Surgical Artistry is staffed by Dr. Tammy Wu and Dr. Calvin Lee.  Located in Modesto, California, we offer services in Plastic Surgery, Botox, Acupuncture, and Veins (facial veins and leg veins)

Tammy Wu, MD  |  Calvin Lee, MD  |  (209) 551-1888  |  www.SurgeryToday.com 
Mon-Fri 8am -5pm    2336 Sylvan Ave. C, Modesto, CA 95355 (next to the post office)

 
FaceBook for Surgical Artistry, Plastic Surgery in Modesto, CA - we would love for you to "like us"   BD = Brilliant Distinctions offered by the makers of Botox and Juvederm.  Discounts for Botox, Juvederm, and Latisse are available.  We can also sign you up at our office.    Plastic Surgery  |  Botox  |  Acupuncture  |  Veins


MODESTO BOTOX INJECTIONS

Artistic Botox injections from a Violinist?

Written by Dr. Calvin Lee, a Board Certified General Surgeon who is also an acupuncturist and violinist.

Dr. Calvin Lee, Botox Surgeon
Dr. Calvin Lee,
Botox Surgeon

There's quite a bit of information here.  It probably borders on too much (sorry, I get carried away at times).  Injecting Botox is a combination of science, art, and technique.  I placed much of the Botox anatomy information on another webpage.  I am probably too heavy on the complications section here, but it's what I worry about so that the patients don't have to.
 

What is Botox used for in the face cosmetically?

possible treatment options for botox on the face - cosmetic use

 

About me


Dr. Calvin Lee, rehearsing Mendelssohn violin concerto as
invited soloist at the Hong Kong Cultural Center in 2009

I was born in New York City.  I am a graduate of Brown University where I studied Neurosciences and got the opportunity to play violin at Carnegie Hall for the first time.  I was kindly offered admissions to Harvard and all the other Ivy League colleges that I applied to and I had to make a hard decision to go to Brown University.  At Brown, I met my wife, Dr. Tammy Wu - thus solidifies the good decision making.  Then I went to Brown University Medical School and became a doctor.  My wife did the same except that she graduated top of the Ivy League medical school class (no small feat!).  Six years after medical school, I became a General Surgeon.  Modesto offered me a great initial job in 2003 as a General and Trauma Surgeon with the McHenry Medical Group.  This was my dream job which I had wanted in a town (Modesto, CA) which would have a need for surgeons to practice diversified procedures.  I later realized that I wanted more artistry with my surgical skills.  Thus I joined my wife, Dr. Tammy Wu, Plastic Surgeon and created Surgical Artistry in 2006.  During the transition process, I became an acupuncture through Stanford's physician acupuncture training program.  During that time, I got a chance to play violin at Carnegie Hall for the second time with the YouTube Symphony (as their only physician violinist), plus did some touring around the globe on solo violin.


Newspaper announcement from 2003 when I first came to Modesto, CA
I had more hair back then.  Modesto Bee.

What to wear to your Botox appointment

For the most part, you can come however you like and we'll do fine.  But here are some pointers to make everything go even more smoothly.

What to do after the Botox injection

Each doctor and/or injector will have different instructions.  Here are my suggestions to my patients

Botox Cost

Pictures of our Office (Modesto, CA)

First picture is part of the lobby.  Second picture is my main Botox injection procedure room complete with operating room light and comfortable chair.  The third picture is the outside of the office.  You can sort of see the edge of the Modesto Sylvan Ave. Post Office.

lobby    botox injection room    outside our office, located in Modesto, CA

Botox cost broken down per area

Prices gathered from May 2012, Surgical Artistry, Modesto, CA.  The price may fluctuate but the number of Botox units would most likely stay the same.   Note only the glabellar area is an FDA approved on-label indication for Botox Cosmetic.  The other areas are considered off-label, and require careful consideration of appropriateness with your doctor.  The charts are not intended to be used as medical advice or advertising material.  They are presented here to be used as medical information only.

Location of Botox injection

Most Common
cost of Botox

Common
Cost Range

Area between the eyes (Glabellar area)

$234

$140-$280

Crows feet (both)

$234

$140-$280

Forehead

$117

$70-$234

Around the mouth (top and bottom)

$82

$46-$93

Dimpling of the chin

$117

$93-$140

Vertical neck bands (each)

$70

$70-$93

Jowls (both)

$140

 

Down turn of the mouth (both)

$93

$46-$93

Note:   Botox is different from Dermal Fillers.  Dermal fillers (ie. Juvederm) cost about $580 per syringe.  For example for the lips, usually one syringe is what's needed.  Botox is for relaxing muscles.  Fillers are for just that - filling with an injectable gel implant.

Chart of Most Common Units used of Botox and Range per Area

Location

Most Common Botox Units

Common Botox Units Range

Area between the eyes

20

12-24

Crows feet (both)

20

12-24

Forhead

10

6-20

Around the mouth (top and bottom)

7

4-8

Dimpling of the chin

10

8-12

Vertical neck bands (each)

6

6-8

Jowels (both)

12

 

Down turn of the mouth (both)

8

4-8

Average Age of Botox Patients

How long does Botox last?

Artistic and Skillful Botox Injections

These are acupuncture needles.  But the skill used to insert these are transferred to the skill for botox injections and location finding

Individualized Botox recommendations

Botox Side Effects with Cosmetic Botox injections

Botox injections are safe and effective aesthetic treatments.  Common adverse effects are mild and temporary.  Serious adverse effects are extremely rare. 

