?

Onabotulinumtoxin A injections are used to address glabellar lines (aka frown lines or ‘elevens’) that develop above the bridge of the nose and in between the eyebrows. The horizontal creases that form on the forehead as well as the wrinkles that develop at the outer corner of each eye (aka crow’s feet). In addition, Dr. Purewal can use these injections to address cobblestone-looking skin on the chin, the lines that form at the corners of the mouth (aka marionette lines) as well as to address the bands that develop on the neck.

What Causes the Issues that Onabotulinumtoxin A Injections Can Be Used to Address?

Cellular changes that occur as we age can result in facial line development, however, there are also other factors that contribute to the signs of aging.

These factors include:

  • Free-radical, sun and environmental damage.
  • A reduction in the amount of collagen the body produces.
  • Frequently repeated muscle contractions.

Which Repeated Muscle Contractions Commonly Lead to Facial Changes?

Facial lines and wrinkles can develop due to squinting, frowning, grimacing and the act of raising one’s eyebrows. Each of these actions cause the skin in a particular area to become creased and folded, which, over time, results in the formation of the lines and wrinkles in these specific areas of the face.

BOTOX addresses these facial changes by working beneath the surface of the skin to decrease the underlying muscle activity that is responsible for the moderate to severe forehead lines, crow’s feet and frown lines. Once onabotulinumtoxin A is injected, these lines will appear visibly smoother.

Targeted Botulinum Toxin Type A Injections Can Stop Repeated Muscle Contractions

Repeated muscle contractions stop after targeted injections of onabotulinumtoxin A because the muscle that contracts to create the ‘dynamic wrinkle’ is paralyzed. Dynamic wrinkle refers to wrinkles that only appear with muscle contraction.

Muscle contractions, explained:

  • Moderate to severe crow’s feet – these lines develop from squinting, grimacing and smiling. While performing each of these actions, the muscles at the outer corners of each eye contract, eventually leading to the formation of crow’s feet. During an injection treatment session to address crow’s feet, Dr. Purewal targets the orbicularis oculi muscle at the outer corner of each eye, temporarily paralyzing it to make the crow’s feet look smoother.
  • Moderate to severe frown lines – whenever we concentrate or frown, the corrugator supercilii muscle that is above the nose and in between the eyebrows contracts, which causes furrowing and folding of the skin in this area. Dr. Purewal injects the corrugator supercilii muscle with onabotulinumtoxin A to paralyze it, which helps these lines become smoother, thus, providing a temporary solution for this problem.
  • Moderate to severe lines on the forehead – whenever we raise our eyebrows, our frontalis muscles contract, which causes folding and furrowing of the skin in this area. Dr. Purewal injects BOTOX into these muscles, to temporarily smooth the lines of the forehead.

How Does BOTOX Reduce the Visibility of Wrinkles?

Some people believe that onabotulinumtoxin A actually removes wrinkles, this is a misconception. In reality, botulinum toxin type A temporarily disables the muscles located in the face and the neck that cause these wrinkles to develop in the first place. This is accomplished by blocking the connection between the nerves and the muscles in the neck and the face. Due to this blockage, the nerves cannot tell the muscle to contract.

The Nerve Blocking Process of BOTOX in New Jersey, Explained

Onabotulinumtoxin A is a substance that targets the nervous system. Substances that target the nervous system are referred to as neurotoxins.

Neurotoxins can disrupt the nerve signaling processes of the body by preventing the release of acetylcholine. Acetylcholine is a chemical messenger that the nerves release at the junction where the muscle cells and nerve endings meet.

Once the junction is reached, the acetylcholine attaches itself to the muscle cells’ receptors, which causes the muscles to shorten or contract. Injections of onabotulinumtoxin A effectively stop the release of acetylcholine, which allows the muscles to relax, causing the wrinkles to soften.

Dr. Purewal Can Soften Deep Creases Using BOTOX in New Jersey

As the production of collagen decreases, the skin begins to lose its elasticity. This lack of elasticity can cause the formation of a permanent crease: A crease that is visible even when the muscle that lies beneath it is relaxed. Since the muscle is already relaxed, there is no need to paralyze the muscle, however, a treatment with onabotulinumtoxin A may help soften the wrinkle’s appearance.

