State-of-the-Art Non-Surgical Cosmetic Procedures like Botox®; Soft Tissue Fillers including Restylene®, Juvederm® and Radiesse®; Chemical Peels and Dermabrasion are performed by Dr. DiMario, who has been performing the art of Cosmetic surgery for over 25 years.

Tiny injections of BOTOX® (botulinum toxin type A) that temporarily reduce or eliminate frown lines, forehead creases and lines near the eyes. The toxin blocks the nerve impulses, temporarily paralyzing the muscles that cause wrinkles and giving the skin a smoother, more refreshed appearance.

Procedure at a Glance (BOTOX)

Candidate:  Lines on forehead, between the eyelids, around the eyes

Procedure Time:   10 – 20 minutes

Anesthesia:  None or topical cream

Number of Treatments: Repeated 3 - 6 months

Results: Temporary


Botox is the number one cosmetic procedure preformed in the United States. Botox was introduced in the late 1980s for treatment of optic muscle disorders. It was approved by the FDA for cosmetic use in 2002, helping millions of patients with bothersome facial lines and wrinkles.

Today, the variety of Botox uses includes; ocular muscle spasms, problems with eye coordination, neck muscle spasms, severe armpit perspiration, and as an anti-wrinkle treatment for lines around the eye, between the eyebrow, and on the forehead.


How Botox Works

Overactive facial muscles especially between the eyebrows, forehead and around the eyes contribute to the formation of lines and wrinkles. The loss of collagen in the skin, with aging, along with the effects of the environment and sun damage, cause the lines become increasingly apparent and permanent.

Because we are continuously making facial expressions, the underlying muscles are constantly contracting and over time, the tissue around the eyes and mouth begins to thin and wrinkle from all the contracting and pulling. These wrinkles show up as line between the eyebrows, around the eyes, lines on the forehead, and fine lines around the mouth.

During your treatment, BOTOX® is gently injected directly into the muscles that cause these wrinkles.    

Wrinkles are caused by environmental factors, age, thinning skin and by overactive muscles.  BOTOX® works by temporarily disrupting signals between the nerve and the muscle. Muscular movement occurs when a nerve transmits a signal to a muscle, causing it to contract or pull. The nerve ending is separated from a muscle by a small gap called a neuromuscular junction. BOTOX® prevents the signal from crossing the neuromuscular junction, thereby temporarily paralyzing the muscle, allowing it to relax and helping to eliminate the wrinkles and lines that lie above. The effect of the BOTOX® treatment is temporary and typically lasts 3 – 4 months in facial muscle.


Botox typically reduces wrinkles by 80 percent. Patients are usually between the ages of 35 and 60. Results vary among individual cases, and the results are temporary. You will need to plan for additional injections, depending on your long-term treatment goals.

Botox combats wrinkles that are created when nerve cells within the muscles beneath the skin release a chemical called acetylcholine


The Botox Procedure    What to expect during your office visit?


It usually takes approximately 10-15 minutes to inject BOTOX depending on the size of the area treated. No anesthetic is necessary, although some patients do prefer a topical numbing cream. Most patients notice little to no pain during treatment and describe the feeling as a slight stinging sensation that quickly subsides.


The selection of injection points is critical to the success of the procedure. The points of injection are marked with a marking pen. The doctor may select numerous injection points for each location to be treated. These points are usually located on the area where the muscle contracts. Antiseptic is also applied.

It is usually  injected into the following:

  • The glabelar muscles of the forehead, which gives an "angry look".
  • The orbicularis oculi, which creates wrinkles around the eyes.
  • The frontalis, which creates the wrinkles of the forehead.


The Botox is then injected into the marked points beneath the skin, utilizing an ultra-fine needle. The toxins in Botox attach to the nerve endings, which control the muscle, thereby inhibiting the release of acetylcholine. This will stop the muscle contractions that wrinkle the skin.

The effects of BOTOX are usually visible within a few days and last approximately 3-4 months or longer.



Botox Recovery  and Side Effects


You can resume normal activities immediately, but some restrictions will be discussed at the time of your consultation.. Report to the office if you experience any pain or symptoms that are progressive or abnormal.


Make sure, before your treatment that you fully understand the risks, complications and remedies.  The treatment has proved to be relatively safe. Precautions include: know allergy to botox or albumin, muscle weakness, use of aminoglicozide antibiotics, pregnancy or breastfeeding.


The most common side effects of Botox include headache, nausea, flu-like symptoms and redness and pain at the injection points. Infrequently, patients may experience muscle weakness or drooping of the upper eyelid muscles or other muscles injected. This side effect usually resolves itself within days, or in rare cases, months after the procedure.



Alternative and Additional Treatments


There may be alternative treatment options, depending on your situation. Other minimally invasive procedures include dermabrasion, chemical peel, laser skin resurfacing, collagen, dermal fillers and fat fillers. For severe wrinkling, surgical procedures may be more appropriate, such as a facelift, forehead lift, and eyelid surgery.

Some of our most popular procedures include:
Facial Fillers - Restylane® / Juvederm® / Radiesse®         • Botox®
Skin Rejuvination                                                            Lasers and Intense Pulsed Light Therapy
Micro Peels  (Dermabrasion and Chemical)                        • Spider Vein Treatments
Permanent Makeup                                                         Scar Revision
Hair Restoration (Men and Women)                                  •
Surgical Procedures

610-400-8300  •  West Chester, PA • Bala Cynwyd, PA  •

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