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Botox is the brand name for Botulinum Toxin type A. It is a nonsurgical procedure that smoothes deep, persistent lines by weakening the muscles that cause wrinkles. Botox is most commonly injected into the frown lines, horizontal forehead lines and crow's fee. By relaxing these muscles, the lines become less visible. Botox is also used in the prevention of wrinkles as well, because it keeps you from making the facial expressions that cause wrinkles. Botox injections last an average of three to six months.

The Procedure

The treatment may take 10 to 20 minutes. Anesthesia is rarely needed, but sedatives and numbing agents may be used. Botox is injected with a tiny needle into the muscles required. There may be some discomfort associated with the injection, but most patients report little pain. Some describe the feeling as a “pinch” or “bee sting.” The effects of Botox can be seen in a few hours or sometimes it takes several days.

The Recovery

You can resume regular activities immediately. After treatment, the area may be slightly red and bruised and you may experience a headache. It’s important to allow the Botox to settle in by keeping your head upright and avoiding moving the muscles in the area that was treated.

The Best Candidates for Botox

The Best candidates for Botox are those with deep lines around their eyes or forehead. It’s important to have realistic expectation of what Botox can do for you. A Botox injection may not totally erase deep lines. If you are pregnant, nursing or taking certain medications, you are not eligible to receive Botox treatments.

The Risks

A rare side effect is a temporary drooping of one eyelid. This condition will correct itself without treatment in a few weeks. There is no risk of Botulism, which is usually caused by eating contaminated foods. Very high doses, much more than would be normally used would have to be injected. Again, if you are pregnant, nursing or taking certain medications, you are not eligible to receive Botox treatments. The effects of Botox can be increased with the use of certain antibiotics or other drugs that interfere with neuromuscular transmission. Be sure to discuss all possible risks with your doctor before treatment.

Background

Botulinum toxin (BTX) injections, often referred to by the product names Botox® or Myobloc®, are biological toxins transformed into a therapeutic agent. Work with BTX began in the late 1960s to treat neurological disorders. Today, BTX is used for the treatment of frown lines, forehead furrows, "crow’s feet," lines and wrinkles of the lower face, and even nasal muscles (to decrease nostril flaring). BTX injections have proven to be a very popular nonsurgical cosmetic procedure; see current American Society for Aesthetic Plastic Surgery (ASAPS) statistics. Aesthetic plastic surgeons have found that the type of lines and wrinkles that respond to BTX injections are those caused by the muscles—specifically those muscles that contract during facial expressions such as frowning or squinting.

Technique

The patient is asked to contract the muscles in the area being treated so the surgeon can determine the proper location for injection. In most cases, BTX is injected directly into the muscle with a tiny needle. It takes a few days to realize the effect of BTX injections.

Benefits

• No downtime. Patients can immediately resume normal activities.
• Long experience has proven BTX to be safe. To date, no systemic complications associated with BTX injections have been documented.
• Treatment is reversible within several months.
• May be beneficial for treatment of migraine headaches.

Other Considerations

• BTX injections are a temporary solution for the treatment of wrinkles. The effects last from 3-4 months and require repeat treatments.
• Possible side effects include local numbness, swelling, bruising, or a burning sensation during injection. Some patients have reported temporary headache and nausea. Most complications are of short duration and can be avoided with proper injection techniques.
• A small percentage of patients are reported to experience no improvement at all.

ASAPS Position

The American Society for Aesthetic Plastic Surgery (ASAPS) maintains that BTX injections for aesthetic purposes appear to be safe and effective. Patients, who show early signs of aging, as well as those who may not be suitable candidates for more extensive aesthetic facial surgery, may be good candidates for this procedure. Certain medications (some antibiotics, anti-inflammatories, or aspirin) and even some vitamins and herbs may increase the potency of BTX and may increase bleeding and bruising at the time of injection. Therefore, patients should be candid with their surgeon about all medications and supplements. Pregnant or nursing women should postpone undergoing this procedure. It is not known whether injection of BTX has any effect on a fetus or whether it is found in breast milk.