PlasticSurgery.com Staff Report © 2005-2009
Botox ® is the top non-surgical cosmetic procedure in the United States -- approved by the Food & Drug Administration (FDA) for aesthetic purposes since 2002. The most common purpose of Botox ® is to temporarily reduce the appearance of wrinkles, such as the moderate to severe glabellar lines between the eyebrows. However, Botox ® has been approved by the FDA since 1989 for other medical conditions.
It is most successful when used on wrinkles that are the result of repeated facial expressions where the muscles contract generally on the upper third of the face. Some examples of these grooves caused by overly-worked muscles are horizontal forehead furrows, vertical frown lines, and wrinkles in the corner of the eyes, commonly known as “crow's feet.” Some doctors are even using it to treat lips and nasolabial areas. Other less common uses of Botox ® include the treatment of excessive sweating in the armpits, hands, and feet, as well as migraine headaches.
"The pain associated with Botox ® injections is generally minimal and brief"
Botox ® is successful in diminishing the appearance of wrinkles caused by repeated contractions of the muscle because it produces a paralytic effect. When injected directly into the muscle, it actually impedes the muscle's ability to contract by blocking the transmission of nerve impulses to its location. If a muscle cannot tighten, a wrinkle cannot be formed. Botox ® is a botulinum toxin type A, which is derived from a naturally-occurring bacterium. Through tiny injections, the purified protein can relax overactive muscles that cause frown lines to form. For medicinal uses, it is extremely diluted, purified, and sterilized. It has been used to treat neurological disorders for several years, and is proven to be safe in small doses.
Ideal Botox ® Candidate
If a patient is considering Botox ®, he or she should meet these qualifications:
- Between the ages of 18 and 65
- Possess early signs of aging
- Have vertical frown lines, horizontal forehead lines, "crow's feet," or other unwanted facial wrinkles. (Note: Botox ® works best on the wrinkles that are caused by repeated contractions of the muscles, like frowning or squinting, rather than wrinkles that are caused by gravity or age.)
- Looking for a temporary, non-surgical solution to appear younger and more refreshed
- Knowledgeable about the procedure
- Realistic in expectations
- Good physical and psychological health
The above criteria may not be comprehensive. Be sure to discuss treatment options with your doctor, and if you are an ideal candidate for Botox ®.
The Benefits of Botox
Botox ® does not stay in the body indefinitely, so if there were to be an adverse effect, it is only temporary. There is also a likely possibility that with frequent treatments, the injected muscles will atrophy, allowing the patient to go longer between treatments.
Choosing a Doctor and Facility
Any health care professional can administer Botox ® injections. However, a board certified plastic surgeon, facial plastic surgeon, or dermatologist is recommended. He or she should be a specialist experienced in Botox ® and have an intricate understanding of facial anatomy and physiology.
With the FDA's approval of Botox ®, it has become increasingly popular to administer it in social settings and/or non-medical facilities, sometimes without trained personnel. Although, this can help reduce the costs for patients, they should be aware of some of the concerns.
The environment needs to be sterile and equipped to handle any adverse situation. A physician's office or clinical setting is generally considered the best option. Finally, adherence to post-treatment instructions is key.
"Over two-and-a-half million Botox ® injections were performed in 2004, making it the top non-surgical cosmetic procedure in the United States"
The Initial Consultation
At the initial consultation, your doctor will first determine if you are an appropriate candidate for Botox ® and if indeed, it is the best treatment for the results you desire. During this time, a doctor will ask of your medical history so he or she can predict any potential allergic or hypersensitive reactions. Furthermore, it is important to disclose all medications, vitamins, herbs, and supplements you currently take. These substances could hinder or intensify the potency of Botox ® or cause bleeding and bruising at the injection sites.
The Botox ® Procedure
Botox ® is a simple, non-surgical procedure. The doctor will ask the patient to contract the muscle area to be treated, in order to determine appropriate injection sites. Then targeted injected areas may be numbed with an ice pack or a topical numbing agent. No anesthesia will be used. Finally, the doctor will administer several tiny injections of Botox ® directly into the muscle. Only the injected areas will become paralyzed.
The procedure should be completed in about 10 to 15 minutes, although it depends on the number of injections needed. Because the procedure is non-surgical and often done right in the doctor's office, there is no hospital stay required. The pain associated with Botox ® injections is generally minimal and brief. Some patients have compared it to a bug bite or prick. Pain can be reduced by proper injection techniques, as well as numbing injection sites with a cold pack or anesthetic cream.
Risks, Limitations & Possible Complications
As with any medical procedure, there are possible risks and side effects. Since this is a non-surgical procedure, the risks and possible complications are infrequent, minimal, and temporary. The most commonly reported side-effects are headaches, respiratory infection, flu syndrome, temporary eyelid droop, and nausea. Less commonly reported side effects are pain, redness at spot of injection, and muscle weakness. There is also the possibility of bruising at the injection site.
Because there is also the likely possibility that with repeated treatments, the injected muscles will atrophy allowing the patient to go longer between sessions, a patient's body may develop antibodies that would cause the treatments to become less effective over time. This resistance can be minimized by using the lowest dose possible, and lengthening the time between sessions.
Botox ® injections cannot be performed if there is any infection at the injection sites, if you are hypersensitive to any ingredient in the botulinum toxin type A or if you are pregnant or nursing. There is also an increased risk with patients that have any neuromuscular disorders.
Results and Recovery
Wrinkle reduction is usually noticeable within three to four days. There may be mild, temporary bruising, numbness, or redness around the injection sites. Botox ® may not take 20 years off an patient's life, but his or her appearance will look more relaxed and youthful. Because the procedure is non-invasive, the patient should be able to return to normal activities immediately. However, to avoid spreading the toxin to other muscles, they should not rub or massage the injected area, and remain upright for many hours. Physical activity should also be avoided the first four to six hours. Ask your Botox ® specialist to see before and after Botox photos in order to see the final results of the procedure.
Botox ® may last up to six months. If patients wish to maintain a youthful look, follow-up injections are necessary. If another round of Botox ® is not performed, lines can return to their pre-treatment appearance. However, patients should wait at least three to four months before undergoing more treatment.