What is Botox?

Botox is a new concept in treating facial wrinkles in the forehead, between the eyes, and in the "crows feet" areas (upper third of the face). Botulinum toxin, or Botox works by weakening the muscles of facial expressions. Once the resting tone of the treated muscles are weakened, the pull on the muscles relaxes and the overlying skin flattens. This approach is different than the other local treatments for the aging face. Silicone, Collagen, Autologous Fat Transfer, Alloderm, Softform, etc, all work by filling in wrinkles or depressions. These fillers are frequently not as effective as Botox in treating wrinkles in the upper third of the face. By physiologically weakening the muscles, wrinkles are lessened naturally.

Before

After

How long does it last?

Injection of this material into the small muscles between the brows, in the forehead, and at the corners of the eyes causes those specific muscles to halt their function (be paralyzed), thereby improving the appearance of the wrinkles. This paralysis is temporary, and reinjection is necessary within three to ten months. Options for alternative treatments include injection of either collagen or free fat, or the surgical excision of the muscles, usually through a brow lift.

How is it used?

Botox is freshly prepared on the day of injection. Once prepared, the medication needs to be used within 12 hours, as the potency diminishes with time. Because of the short shelf life and the cost, Botox is not available every day in our office. In order for the treatment to be cost effective, more than one patient must be treated on the same day. Using a very tiny needle, small amounts of Botox are injected into the muscles to be paralyzed. Depending on the areas being treated, 5-15 needle pricks (or more) may be required. Discomfort is minimal and lasts only a few seconds.

Side Effects:

Occasionally, the needle may puncture a small blood vessel during the injection and a black and blue area may develop. Such an area can last 5-10 days and may require make-up to cover.

If any of the Botulinnum toxis reaches a facial muscle not being treated, partial weakness of that muscle may last for several months. (For this reason, you are requested not to massage the injected areas for 12 hours following the injection.) If an untreated area experiences muscle weakness, the only "treatment" is to wait for the effect of the toxin to wear off in several months.

There are no recognized permanent side effects of Botox. Complications are rare but may include paralysis of a nearby muscle, resulting in its temporary loss of function (e.g., a drooping eyelid). Botox has been used safely in the treatment of muscular facial spasms for approximately 15 years.

Notes:

The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.