Cosmetic is a therapeutic muscle-relaxing agent derived from the bacterium,
Clostridium Botulinum. For over a decade, ophthalmologists have applied BOTOX
Cosmetic for its original intention, the treatment of blepharospasm. Physicians
have utilized BOTOX Cosmetic for years as a cosmetic treatment to correct
visible signs of stress and aging.
How does BOTOX Cosmetic work?
contractions and movements of the facial muscles are controlled by signals from
the brain. BOTOX Cosmetic simply prevents the muscle from allowing responses to
these messages. As a result, the muscle relaxes and the overlying skin remains
unwrinkled and smooth.
What do most expect with treatment of BOTOX?
a very fine needle, BOTOX Cosmetic is injected into the specific muscle that is
contracting and causing the lines and wrinkles on the face. Treatment is
effective, safe, and takes approximately 10 minutes. The pain is a minimal "pin
prick" and no anesthetic is required. BOTOX will paralyze the muscles and stop
the lines created with muscle motion and soften the lines present at rest due to
resting tone of the muscles.
How long does a BOTOX Cosmetic treatment last?
effects usually last 3 to 4 months, and fade away gradually. Following several
treatments, the results may last 4 to 8 months or longer. BOTOX Cosmetic offers
extended relief over the course of long-term treatment.
discomfort if at all from BOTOX is minimal and very brief. Some physicians
prefer to numb the area first with a topical anesthetic cream (such as EMLA
Cream), which you leave on for at least 10-15 minutes before the injection.
However, many patients require nothing prior to the injections. After the
injections, your physician might give you a cold compress to help at the
injection sites to make sure no bruising occurs.
What are the side effects of BOTOX?
effects of BOTOX Cosmetic, if any, are usually mild and temporary. Botulinum
toxins contain proteins, which in some circumstances may be naturally
safeguarded against by the body's ability to produce antibodies. If antibodies
are formed, the therapy will generate a lesser response. Temporary bruising is
sometimes experienced, though this symptom resolves itself within 2 to 3 days.
In rare cases, there can be a slight drooping of an eyelid or asymmetry of
expression. If this should happen, return to your physician.
most common side effects from BOTOX include:
temporary eyelid droop
localized pain from the injection site
should not be given with patients who have certain neuromuscular disorders such
as ALS, myasthenia gravis, or Lambert-Eaton syndrome – as they might be at an
increased risk of serious side effects.
What typically are the results seen with BOTOX?
effect of BOTOX Cosmetic is visible within 3 days. Maximum benefits are reached
between 10 to 14 days; however some patients notice results within 3 to 5 days.
Once the muscle becomes dormant and the skin softens, you will have a more
relaxed and youthful appearance.
How much does BOTOX cost?
price of BOTOX has significant geographic variability. Prices per unit vary
from about $10 per unit to $25 per unit. Each area requires around 10-30
units. Some patients require more BOTOX depending on the severity of the
wrinkles they are trying to treat. The manufacturer however states, that no
more than 200 units of BOTOX should ever be used. In one vial of BOTOX there
are 100 units available.
physicians charge by area of injection without disclosing to the patient how
many units of BOTOX Cosmetic will be injected in each area. You must be aware
that dilution matters, ask the doctor how much saline solution he or she uses to
dilute the vial of BOTOX Cosmetic and how many units will be injected in each
vial contains 100 units and should be diluted with no more than 4 cc of saline.
If the doctor dilutes the BOTOX with more then 4 cc of saline, then you will be
getting a smaller dose of BOTOX Cosmetic which will be less effective and
comparing BOTOX Cosmetic injection prices among different offices, be sure to
ask each office how much they dilute the pure BOTOX. Be aware of BOTOX
injections at very low prices may be suspect for over diluting the BOTOX. Highly
diluted BOTOX will usually give a short and less than optional result - NOT what
are better off asking the doctor to charge you the BOTOX Cosmetic injections by
the unit, rather than by area of injection.
Allergan, Inc. has a discount program you can investigate and is available at offices
with experience with the product.
Who should administer injections of BOTOX?
State regulatory agencies oversee who can inject BOTOX and this varies state by
state. The cosmetic market is inundated with medical spas performing BOTOX
injections at discount prices. This should never be a factor when deciding who
you trust to inject BOTOX; ideally it should be performed by a board certified
physician in a medical office.
the state of California, BOTOX may be administered to a patient by an MD,
Physician Assistant (PA), or Registered Nurse (RN). Both the Physician
Assistant and the Registered Nurse should work under the medical direction of
the physician in order to inject BOTOX. RN's may inject BOTOX only after the
patient has first been seen by the physician or physician assistant.
is an answer as to the regulatory qualification. From the perspective of who is
most qualified, you should consider the training and experience of the
professional that you choose to administer your BOTOX.
Allergan’s website has a list of physicians who are “Platinum Level” practices.
This means that there is a lot of experience with the administrating of BOTOX
should always ask questions of your injector in regards to how long they have
been administering BOTOX Cosmetic and how many patients do they see each week
for BOTOX alone.
