BOTOX Cosmetic is the only FDA-approved treatment to temporarily improve the appearance of both moderate to severe frown lines between the brows and crow’s feet in adults.
Botox is a brand name of a toxin produced by the bacterium Clostridium botulinum.
The FDA approved its usage in the late 1980s upon the discovery that Botox could stop ailments like blepharospasm (uncontrolled blinking) and strabismus (lazy eye). Doctors have been using Botox for years to successfully treat wrinkles and facial creases. In April 2002, Botox gained FDA approval for treatment of moderate-to-severe frown lines between the eyebrows – called glabellar lines. However, Botox is often used for other areas of the face as well.
How Does Botox Work?
BOTOX® acts as a nerve impulse blocker. Botox® actually prevents wrinkles from appearing by relaxing the underlying muscles so they don’t contract. Botox® binds to the nerve endings and blocks impulses from the nerve to the tiny facial muscles that are related to expression lines. After treatment, the overlying skin remains smooth and unwrinkled while the untreated facial muscles contract in a normal fashion, allowing your normal facial expression to be unaffected.
How Long Does a Botox Injection Last?
The effects from Botox will last four to six months. As muscle action gradually returns, the lines and wrinkles begin to re-appear and wrinkles need to be re-treated. The lines and wrinkles often appear less severe with time because the muscles are being trained to relax.
What Are the Side Effects of Botox?
Temporary bruising is the most common side effect of Botox. Headaches, which resolve in 24-48 hours, can occur, but this is rare. A small percentage of patients may develop eyelid drooping. This usually resolves in three weeks. This usually happens when the Botox moves around so you shouldn’t rub the treated area for 12 hours after injection or lay down for three to four hours.
Who Should Not Receive Botox?
Patients who are pregnant, breastfeeding or have a neurological disease should not use Botox. Since Botox doesn’t work for all wrinkles, a consultation with a doctor is recommended.
How Is a Botox Procedure Performed?
Getting Botox takes only a few minutes and no anesthesia is required. Botox is injected with a fine needle into specific muscles with only minor discomfort. It generally takes three to seven days to take full effect and it is best to avoid alcohol at least one week prior to treatment. Aspirin and anti-inflammatory medications should be stopped two weeks before treatment as well in order to reduce bruising.
Is the recommended dose of BOTOX® Cosmetic is safe?
There has not been a confirmed serious case of spread of toxin effect when BOTOX® Cosmetic has been used at the recommended dose to treat frown lines, crow’s feet lines, or both at the same time.
Do not take BOTOX® Cosmetic if you: are allergic to any of the ingredients in BOTOX® Cosmetic (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); have a skin infection at the planned injection site.
Tell your doctor about all your muscle or nerve conditions, such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects including difficulty swallowing and difficulty breathing from typical doses of BOTOX® Cosmetic.
Tell your doctor about all your medical conditions, including: plans to have surgery; had surgery on your face; weakness of forehead muscles, such as trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® Cosmetic can harm your unborn baby); are breast-feeding or plan to breast-feed (it is not known if BOTOX® Cosmetic passes into breast milk).
Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal products. Using BOTOX® Cosmetic with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received BOTOX® Cosmetic in the past.
Especially tell your doctor if you: have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin, such as Myobloc®, Dysport®, or Xeomin® in the past (be sure your doctor knows exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; take a sleep medicine; take aspirin-like products or blood thinners.
FREQUENTLY ASKED QUESTIONS
What is botulinum toxin type A?
Botulinum toxin is a purified substance that’s derived from bacteria. Commonly known types of botulinum toxin type A injections include Botox and Dysport.
Injections of botulinum toxin blocks muscular nerve signals, which then weakens the muscle so it can’t contract. The end result is diminished unwanted facial wrinkles.
Botulinum toxin can be used to help smooth:
- Crow’s feet
- Forehead furrows
- Frown lines
- Skin bands on the neck
How much Botulinum toxin injections cost?
The average cost of botulinum toxin injections (e.g., Botox, Dysport) is $371, according to 2014 statistics from the American Society of Plastic Surgeons.
The cost of botulinum toxin injections can vary. The average fee referenced above does not include facilities or other related expenses.
A surgeon’s cost may be based on the expertise and qualifications of the person performing the treatment, time and effort the treatment requires, and geographic office location.
Costs may include:
- Prescriptions for medication
- Surgeon’s fee
- Surgical facility costs
When choosing a board-certified plastic surgeon in your area for botulinum toxin, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the procedure.
Am I a good Botulinum toxin candidate?
