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Our skin shows how healthy or young we are. If we have spent a lot of time in the sun, smoked, or from age, weight loss, or genetics, we may have looser or wrinkled skin.

This can happen on our faces, neck, décolletage, and breasts. When our skin is loose or wrinkled it can give the appearance that we are older than we really are. You may have tried everything from facials, using at home sonic treatments, masks, serums, lotions, and creams. While these can help with mild lackluster skin, it will not firm or tighten the skin, or get rid of deep creases.

When your skin becomes wrinkled and loose, it can make you feel less attractive. Even when you eat correctly, get a good night’s sleep, exercise regularly, these lines and wrinkles, and loose skin may not disappear. One way to help with loose and wrinkled skin is to have Botox injection. These injections can be done in more areas than just the face. Some people may not know it can help to lift the breasts, and smooth out the neck, help with overactive bladder, migraines, and neck spasms.

What is Botox?

Botox (Botulinum toxin) is a non-surgical procedure that is given through an injection into the desired area. It can help smooth wrinkles and fine lines, give a moderate lift to the skin, treat migraines, and reduce sweating.

Botox works by sending a signal to the nerve attached to the desired muscle. When this signal is sent, the nerve stops reacting, in turn paralyzing the muscle. This will soften the muscle.

Botox is the most popular cosmetic procedure, with six million people receiving Botox treatments every year. Men and women who choose to have Botox injections may do it in combination with an Eyelift to remove bags around the eyes, and sagging skin on the upper eyelids, Dermal fillers to fill out sunken cheeks, Fat Transfer to naturally fill out sunken checks and the area around the mouth, nose, and eyes, and Skin Rejuvenation and Resurfacing to help get rid of age spots and discoloration on the skin.

Botox is a non-permanent cosmetic procedure that should be repeated several times a year for optimal results. Dr. Silvia Rotemberg, will discuss with you if Botox will help you to achieve your desired results.

Before & After Photos

Candidates for Botox

  • Fine lines and wrinkle around the eyes, mouth, or on the forehead
  • Moderately sagging skin on the face, breasts, or neck
  • Excessive sweating
  • Neck spasms
  • Overactive bladder
  • Gummy smile
  • Have extreme Migraine headaches

Botox Treatments

Botox for Facial Skin

The most common usage of Botox is for facial skin. It is meant to help eliminate fine lines and wrinkles on the facial skin, neck, and décolletage. The Botox injections are placed in the desired area to paralyze the muscles that create wrinkles and moderately sagging skin. This procedure should be repeated every three to four months.


Botox for Migraines

Botox for Migraines is the only FDA approved injected treatment for those with migraines. You must have fifteen or more migraines a month, lasting four or more hours in duration. It is not approved for those who have fourteen or less migraines. It generally will help eliminate up to nine migraines a month. This procedure should be repeated every twelve weeks.


Botox for a Gummy Smile

Botox for a Gummy Smile is for men and women whose gum line shows when they smile. Botox can lower the upper lip to create a smile that does not show the gums. This can be a tricky procedure, and is not ideal for every person. Dr. Silvia Rotemberg will explain to you if this procedure will work for you. This procedure should be repeated every three to four months.


Botox for Excessive Sweating

Botox for Excessive Sweating is for those who have excessive sweating under the armpits. Botox for excessive sweating is a last stop after trying deodorants and creams that don’t work. While Botox is successful for eliminating excessive sweating in the armpit, at this time, it is not known if Botox will work in other areas of the body for excessive sweating. This procedure should be repeated every four to six months.


Botox for a Breast Lift

Botox for a Breast Lift is meant for those with minimal sagging in the breast. The breast lift is accomplished by injecting Botox into the minor chest muscle. This treatment will not help with significant sagging, nor change the size of your breast. The procedure should be repeated every three to four months.


Botox for Neck Spasms

Botox for Neck Spasms is meant for those who have repetitive neck spasms. Botox is injected into the nerves in the neck, therefore the muscles relax. This can lessen the amount of neck spasms you experience.


Alternatives to Botox

botox Rotemberg Plastic Surgery

While there are alternative to Botox for the face, neck, décolletage, and breasts, there is not another alternative cosmetic treatment to treating migraines besides Botox. Many people who suffer from migraines use over the counter and prescription drugs.

