Monthly Archives: June 2014

Why a patient would choose Surgical Artistry – Staff View

Why a patient would choose Surgical Artistry, in Modesto, California

My staff last week sat down in the conference room and over lunch with our Botox / Allergan Representative, they brainstormed (without me) a list some ideas on why we are worth considering for Botox injections.  I have my own thoughts about why choose Surgical Artistry (Calvin Lee, MD) for Botox.  But these are theirs, and I just cut and pasted their summary email which they came up with all by themselves.  I think it’s pretty nice!

Botox is a high priority in our practice and we talk about it often at work.

  • -Dr. Lee is an Ivy league trained general surgeon that has been trained in minimally invasive cosmetic procedures
  • -Dr. Lee highly knowledgeable in facial anatomy
  • -Dr. Lee has been working with needles for over 15 years!
  • -Experience: a patient could not find an office with a better in office experience
  • -longer specialized appointment times
  • -Higher level of service
  • -more consultation time, better experience, better outcomes

Disclaimer:  These are their own opinions.  I have a very enthusiastic team at Surgical Artistry.   I personally have very high regard for other Botox practices and I know I have a lot to learn from others.


Visit our home-made Botox web page:  Modesto Botox by Calvin Lee, Surgeon – our telephone number and other methods of contact are listed there.


Muscles, Nerves and Vasculature of the face for the Botox and Juvederm injector

These are just some notes – this is by no means complete.  Just sporadic notes to supplement other sources.

Lip elevator muscles

  • Levator labii superioris alaeque nasi – gummy smile muscle.
  • Levator labii superioris
  • Levator anguli oris
  • Zygomaticus Major/minor

Lower Lip depressor muscles

  • Depressor anguli oris
  • Mentalis
  • Depressor labi inferioris

The Frontalis Muscle

  • Creates the transverse rhytids
  • Only elevator of the brow – don’t want to entirely weaken this muscle with neuromodulators (ie. Botox).  Consider limiting the injections to the upper 2/3 of this muscle.
  • Wrinkles are perpendicular to the movement of the muscle.

Agonist/Antagonist action of muscles on the Brow

  • Obicularis Oculi, Procerus, and corrugators depresses the brow vs. Frontalis.  Tug-a-war.  Can change the shape and location of the brow with Botox/neuromodulators.

Parts of the Obiclaris Oculi Muscle

  • Palpebral portion= Pretarsal (lies on tarsal plate) and Preseptal = responsible for passive closure of the eye
  • Orbital portion – further out laterally.  Responsible for forceful closure of the palpebral fissue of eye.  Accessory muscle to smiling.

Nerves of the superior orbit

  • Supratrochlear nerve – runs through the belly of the corrugator supercilii.  This nerve provides sensation to the medial 1/3 of the forehead and is a nerve that can be responsible/trigger for migraine headaches.
  • Supraorbital nerve – just lateral to the supratrochlear nerve.  Sensation for the lateral 2/3 of the forehead.


There is much more, but this is a start.

I have made this super webpage a few years ago with BOTOX muscles of the FACE

That link above may be of interest to you.


Meanwhile feel free to visit our self-made Botox home page:  Modesto Botox by Dr. Calvin Lee, Surgeon.  Thank you for visiting.

Facial Fat Compartment Anatomy for Botox and Juvederm injections

Notes regarding Facial Fat Compartment Anatomy

  • Orbital retaining ligament separates the orbital fat compartments from the rest of the face:  Superior, Inferior, and Lateral orbital fat compartments.
  • Cheek fat compartments:  Most medial is the Nasolabial fat compartment (the medial border is the actual nasolabial fold), then there is the medial cheek fat compartment, middle cheek, lateral cheek fat compartment
  • The Jowl is a fat compartment
  • See below for deeper fat compartments.

What does this mean for a cosmetic Botox and Juvederm injector?

  • Looking at the whole face as a continuum
  • Temporal wasting is also something we should start to address – hollowness from temple area to neck – the lateral projection.
  • Many patients start by noting nasolabial fold and jowel fat compartments.  But this is a symptom, not an actual problem.  It may be a symptom of other fat compartments becoming deflated, such as the medial cheek fat compartment.
  • As we age, we lose these volume in these fat compartments, and in addition to face lifts to tighten the skin, we have to consider filling these areas again to regain some of our youthful appearance.

There is fat superficial and deep to muscle which are compartmentalized

  • SOOF – Suborbicularis Oculi Fat – underneath the obicularis muscles.  There is the medial SOOF and the Laterial SOOF.
  • SMAS – Superficial Musculo-aponeurotic System
  • The fat is compartimentalized
  • Deep fat in the cheek – below the musculature.  Can cause a pseudo ptosis of the superficial fat.  Over the Maxilla.  Medial and Lateral aspect to the deep medial cheek fat.  Refilling the deep fat in some patients can create a lift in this area of the mid cheek.


There is no medical advice here.  Read more: Why choose Dr. Calvin Lee for your Botox injections.

More information at our personally designed Botox page:  Modesto Botox by a Surgeon-Violinist, Calvin Lee, MD.  We are located in the heart of Stanislaus County, California.

After Botox, I have a headache

Headache after Botox

About once a month, I’ll hear someone tell me about this experience.  I myself get this problem when I have Botox, Dysport, or Xeomin injected for my wrinkles lines on my face.  I also have heard of this phenomenon after facial rejuvenation acupuncture.  I think with acupuncture this may be related to the qi which is brought to the face and scalp for facial rejuvenation acupuncture.  And I have also heard of this problem after mole removal from the facial area – a procedure I also do often.  Thus I’m not always sure that the cause of the headache after Botox is entirely caused by the Botox.  It may be from the placement of needles or the stress of having the procedure.  Regardless, the headache after Botox should resolve with the use of routine headache medications, such as advil, aleve, and tylenol.

What happens if the after-Botox headache lasts longer than a few days?

It may be possible that a nerve was irritated by the proximity of the needle used to inject Botox.  This also should resolve with time.

Most of my patients who get headaches after Botox still feel that the procedure is entirely worth repeating every 3-4 months.


The information here is for informational purposes and should not be considered medical advice.  We would recommend that you see your doctor in person.  If you want to see me in person:  More information about my Modesto based Botox practice.  And here’s a link to other emergencies and complications due to cosmetic injections.

Our Botox Home Page:  Modesto Botox.  Thank you for visiting!