Issues that BOTOX in New Jersey is Unable Address

Any wrinkles or creases that develop due to gravity and/or sun damage will not respond to treatments with onabotulinumtoxin A because these wrinkles are not created by a muscle.

Who Should Consider Treatments with Botulinum Toxin Type A?

Onabotulinumtoxin A injections only take a few minutes to administer and do not require the use of anesthesia. Individuals who have facial creases that are caused by repeated muscle contractions and/or those who have muscle bands on their necks may be good candidates for BOTOX injections with Dr. Purewal at her office in New Jersey.

Is There Anyone Who is Not Considered a Good Candidate for BOTOX?

Yes, there are several issues that may disqualify an individual from having onabotulinumtoxin A injections.

Individuals who are not good candidates for BOTOX Cosmetic injections in New Jersey include those who:

  • Are under 18 years of age.
  • Have any type of neurological disease.
  • Are pregnant or breastfeeding.
  • Are taking blood thinners.
  • Have previously experienced an allergic reaction to BOTOX itself or any of its ingredients.
  • Have had an allergic reaction to any of the other botulinum toxin products (e.g., Xeomin, Dysport or Myobloc).
  • Are currently experiencing an infection, inflammation or cold sores at the planned injection sites.

Since onabotulinumtoxin A will not work for every wrinkle, choosing an experienced Expert Injector is vital. An experienced injector knows the structure of the face and the best location to inject onabotulinumtoxin A so as to provide the patient with youthful, natural-looking results.

An Initial Consultation at Fresh Face & Eye in New Jersey

During the initial consultation at Fresh Face & Eye in Chatham, New Jersey, patients need to tell Dr. Purewal if they have any nerve or muscle conditions. Individuals who have Lou Gehrig’s disease, Lambert-Eaton syndrome or myasthenia gravis may be at an increased risk of experiencing serious side effects following their injection session. Serious side effects include difficulty breathing and swallowing. These side effects can result even when only a small dose of botulinum toxin type A is administered.

Dr. Baljeet K. Purewal needs to know about every medical condition the patient has, if the patient has plans to have surgery in the future and whether he or she has previously had any surgical procedures performed on the face and/or the neck.

Patients should bring a list of their current medications, vitamins and herbal supplements with them to this appointment. Other information should include the dose, frequency and the reason for the medication.

In addition, patients should let Dr. Purewal know if they are experiencing problems lifting their eyebrows, have noticed abnormal facial changes and/or are experiencing droopy eyelids (that may or may not be affecting the patient’s vision).

Women who are pregnant or are planning to become pregnant should inform Dr. Baljeet K. Purewal of this during the consultation because it is unknown whether these injections of onabotulinumtoxin A can cause harm to an unborn baby. Also, women who are currently breastfeeding or who are planning to breastfeed need to inform Dr. Purewal of this. Just as with pregnancy, it is not known whether injections of botulinum toxin type A are passed to a baby through the mother’s breast milk.

Preparing for BOTOX Injections with Dr. Baljeet K. Purewal at Fresh Face & Eye in New Jersey

Dr. Purewal requests that her patients avoid alcoholic beverages for at least seven days before their injection treatment session. In addition, patients need to discontinue taking certain types of medicine, including anti-inflammatory medications and aspirin. These medications need to be avoided for at least two weeks before their injection treatment session as both of these medications can cause excessive bruising.

Are Patients Usually Satisfied with their BOTOX Results?

Yes, as long as patients realize that they are not having a facelift, they are happy with the results achieved using onabotulinumtoxin A injections. Understanding the limitations of each treatment helps patients make decisions about which procedure(s) will provide them with the results they desire.

A Combination Treatment Session

Many of Dr. Baljeet K. Purewal’s patients decide to have several procedures during a single injection treatment session.

Procedures frequently combined with onabotulinumtoxin A injections include:

  • Dermal fillers.
  • Photofacials.

By combining onabotulinumtoxin A injections, dermal fillers and photofacials, patients enjoy a more youthful-looking and rejuvenated appearance.

How Long Does It Take for the Final Results to Become Evident?

Some results can usually be seen within 48 hours of the treatment.

At around five to 10 days’ time, the results become more noticeable.

These results will last from four to six months.

At the six-month mark, patients who would like to maintain their results need to have another onabotulinumtoxin A treatment.