Laser Therapy

Laser Therapy is a cosmetic procedure that uses laser technology to reduce fine lines and wrinkles, as well as to help reduce moderate sagging skin on the face. This procedure will not work on deep creases, the way Botox can.


Ultherapy uses ultrasound therapy to help produce collagen in the skin. The doctor will use ultrasound imaging to see the foundational layers of the skin in order to create a smooth appearance, and to tighten the skin. The result usually take two to three month to show, as it works from the inside out. This procedure will not help with the deep creases in the skin, but can give an overall rejuvenated appearance to the facial, neck, and décolletage areas. It is considered a non-surgical facelift

Eyelift Surgery

If your major problem area is your eyes, you may want to get eyelid surgery to remove bags and take away excess skin around the eyes. Some people may want to do Botox at the same time, as Botox can help with the crow’s feet around the eyes.

Brow Lift Surgery

If you have a furrowing brow or excess skin on the brow, Brow lift surgery can lift the skin creating a brighter appearance to the eye and face. This will not help with deep lines around the mouth or eyes.


If you have sagging skin, wrinkles, loose muscles on the face, a facelift may be a good alternative for you. This surgical procedure will lift the entire face, remove fat, tighten muscles, and give the appearance of a tighter more youthful face.

Breast Lift

If your breasts sag, nipples droop downward, or you have asymmetrical breasts, a breast lift surgery will help you accomplish more than Botox, alone. This surgery can be performed in varying ways to accomplish the desired breast lift for your body type.

Chiropractic and Acupuncture

If you have neck spasms, chiropractic and acupuncture may help. Chiropractic may be able to help align the neck. Whereas acupuncture needles may help you to release tension. It’s recommended that you see a medical doctor before seeking alternative treatment. This usually takes several visits to see results, unlike Botox, which can have more immediate results.

Physical Therapy

A physical therapy may be able to help you with neck spasm and overactive bladders. These treatments usually take several visits to see results, whereas Botox can have more immediate results.

Periodontal Surgery for Gums

If you have a gummy smile there, periodontal surgery can help close the gap. This surgical procedure. These can be done by removing tissue in the gum, lengthening the crown, or by lowering the upper lip. These surgeries will result in a more permanent solution than Botox, but will require downtime, and can be more painful to receive.

What To Expect During The Consultation

Dr. Silvia Rotemberg’s collaborative process begins by discussing your specific desired needs. She will then go over what can be accomplished by receiving injections, and if an alternative may produce better results.

As one of Miami’s top female plastic surgeons, Dr. Silvia Rotemberg, will do a full examination of your health, access the specific area you would like to address, and both you and the doctor will make an informed decision based on your goals. She will show you before and after pictures to give you an idea of what can be accomplished. If you are interested in Botox for the face, she suggests you bring in pictures of yourself from a few year ago. From these pictures, she will better understand what can be accomplished. If you are coming in for migraine treatment, you will want to bring in medical records showing that you have had fifteen or more migraines a month.

Dr. Silvia Rotemberg will explain how the treatment will work, what can be achieved, and if Botox, or one of its alternative treatments or surgeries would be right for you.


Botox injections are a rather quick procedure. The injections do not require numbing, however, Dr. Silvia Rotemberg understands that many people prefer to numb the area. If this is the case a prescription numbing cream can be applied to the area sixty minutes before, the doctor can inject you with a numbing agent, or a cold spray can be applied (lasts only about ten seconds after spray). The doctor will then inject a thin needle with Botox into the desired area.

The treatment is done in the doctor’s office, and most patients are able to return to work immediately after.


The great part about Botox is there is no down time. However, with that said, there are things you should avoid doing. Dr. Silvia Rotemberg suggests that you do not rub the area or lay down, right away.

Dr. Silvia Rotemberg is an experienced Botox plastic surgeon, and while most people will have no side effects, she highly encourage her patients to contact her with any questions or concerns.

The results will show in about two to three days, and can last from three to twelve months.


The costs of a Botox will vary on the area and the treatment you desire. Dr. Silvia Rotemberg’s consultation will provide costs for each procedure.