What is a BOTOX party?
BOTOX party is a social gathering at which a doctor injects the participants
with BOTOX (botulinum toxin) to reduce or remove facial wrinkles.
straightforwardness of the procedure has led to the wonder of the BOTOX party;
which has been modeled after other type parties where it gets a bunch of people
together to buy something. Some patients prefer going to BOTOX parties, because
they have the support of their friends with them while getting the injection and
most patients receiving the BOTOX can get a better deal on the cost.
topic is a controversial discussion for most physicians. All in all most
physicians look down on any procedure that is not being performed in a
completely controlled environment, such as a medical office. However, if a
board certified physician is the one giving the injections at the BOTOX party,
then most patients have no problem with this type of atmosphere.
most important factor with deciding if BOTOX is for you is to make an informed
decision about the pros and cons of treatment with a qualified doctor.
talented injector can perform a BOTOX eyebrow lift to elevate your corner of
your eyebrow 1 - 2 mm to give your eyebrow a classic arch and to frame your eye.
What is a BOTOX Brow Lift?
can be used to achieve a 'chemical brow lift'. BOTOX when injected in the wrong
area can make a brow droop; however, when injected correctly it can actually
cause an elevation of the brow. There are many muscle groups that work to move
the brow. The frontalis and obicularis oculi
muscles are "antagonistic muscle pairs" for eyebrow position -
when one contracts the other relaxes - changing the eyebrow position. BOTOX Cosmetic works by paralyzing the targeted muscles.
How many units of BOTOX can be injected into the crow’s feet?
Typically there is a range of answers, as no two patients are alike with their
needs and of course age is a factor. Patients who are in their thirties
normally get a lesser amount as their crow’s feet might not be as severe as a
fifty year old. The range is 10-16 units per crow's feet are injected however;
there definitely is some variability from individual to individual.
Another factor to consider is the “freshness” of the BOTOX. If the BOTOX has
been opened for awhile, the injector might use more units than a fresh box.
How many units of BOTOX can be injected into the forehead/glabella area?
average amount of BOTOX used for the “11” lines or Glabellar (which is between
the eyebrows) is around 20-30 units for a female. Males will usually require
more units as their facial muscles are often thicker and stronger. The number
of units used for injection depends on the size and strength of your corrugator
the upper forehead area the units range from 15-25; however this changes
depending on the severity of the wrinkles.
Can I use BOTOX on other wrinkles?
is only approved to treat wrinkles between the eyebrows, the forehead wrinkles
and crows-feet by the eyes. Any other application is considered “off label”.
being used by some physicians in these following areas:
To improve the appearance
of new and old facial scars
Women may exhibit
wrinkling of the central mid chest (décolleté) BOTOX injections can
successfully reduce those wrinkles.
Should there be wrinkles after the injection of BOTOX?
may be noticing previous lower lid wrinkles now that your Crow's feet are
improved. Sometimes the injection is being administered too deep in the muscle
around the eye, causing the fatty tissue to also drop creating bags which bunch
up when you smile. The BOTOX will wear off, so this is not a permanent
Sometimes this area looks worse in contrast to the smoother lateral eye area.
the possible swelling does not improve, 1 to 2 units of BOTOX placed just below
the eyelashes works to reduce this creepiness. Be sure your Cosmetic Surgeon is
very experienced to treat this area.
Can a person become immune to BOTOX?
is a rare instance of people becoming immune to BOTOX. This happens in less than
1 out of 10,000 people. These people form an antibody to the BOTOX molecule so a
different variant of Botulinum toxin must then be used to achieve the same
Will my lines look worse if I choose not to continue treatments?
Your lines gradually revert to their pre-treatment appearance.
What if a droopy eye results from BOTOX – is there anything to help this?
you do get a
droopy eye from BOTOX, some physicians are using Alphagan and
Iopidine to correct the situation. It is actually quite safe and the only
contraindication is use of a (MAO) monoamine oxidase inhibitor. Alphagan works
by stimulating a second set of muscles called Muller's muscle which causes
lifting of the eyelid muscle.
Lopidine (Apraclonidine) Eye Drops mode of action is that it goes to work on a
tiny muscle in your eyelid and help pull it up 1 to 3 mm. The drops must be
repeated a few times a day for a continued effect. If you have drooping eyebrows
leading to full eyelids, these eye drops will have no effect.
How often can I receive a treatment of BOTOX?
manufacturer of BOTOX – Allergan, Inc. - suggests injections every 4 months as
the most effective suggestion in the average patient.
Are Face Creams that use the marketing that they help wrinkles better than BOTOX
most of these are false claims, simply put there are no creams that work like
is a protein that relaxes the muscle that causes wrinkling by blocking the
communication between the nerve and the muscle. The result is the nerve
temporarily can not tell the muscle to contract.
is no substitute for BOTOX injections. Creams cannot get into the muscle, which
is where the product needs to be in order to have any effect.