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BOTOX ® Cosmetic

Botulinum Toxin Type A
Many wrinkles are actually creases that have been worn into the skin by making the same expression thousands of times. These expression lines, often called frown lines or crow’s feet lines, are due to the contraction of a muscle under the skin in that area. Botox ® Cosmetic is a purified protein toxin that is injected into the muscle that creates the wrinkle. It blocks the nerve impulse from reaching that area and as a result, the muscle weakens. As the muscle weakens, the skin overlying the muscle relaxes and the wrinkle in the skin gradually softens. Botox ® Cosmetic has been used safely in ophthalmology for over 10 years and for wrinkle therapy for over 6 years. Botox ® Cosmetic does not affect the nerve, so there is no numbness in the immediate area of injection. The muscles related to other expressions are unaffected. The effects of Botox ® Cosmetic usually last 3 to 5 months, at which time another injection is required. After several treatments, the effects of Botox ® Cosmetic may begin to last longer, sometimes up to 6 to 8 months. Treatments are performed in the office and take just a few minutes to complete. Deep and persistent wrinkles, especially between the eyebrows, the horizontal forehead lines, and the crow’s feet area are the most common areas treated. This procedure can be used by itself or in conjunction with laser resurfacing if other unwanted skin changes are present.

Botox ® Cosmetic injections appear to be very safe. The most serious side effect that has been observed is either drooping of the eyelid or double vision. This results from weakening of the muscles very close to the eyelid. The complication is self-limited and wears off—usually within a few weeks. To avoid this, injections are kept away from the eyelid itself. Bruising can also occur at the injection site, but this clears rapidly and is usually gone within a day or so, and is easily covered with make up. No systemic side effects have been noted.

While the treatment can be used alone, it is often used as an adjunct to other cosmetic procedures such as a face-lift, blepharoplasty, laser resurfacing or with other minimally invasive procedures. We are excited about this new procedure. Our experience, to date, has been highly satisfying and we are recommending this treatment with enthusiasm.

WHAT TO EXPECT / DO’S & DON’TS

Preparation for the procedure requires avoidance of aspirin or aspirin containing compounds for 10 days prior to the treatment.

The treatment requires 10-15 minutes in the office or the skin care clinic. A light cold pack afterwards minimizes any risk of bruising or significant swelling. DO NOT rub the area or areas treated for 48 hours. Remain upright for at least 4 hours after the treatment. You may resume light activities immediately. Avoid exercise for 24 hours. Re-treatment if partially or completely unsuccessful may be performed at a minimum of 2 weeks following the initial treatment.

Expect to see results from the Botox ® Cosmetic in 1-2 days, optimal response in 1-4 weeks, declining effect of the treatment over 3-4 months. To maintain the effects of Botox ® Cosmetic, re-treatment is required at various intervals.The treatment is uniformly quick and painless with minimal downtime. Mild headache, nausea, upper respiratory or flu like symptoms, and eyelid droop have been reported as side effects. These are generally self-limited and resolve quickly. Eyelid droop may be significant, may take several weeks to resolve, and may require medication to speed up the resolution of the droop.Diluting Botox ® Cosmetic can decrease its effectiveness. We prefer to use higher concentrations and smaller volumes to maximize its effect and reduce side effects.

Individuals with existing neuro-muscular disorders such as multiple sclerosis, or other significant systemic or disabling diseases or conditions are not candidates for treatment.
Infection at treatment sites is also a contraindication.