Can the Results Achieved with BOTOX in New Jersey Be Reversed?

Once injected, the results achieved with onabotulinumtoxin A cannot be reversed, however, the results do wear off with time.

BOTOX Injections Can Even Be Used to Prevent the Signs of Aging

For the most part, patients who choose to have botulinum toxin type A injections are between the ages of 30 and 60. However, there has been a rise in the number of individuals in their mid to late 20s who are seeking this treatment. These individuals want to prevent the wrinkle formation that occurs on the forehead and around the eyes as a result of repeated muscle contractions.

How Onabotulinumtoxin A Injections Prevent Wrinkle Development

While onabotulinumtoxin A injections are very effective when it comes to smoothing existing fine lines and wrinkles, these injections can also help prevent the development of new lines that could have formed as a result of the movement of muscles that were previously treated with onabotulinumtoxin A injections.

Are There Any Side Effects Associated with Onabotulinumtoxin A Injections?

Generally, people tolerate these injections well and side effects are rare. However, the most common side effect following these injections is temporary bruising. Some patients also experience a stinging sensation around the injection sites as well as flushed-looking skin in the injection areas.

While rare, some patients do develop a headache that lasts from 24 to 48 hours. A very small number of patients may develop an eyelid droop, but this typically resolves itself within three weeks’ time. The eyelid drooping occurs when some of the injected product moves away from its intended location; therefore, to help prevent this complication, patients must avoid rubbing and touching their treated areas for at least 12 hours following their injection session. In addition, lying down too soon after the session can also result in product migration.

Onabotulinumtoxin A injections can also cause some unwanted effects. However, these side effects are typically mild and short lived.

Possible unwanted effects include:

  • An upset stomach.
  • Flu-like symptoms.
  • Fatigue.
  • Numbness.
  • Unwanted weakness or temporary paralysis of nearby muscles.
  • Mild pain, bruising and/or inflammation around the injection sites.
  • A general feeling of being unwell.

Some patients who receive BOTOX injections will develop antibodies to fight the toxin, making future treatments ineffective. In addition, there are individuals who have a genetic predisposition to BOTOX, which could cause him or her to experience an unusual response to the drug.

Anyone who is interested in trying injections with botulinum toxin type A should make an appointment for an initial consultation at Fresh Face & Eye. Dr. Baljeet Purewal can help determine if this type of treatment will provide the patient with the look he or she desires.

Potential Complications

While rare, when a complication does occur it is temporary and mild. Any complications or side effects that do result will relate to a particular injection site. For instance, if injections are performed close to the eyes, the complication may affect the brow line and/or the eyelids.

Other complications that may occur include:

  • Problems swallowing (when injections are administered into the neck muscles).
  • Excessive muscle weakness around the eyes causing a droopy eyelid, which can obstruct the patient’s vision.

In addition, onabotulinumtoxin A injections may interact with certain medications, including antibiotics. For this reason, during the initial consultation at Fresh Face & Eye in Chatham, New Jersey, patients must remember to bring the list of medications they created. Using this list, patients can quickly and easily inform Dr. Purewal of all the medications, vitamins and herbal supplements they take.

The Importance of Choosing an Experienced Expert Injector

When a provider is not familiar with performing BOTOX injections, he or she may inadvertently use the product improperly. Improper use of botulinum toxin type A can lead to what is referred to as a ‘frozen face.’

When a patient experiences frozen face, the procedure itself is highlighted instead of the wrinkles the procedure is supposed to conceal. Individuals who are seeking treatment with onabotulinumtoxin A and/or with dermal fillers need to find an Experienced Expert Injector to perform their injections.

Patients need to know that, although dermal fillers can be dissolved if the patient is unhappy with the results, the results attained using botulinum toxin type A cannot.

How Much Does a BOTOX Treatment in New Jersey Cost?

How much a treatment with onabotulinumtoxin A costs depends on the number of syringes a patient needs to attain his or her cosmetic goals. If you are interested in learning more about botulinum toxin type A injections, contact Dr. Baljeet Purewal’s office at (973) 635-4000 to schedule your initial consultation.

Will Health Insurance Cover BOTOX Treatments?

When used for aesthetic reasons, health insurance will not cover onabotulinumtoxin A injections. Dr. Purewal recommends that each patient contact his or her health insurance company to ask about coverage.

