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Skin Treatments
Botox
(Botulinum Toxin A)
BOTOX® injections were originally used to treat to medical conditions such as eye spasms and central nervous system disorders, and are now also administered to reduce horizontal creases in the forehead, frown lines and wrinkles in other areas of the face. Botulinum Toxin A, a purified protein made from botulism bacteria, binds to the nerve endings, preventing the release of the chemical transmitters that activate muscles. When injected into specific areas of the face, it paralyzes the small muscles that cause frown lines, crow's feet and other wrinkles.
BOTOX® treatment is unique in that it decreases the ability to frown or squint, thereby preventing the appearance of lines and wrinkles caused by what is known as “dynamic” wrinkles, meaning, wrinkles that are caused by repeated facial expressions. Although the injections affects movement, there is still feeling in the areas treated. For people with deep wrinkles, a combination of BOTOX® and a line filler such as collagen is sometimes recommended. Furthermore, BOTOX® can also prove to be an additional treatment following more extensive procedures like a facelift or laser skin resurfacing.
What does it cost?
BOTOX® injections and treatments vary in cost according to the individual physician and where he or she practices. Generally, “crow's feet” treatment can range from $400 to $900, whereas a forehead treatment can cost from $600 to $1300.
What happens during the procedure?
BOTOX® is considered to be most effective when administered around the eyes and forehead but other areas of the face and neck can be treated. The effect of BOTOX® injections only last for four to five months. There seems to be a "build up" effect after frequent treatments and some studies show that after at least five treatments, results can lasted longer.
The procedure is usually performed in your doctor’s office and takes between 10-30 minutes.
First, the skin is treated with a topical anesthetic, and some patients are given a sedative as well. A thin, fine-gauge needle is then used to inject the BOTOX® into the skin and muscle of a specific part of the face. “Crow’s feet” are treated with three or more injections on the side of the face close to the outer eye area (the orbital rim). Forehead creases are treated with 10 to 16 small injections, thereby weakening, rather than paralyzing the forehead muscles.
BOTOX® can be used to improve the appearance of "laugh lines" between the nose and lips (naso-labial folds), however, there is a risk that the lip will droop when treating the naso-labial folds. Lines in the neck or chin can be reduced with BOTOX® but these areas are treated less frequently.
Alternatively, a needle connected to an EMG (electromyography) recorder can be used to administer the BOTOX® to guide your physician in locating muscles. While this allows the physician to target the most active part of the muscle, it can be more painful. At any rate, experience is what is required for successful BOTOX® injections, not the use of EMG.
Are there risks or potential side effects?
At present, BOTOX® is not officially approved for cosmetic use, however, there are few risks when it is administered by a well-trained physician to an appropriate candidate. Patients should be aware that the effects of BOTOX® treatment are not permanent and are, therefore, reversible.
A potential side-effect for about 5% of patients who have BOTOX® treatments to the forehead is drooping eyelid (ptosis). It is temporary but can take 1 to 6 weeks to disappear. In some cases, your doctor will prescribe iopidine eye drops to speed-up the process.
What to expect post-procedure?
Although there is some discomfort involved with the injections, the feeling is much like any other injection or an insect bite and there is virtually no pain afterwards. The treatment can sometimes cause a brief headache and bruising can occur at the injection site. Applying ice packs over the treated site before and after the injections can reduce the discomfort, swelling and bruising.
Effects are not immediate. It takes four or five days for the injected muscles to be completely affected by the BOTOX® and, in some areas, it can take two weeks to see the effects. In most cases the treatment last for about 4 to 6 months.
How soon does normal life resume?
You can go back to work and resume regular activities right after the treatment. It is important, however, to keep the head upright for 4 to 6 hours and to avoid touching or massaging the treated area. Repeated contraction of the muscles treated can speed the absorption of the BOTOX®.
Who performs it?
BOTOX® injections are usually administered by a plastic surgeon, a dermatologist or an otolaryngologist (ENT).
Are you a good candidate?
As with all elective surgery, good health and realistic expectations are prerequisites, but if you want to reduce or eliminate wrinkles without surgery, then BOTOX® injections may be appropriate, however:
- Pregnant women and women who are breast feeding should not undergo BOTOX® treatment as there has been limited research into the effects to unborn fetuses and to infants
- If you suffer from a neuromuscular disease, such as muscular dystrophy or generalized movement disorders, you may not be a candidate for BOTOX® and you should consult your neurologists before making a decision.
- The treatment is not advisable for users of marijuana, anabolic steroids, or heavy users of alcohol.
- Make sure you have no known allergies to saline solution and human albumin, two major components of BOTOX®.
- Make sure your doctor is aware of any and all medical conditions and any allergies you may have and whether you are a smoker. Also, tell your doctor about any medications, herbal supplements or natural supplements you are taking (both prescription and non-prescription).
- Make sure you have a good understanding of the limitations of the procedure.
Some patients treated with BOTOX® claim it reduces the incidence of tension headaches and research is now being done to see if it can have similar effects on migraine sufferers.
How to prepare for surgery?
Your doctor will give you specific instructions to prepare for surgery but here are some general guidelines:
- Avoid aspirin, any aspirin containing medication or any other non-steroidal anti-inflammatories (NSAID), such as Motrin® or Advil®, for two weeks prior to treatment. Because aspirin thins the blood, it can interfere with normal blood clotting and increase the risk of bleeding and bruising.
- Smoking increases muscle activity and can contribute significantly to wrinkles.
Are there alternatives to this procedure?
Although BOTOX® injections can have a dramatic effect on dynamic wrinkles, while preventing further wrinkling, it has no overall effect on the texture of the skin. For those who seek to smooth the skin, laser skin resurfacing, dermabrasion and chemical peels are necessary and only a facelift or brow(forehead) lift can actually tighten sagging skin.
Locate a certified physician with our Doctor Locator.
To view Personal Stories about this procedure contributed by our members, Click Here.
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About 70 percent of obese girls remain obese as adult women.
(Source: the Role of Weight Management in the Health of Women" by Sachiko T. St. Jeor, professor and director of Nutrition Education and Research at the University of Nevada, School of Medicine)
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