Smiling, frowning, squinting, and even chewing – basically any facial movement – can eventually lead to one of the most common signs of aging: wrinkles. They can make you appear tired or even angry when you are not. One of the quickest and safest remedies to remove wrinkles is an injection of botulinum toxin type A.
Botulinum toxin can be combined with other cosmetic skin procedures – such as chemical peels, dermal fillers, ormicrodermabrasion – to further improve your results. This combination of therapies can even help to prevent the formation of new lines and wrinkles.
How much time is required to see results?
You may notice results within a few days, but it can take up to a week to see the full effect. This improvement typically lasts about three to four months.
When the effects of botulinum toxin begin to fade, your muscle reactions and the wrinkles will return.
Is the Botulinum toxin procedure simple?
Injections of botulinum toxin may seem like a simple procedure to you, since it’s just a few shots. But it’s actually both an art and science that only an experienced healthcare professional should do.
There are 43 muscles in your face and it’s vital that the person who performs botulinum toxin injections understands and pinpoints the correct spots to optimize your treatment.
A very thin needle is used to inject small amounts of botulinum toxin into specific muscles.
By carefully choosing specific muscles, your healthcare provider weakens only the wrinkle-producing muscles, preserving your natural facial expressions.
Botulinum toxin treatment injections usually take less than 15 minutes.
The number of injections you need will depend on your facial features and the extent of your wrinkles. Crow’s feet, for example, usually demand two to three injections. Furrows above your brow could take five or more.
What is the downtime/recovery time for Botox?
No anesthesia is required. There is no down time or recovery time for botulinum toxin injections.
You may resume normal activities immediately.
One note of caution: Don’t rub or massage the treated areas after the wrinkle treatment because it can cause the botulinum toxin to migrate to another area of your face. If this happens, you could have temporary facial weakness or drooping.
Your botulinum toxin consultation preparation?
During your botulinum toxin consultation be prepared to discuss:
- Your goals.
- Medical conditions, drug allergies, and medical treatments.
- Current medications, vitamins, herbal supplements, alcohol, tobacco, and drugs.
Your plastic surgeon may also:
- Evaluate your general health status and any pre-existing health conditions or risk factors.
- Discuss likely outcomes and any risks or potential complications.
Botulinum toxin is a non-surgical injection that’s given in your plastic surgeon’s office.
It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of stress. Don’t be shy about discussing these feelings with your plastic surgeon.
Questions to ask my plastic surgeon
Use this checklist as a guide during your botulinum toxin consultation:
QUESTIONS TO ASK YOUR Doctor
Ready to schedule a consultation?
1-Do they have medical expertise in facial anatomy?
2-How many years of experience do they have injecting BOTOX® Cosmetic?
3-How often do they treat patients with BOTOX® Cosmetic?
4-Do they schedule a follow-up visit after treatment?
5-Will they show you before-and-after pictures of other patients they have treated?
6-What are the most common side effects they have seen in their clinical experience?
7-What should you do if you experience any side effects?
8-What do they need to know about your medical history? Be prepared to tell your provider about any medical conditions, including any prescription medications, vitamins, or herbal?
9-Are you certified by the American Board of Plastic Surgery?
10-Were you specifically trained in the field of plastic surgery?
11-Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
12-Am I a good candidate for botulinum toxin?
13-What will be expected of me to get the best results?
14-Who will perform the botulinum toxin injections?
15-Have they been specifiaclly trained in this procedure?
16-Where and how will you perform my procedure or treatment?
17-How long of a recovery period can I expect?
18-What are the risks and possible complications associated with my procedure?
19-How can I expect to look over time?
20-What results are reasonable for me?
Choose a plastic surgeon you can trust
The decision to have botulinum toxin type A injections involves many choices. The first and most important is selecting a member of the American Society of Plastic Surgeons (ASPS) surgeon you can trust.
- ASPS member surgeons meet rigorous standards:
- Board certification by the American Board of Plastic Surgery® (ABPS) or in Canada by The Royal College of Physicians and Surgeons of Canada®
- Complete at least six years of surgical training following medical school with a minimum of three years of plastic surgery residency training
- Pass comprehensive oral and written exams
- Graduate from an accredited medical school
- Complete continuing medical education, including patient safety, each year
- Perform surgery in accredited, state-licensed, or Medicare-certified surgical facilities
Do not be confused by other official sounding boards and certifications.
The ABPS is recognized by the American Board of Medical Specialties (ABMS), which has approved medical specialty boards since 1934. There is no ABMS recognized certifying board with “cosmetic surgery” in its name.
By choosing a member of the American Society of Plastic Surgeons, you can be assured that you are choosing a qualified, highly trained plastic surgeon who is board-certified by the ABPS.
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