BOTOX® Cosmetic Treatment

History: Injections of botulinum toxin A or BOTOX® Cosmetic have been in use since the 1970 when they were injected into the muscles of the eye to treat "lazy eye" and then later found success in the treatment of involuntary spasms of the facial muscles (blepharospasm). Today BOTOX® Cosmetic injections have become a popular method for softening forehead lines, crow's feet, and frown lines.

There are a couple of factors that cause the skin to wrinkle in these areas - the progressive loss of elasticity due to aging and the stretching and contraction of the muscles in the upper portion of the face causing a folding of the skin. BOTOX® Cosmetic is injected into the muscles of the upper face, weakening or paralyzing the muscle, which lessens the lines of facial expression.

It can take 24 hours, up to 10 days for results to appear and they will last anywhere from three to six months.

The sites that are most commonly treated by BOTOX® Cosmetic include the forehead, which would minimize the transverse wrinkle lines, the crow's feet area, and the glabellar complex (the area between the eyebrows containing the corrugator and procerus muscles).

Procedure: Although there are no drugs that an otherwise healthy patient would be taking that would interact with BOTOX® Cosmetic, there are some things you should avoid before treatment. You should avoid taking anti-inflammatory medication, Vitamin E and aspirin for two weeks prior to treatment. Each of these medications may cause bruising when the BOTOX® Cosmetic is administered.

The entire procedure takes approximately 10 minutes, and is given through a very fine gauge needle, minimizing the discomfort from the injection. If patients have a very low pain threshold, it is recommended that they take Tylenol ® or other medication prior to the injection. Topical anesthesia with Emla ® or another anesthetic may be used. After the treatment, we will ice the area to reduce the swelling and discomfort. After you have received the BOTOX® Cosmetic injections, wait four hours before lying down, do not massage the treated muscles as this can cause the botulinum toxin to spread to the muscles around the eyes. Exercising the muscles every 15 minutes for one hour after the treatment probably increases the effect.

BOTOX® Cosmetic treatments can be repeated every four to six months and to date, no long term side effects have been detected. Patients will require less frequent treatments as they break the habit of contracting frown lines, thereby causing atrophy of the underlying muscle.

Complications from BOTOX® Cosmetic: There are a few possible side effects from the BOTOX® Cosmetic injections but they are rare and always reversible. Sometimes an injection is not effective and a repeat is necessary. Patients may see some minor swelling or bruising and on rare occasions, drooping of the eyebrow or eyelid can occur.