If you are in New Jersey and you are considering BOTOX injections, be sure to choose an Expert Injector to administer your BOTOX treatment. At Fresh Face & Eye, Dr. Baljeet Purewal frequently performs these injection sessions to help individuals address the signs of aging brought on by muscle contractions. Dr. Purewal is an Expert Injector as well as a board-certified Oculoplastics and Reconstructive Surgeon.

Schedule an initial consultation with Dr. Baljeet K. Purewal today by calling (973) 635-4000. Fresh Face & Eye is located at 82 Main Street in Chatham, New Jersey.


Worried about your worry lines? Frowning at your frown lines?

If you’re ready to smooth your worry lines, the dreaded “11s” (frown lines between your eyebrows), or the fine lines around your mouth and eyes, Botox is a great option for you. Cosmetic injections, like Botox, not only smooth out those wrinkles, they can help prevent them from starting or becoming worse over time.

What is BOTOX?

Botox is a prescription injection used to treat permanent furrows and deep wrinkles in the skin that are formed by the continual contraction of facial muscles. BOTOX Cosmetic is used to treat the following:

  • Forehead furrows
  • Frown lines
  • Crow’s feet
  • Skin bands on the neck

How does BOTOX work?

Although originally approved by the U.S. Food and Drug Administration for the treatment of eye and muscle spasms, BOTOX Cosmetic was quickly recognized for its cosmetic value. Properly placed injections of BOTOX Cosmetic block nerve impulses sent to muscles, weakening them to the point where they cannot contract, and temporarily eliminating moderately severe furrows and lines.

Will BOTOX prevent wrinkles?

Most patients receiving BOTOX treatments are between 30 and 60 years old, and it is very effective at smoothing out existing fine lines and helping prevent further lines from developing.

Increasingly we are seeing patients in their mid-late 20s seeking BOTOX treatment to prevent wrinkles from forming. Because Botox prevents the flexing of muscles that eventually cause wrinkling, it can be effective on the forehead and around the eyes as a preventative treatment.

How long does BOTOX work?

Botox and other botulinum toxin A injections last for about four to six months. Typically patients will have longer-lasting results for the first few treatments (6 months or longer) and then come back for touch-ups every 4-5 months.

Does BOTOX cause side effects?

Any cosmetic injection treatment, including Botox, has potential side effects. Dr. Purewal will take time to talk with you about any potential side effects before you determine whether BOTOX injections are right for you.

Are patients typically happy with their results?

Yes. It’s important to understand that you aren’t going to get facelift results from a non-surgical treatment such as Botox. However, many of our patients choose a combination of treatments, such as Botox + dermal fillers + photofacials, that can help rejuvenate skin and restore a youthful appearance.


FAQ: Botox

What is Botox?

Botox has become synonymous with botulinum toxin type A, but Botox is a specific brand name for a specific product that has been highly refined and widely tested. Botulinum toxin is delivered as a freeze dried powder in a glass jar. It has to be diluted before it can be used.

Am I a candidate for Botox?

Botox relaxes facial muscles and diminishes their secondary wrinkle-producing effects. It is a foundation on which other non-invasive and even surgical procedures can be built. Common areas that respond very well to Botox treatments include the area between the eyebrow, also known as the “11”, forehead furrows and crow’s feet.

Will I look frozen after a Botox treatment?

Botox treatments should be subtle, and the entire experience should be easy. Our goal is a natural, relaxed look—to soften and diminish lines and furrows.

Will Botox still work for me if I keep using it?

The goal of Botox injections is to use the smallest dosage that produces an optimal effect. This will allow the continued use of Botox for years without any lessening of the effects.

Will I bruise from Botox?

The needle used to inject botox is tiny and we take great care to avoid bruising. Ice packs are applied after treatment along with gentle pressure. We recommend Arnika Forte before and after treatment if you have a tendency to bruise easily.

At what age should I start Botox treatments?

Botox can be used as a preventative treatment to avoid getting fine lines or wrinkles. For some patients, this may be in their mid-twenties if lines they make during expression stay once they are relaxed. Factors such as lifestyle, genetics and skin color also can determine ideal time for intervention. In general, when lines or wrinkles begin to bother you on a regular basis, it is a good time to consider botox treatments.



Related Procedures