Some wrinkles are caused by repeated contraction of muscles in the face. You may have heard the expression “laugh lines” or “smile lines.” Over time, creases formed can lead to a persistent frown and a more aged appearance. The precise use of Botox* is the best approach to prevent and eliminate these lines. Treated facial muscles become chemically relaxed for an average of 3-4 months. Botox may be used in addition to, or in place of, other cosmetic procedures.
Botox blocks impulses from the nerve to the tiny facial muscles that are related to expression lines. Botox relaxes the muscles so they do not contract. The contraction of the muscle is the culprit causing the wrinkles. After treatment, the overlying skin remains smooth and unwrinkled while the untreated facial muscles contract in a normal fashion, allowing normal facial expression to be unaffected.
Botox was officially approved for cosmetic use in 2002 by the FDA for glabellar lines (vertical lines between the brows) and is often used off label by physicians for other areas, including the forehead, crow’s feet (next to the eyes), perioral lines, and sometimes even to shape the brow.
Cosmetic denervation with Botox is a simple and safe procedure. Using a tiny micro-needle, a very small amount of Botox is injected, very precisely, into several locations on the face. Because the needle is so fine and only a small amount of liquid is used, the pain associated with the injections is minimal. Most patients compare the sensation to a bug bite. No sedation or local anesthetic is required, and you can resume normal activities immediately. Some patients experience a slight temporary bruising at the injection site that can easily be covered with makeup.
No long-term side effects have been described with the cosmetic use of Botox. Botox is very safe and used in much larger doses in other fields of medicine. Although rare, the medication can affect nearby muscles, causing temporary, but unintended, muscle paralysis. Examples include eyelid droop or double vision, seen in only a very small percentage of patients treated. Those effects are always temporary and often can be treated with eye drops.
Patients on selected medications or with certain medical disorders are not advised to have Botox. Captopril may inhibit Botox while certain antibiotics may exaggerate the effect. Individuals who are pregnant, or have egg allergies, or a neuromuscular disorder are advised to avoid Botox.
After treatment a few simple techniques may maximize the benefit and minimize side effects. Gauze should be held over the skin until pinpoint bleeding stops. It is also helpful to frown repeatedly during the first hour after injection. Patients should avoid touching the area or lying down for four hours.
In summary, Botox is a safe, effective, FDA-approved tool that may be used to treat certain types of wrinkles for 3-4 months at a time. Side effects as described above are minor and temporary. The procedure may be repeated as desired by the patient and may be used in combination with other treatments to achieve a more youthful appearance.
