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Botox and Dermal Fillers

Dr. Annelle Onishi received her medical degree from the John A. Burns School of Medicine in Honolulu, Hawaii in 1996, and completed her medical residency training with the Penn State Family Medicine Program in Hershey, Pennsylvania. She received advanced training for medical aesthetics at the Esthetic Skin Institute training program. Her medical center is located in Wailea on the island of Maui, and serves Kihei, Makena, Wailea and South Maui.

Botox and Dermal Fillers
Photo courtesy of Allergan

What Is Botox?

Botox Injection
Photo courtesy of Allergan

Botox- Also known as onabotulinumtoxin A, is a purified protein manufactured by Allergan works by blocking nerve impulses to injected muscles. Botox® is the number one non-surgical physician-administered aesthetic procedure in the world. With over 15 million men and women satisfied, this procedure is safe, quick and lasts approximately 3-4 months. Wrinkle lines disappear when muscle contractions are reduced.

  • FDA approved for cosmetic use in 2002.
  • Improves the look of moderate to severe frown lines between the eyebrows in people 18-65 years of age.
  • It is also commonly used by physicians to treat the horizontal forehead lines, Crow’s feet on the side of the eyes, bunny lines of the nose, chin dimpling, and other areas.
  • Is one of the world’s most widely researched medicines with approximately 2,300 publications in peer-reviewed scientific and medical journals.


Is Botox Safe?

With regard to safety concerns – there is a difference when discussing medical Botox versus cosmetic Botox. Since 1989 Botox has been used to treat migraine headaches, muscle spasms, eye disorders, and sweaty palms (hyperhydrosis). Patients with these ailments utilize hundreds of units of Botox for these medical conditions. In contrast, cosmetic Botox has been in use since 2002, with most patients receiving at most 50 units. Cosmetic Botox is among the safest procedures in medicine, with thousands of procedures done by qualified physicians. There is minimal to no risk of permanent problems when cosmetic Botox is applied properly.


How Does Botox Work?

Botox is simple in that it relaxes the muscles in your face by blocking nerve impulses. It would be like having a home telephone that functions perfectly fine, except the telephone wouldn’t be able to send or receive phone calls. The phone hardware would work perfectly fine and everything would be intact, there just wouldn’t be a dial tone.


Botox Before & After Pictures

Botox® allows for a more relaxed look on this person’s face. The patient is still able to express themselves naturally, looking kinder and gentler.



After (At day 7):

Frequently Asked Questions

Who performs the procedure?

Dr. Onishi performs all Botox® treatments in our office. She is a board-certified physician in the State of Hawaii, her expertise & experience will allow for the best results in your treatment. In Hawaii, nurses and assistants are allowed to perform injections under the license of a physician, but we believe an experienced board-certified physician is the safest & best route for patients to get optimum results.

How long is the procedure?
Most procedures take no longer than 10-15 minutes, with no downtime. Patients often come in during their lunch break then go back to work.

How long does it take Botox® to work?
It normally takes anywhere from 3 to 10 days for Botox® injections to have their full effect. There will be a noticeable difference in your appearance, often in the form of looking rested, refreshed and more youthful.

How long does Botox® last?
For most people, Botox® lasts about 3-4 months. In some cases with people who use Botox® on a consistent basis, the time between treatments for them gets longer and longer.  This is due to their facial muscles getting weaker over time, thus not metabolizing the Botox® as quickly.

Does it hurt?
No, not at all! No anesthetics are necessary and the injections are akin to a mosquito bite or Tuberculosis (TB) skin text.

What happens if I stop using Botox®?
The best part about Botox® is you will simply return to how you looked prior to your treatments if you stop using it. Many people are starting to use Botox® at a younger age for wrinkle prevention. Celebrities, Models, Actors, Actresses, Movie Stars, Singers, and other famous people utilize Botox® to improve their skin, which is especially noticeable in pictures.


Dermal Fillers

Photo courtesy of Allergan

Dermal Fillers- Such as Juvederm and Restylane are composed of non-animal stabilized hyaluronic acid, approved by the FDA in 2006, are used to sculpt and volume to enhance or replace lost skin volume in a variety of areas such as laugh lines, lips, cheeks, chin, and the back of hands.

Hyaluronic Acid (HA) is a natural component of the skin and other parts of the body. It helps deliver nutrients; hydrate the skin by holding in water and acts as a cushioning agent. HA can hold 1000 times its own weight in water. Its presence in skin has been found to maintain or even accelerate the forming of new collagen.

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