We believe that the we can keep the risks and side effects of Botox low or prevent them by keeping our injection skills at the highest level we can, having great knowledge of facial anatomy, and utilizing individualized injection strategies based on our patients' goals and facial features.

Most common side effect is bruising.  Other side effects are of a very small percentage but they do occur.  And yes, they have occurred in my practice.  But I will take great care to try to prevent them from happening if possible.

I think the risk of bruising is somewhere between 10-20%.  Higher part of the range has been found in the crows feet area.  I do apply Arnica gel to areas with bruise potential right after the treatment to help reduce bruising after Botox.

Incidence of headaches is also similar to the incidence of bruising (10-20%) as reported by our patients.  However, I'm sure there are patients who don't have a chance to tell me, so the incidence is probably not very accurate.  Most patients tell us (me included - I get a mild headache after my own Botox injections) that one dose of Tylenol usually treats the problem.  I've had 2 patients tell me that their headaches lasted longer than 3 days.  But both patients said that they would still continue using Botox.  So this headache risk is a possibility.

Eyelid drooping (belpharoptosis, or lid ptosis) - is most likely caused by migration of Botox through the orbital septum to the levator palpebrae superioris muscle.  This migration could also be caused by excessive pressure on the injected botox sites.  Plus, forhead (frontalis muscle) treatment with botox can aggravate subtle prexisting lid ptosis.  This risk in our practice is less than 1%.   To keep this complication low.  Dr. Wu and I keep our injections of the glabella region (area between the eyebrows) at least 1 cm above the bony orbital rim and we don't cross the midpupillary line.  We also avoid high volume botox dilutions for injections in this area.

Eyebrow drooping (brow ptosis) - is most likely due to low frontalis treatment or overtreatment of the forehead.  I usually encourage patients to get a lower dose of Botox for the forehead to prevent this complication.  I think our risk of this complication is less than 5% of the patients who get forehead injections of botox.  We take steps to keep this complication low by encouraging lower doses of Botox for the forehead for patients who already have a lower-set eyebrow, injecting at least 2 cm above the orbital rim, and we consider adding injections to the crows feet area to help elevate the brows.

Double Vision (diplopia) - is most likely due to medial migration of toxin to the lateral rectus muscle.  I take steps to avoid this by keeping crows feet injections on the shallow side.  So far... (hopefully I will not have to revise this statement), I've had one patient complain of blurry vision after Botox, but she also had eye surgery the week after Botox injections.  She wasn't sure which to blame the blurry vision upon.  She continues to get Botox from me, but has not had any blurry vision since.  But I will always remain cautious.

Botox before and after pictures

Dynamic Wrinkles vs. Static Wrinkles

Botox treatments done by the surgeon injectors at Surgical Artistry, Modesto, CA

I (Dr. Calvin Lee) am the main injector.  Dr. Tammy Wu can also inject with special request.  She was the one who originally trained me to inject Botox.  I have since taken on the art of injecting Botox with passion (bordering on obsession).  In 2010, I have surpassed Dr. Wu's lifetime number of Botox units injected.  As mentioned above, many of these injections are considered "off-label" FDA uses of Botox.  The list here is for informational purposes only.

  • facial wrinkles "11's"

  • crows feet wrinkles on the face besides the eyes

  • forehead wrinkles

  • jowls

  • chin dimpling

  • excess gum show (teeth)

  • nasal flare

  • migraines

  • headaches

  • muscle pain

  • trigger points

  • TMJ (tight jaw muscles)

  • neck bands (vertical bands on the neck in the front)

  • lines around the mouth (ie. smoker's lines above and below the lips)

  • eye twitching

  • blepharospasm

  • hyperhidrosis (arm sweating)

  • palm sweating

  • feet sweating


Empty Vials of Botox on display, as bragging rights

Pregnancy or breast feeding?

Dysport? Xeomin? generic names?

Source of Botox and safety

Platinum level Botox

Brilliant Distinctions Botox Discount (for Juvederm and Latisse too)

Want even more information?

Silly picture but Serious results

I have been told by my patients that I would scare away new patients with this picture (I hope not, I am not a scary person - usually not).  But I figure I have to impart some fun while I poke about 500 needles into patients in the course of a day.   My goal is for my patients to say that they look forward to visiting my procedure room.  Don't try this at home, I got in a whole lot of trouble with my wife for messing up the iron with oils from my face.  Plus if the iron is hot (which it isn't in the picture), you would burn yourself very badly and permanently.

Botox and Juvederm work better for Wrinkles.   Disclaimer - the iron was off and not hot, do not do this

Thank you for reading my blurb on Botox above.  I hope you will consider my botox injections a "jab" well done.

Calvin Lee, MD


RELATED MATERIAL

Dr. Lee's Credentials / Awards  |  Botox Muscle Names  |  Modesto Botox


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Surgical Artistry webpage is for information only, not medical advice.  Dr. Calvin Lee on Google+
www.surgerytoday.com homemade website by Calvin Lee, MD and Tzuying Tammy Wu, MD, Modesto, CA
Botox in Modesto, California  Date of edit: 11/17/2013

Calvin Lee, MD - Surgical Artistry located at 2336 Sylvan Ave, Suite C, Modesto, CA.
Phone: 209-551-1888. .