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Botoxâ Information & Frequently Asked Questions
What is Botox?
Botox is a sterile solution that is injected in small amounts (25-30 units or less) to treat furrows and lines caused by the muscles of expression. In much larger doses (40,000 units or more), the toxin can cause a type of food poisoning called botulism. Botox is one of eight toxins produced by the bacterium, Clostridium botulinum, which is highly purifified and synthetically-produced.
How is Botox used?
In very tiny amounts, Botox has been used safely and effectively for over fifteen years to treat spastic muscles around the face (excessive eye blinking) and unbalanced muscles (crossed eyes). It causes specific, temporary paralysis of the muscle treated. It was noted that these patients tended to lose the wrinkles around the areas treated. Subsequently, since 1989, Botox has been used successfully to relax:
v frown or squint lines (the deep vertical lines between the eyebrows)
v “crow's feet” lines, the lines along the outside edges of the eyes
v “bunny lines” (horizontal lines on the sides of the nose)
v horizontal forehead wrinkles (caused by the muscles used lift the eyebrows)
v radial furrows around the mouth
v unwanted dimpling on chin
v elevate corners of mouth 2-3 millimeters to give a more upturned appearance to the corners of the mouth
v raise the lateral or medial eyebrows 2-3 millimeters
v on young faces, give the eyes a more wide open appearance by injecting small amounts in the fold under the eyes.
These muscles are responsible for facial animation and pull directly on the skin, eventually causing furrowing and then permanently etched lines in the skin. The lines that develop are partly genetically determined and are the result of habitual facial expressions ingrained since early childhood.
Very tiny amounts of Botox, 43 units or less, are injected with a very small, fine disposable needle directly into each desired muscle. No more than 50 units are given at any one time. The pull of these muscles on the skin is subsequently relaxed, flattening out the furrows. It does not entirely erase deeply etched lines, but may efface them considerably. There are individual variations on responsiveness to Botox. Not all persons will respond with the same degree of muscle relaxation. While Botox response is fairly predictable, we cannot guarantee that all your expectations will be met.
How long does the effect of Botox last?
It generally lasts for three to six months before it requires repeating to maintain the effect. As treatment is repeated it tends to last longer. This is thought to be due to eventual atrophy of the muscles due to lack of use, as will happen to any unused muscle. Onset of action is usually within one to two days, but occasional will take up to ten days. Muscle groups should not retreated forat least two weeks.
What does Botox look like?
Botox arrives frozen in glass vials containing small amounts of crystals. A small amount of sterile saline is added to the vial. Botox is a clear solution and contains no small particles.
Do Botox injections hurt?
When injected, Botox causes mild to moderate stinging. However, it does not cause any tissue irritation or inflammation.
Are there any potential side effects?
As with any injection, there can be bruising around the injection site. To minimize the potential for bruising, try not to take aspirin or non-steroidal anti-inflammatory drugs such as Advil, Aleve or Naproxen for several days before treatment. Rarely, Botox can migrate into surrounding areas and cause temporary drooping of the eyebrow or eyelid. Care is exercised when injecting around the mouth. If not, there can result a slight incompetence of the muscles of eating and talking. There can be a flattening of the upper lip when smiling resulting in less teeth show.
Aminoglycoside antibiotics (amikacin, garamycin, tobramycin) may increase the effect of Botox and should not be used at the same time. It should not be used during pregnancy.
Allergy to Botox is very rare.
Are there any post-injection instructions?
Yes. You should remain upright for at least three hours to prevent migration of the Botox. The areas treated should NOT be massaged, again to prevent migration, but you SHOULD use the muscles treated for three to four hours after injection to encourage the nerve-endings of the muscles being treated to take up the Botox solution. Ice should not be used.
Will my insurance pay for Botox?
No. It is considered a cosmetic treatment. You should plan to pay at the time of your treatment as with any cosmetic treatment.
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