What is it Botox® Cosmetic and how does it work?

Botox is the trade name for a purified protein produced by the Clostridium Botulinum bacteria that when injected into selected muscles, inhibits the ability of the muscle to contract. It was initially used to correct lazy eyes in children 20 years ago but more recently has become a very effective tool in treating unwanted facial wrinkles.

The muscles that create frown lines and wrinkles weaken when injected, thereby smoothing the skin, creating a softer, less worried or angry look. Botox works best for those lines and wrinkles we create with facial movements such as frowning (dynamic lines), whereas static lines (those present at rest) are best addressed with tissue fillers such as Restylane, Perlane, Radiesse, Evolence or Teosyal.

What areas are commonly treated with Botox?

Botox is most commonly used to treat the glabellar frown lines (those lines between the eyebrows), forehead lines, crow's feet (lines on the outside of the eye), upper lip lines and chin dimpling. Smaller doses are used in the lower face so that normal expressions are maintained. Deeper lines and folds around the nose and lower mouth are best treated with Restylane, Perlane, Radiesse, Evolence or Teosyal.

Botox is also used to "sculpt" the eyebrow by creating a small brow elevation through targeted treatments.

How often do I need Botox?

	Photos: Courtesy Allergan

What to expect during treatment

We inject Botox using tiny needles and pre-treat with ice or an anaesthetic cream if desired. There is very little discomfort.

Normal activities can be resumed immediately though the treated area should not be rubbed or massaged for several hours after treatment.

The effects of Botox are usually apparent after 3-5 days but full effect takes up to two weeks.

Are there any side effects?

Botox works where it is injected and not elsewhere in the body. It is extremely safe with reported reactions being very rare. The doses used in cosmetic treatments are small compared to doses used in some medical treatments such as relieving spacticity in children or treating headaches.

Bruising and tenderness at the site of injection can occur but are usually transient and mild.

Drooping of the eyelid can occur but is rare (1-2%) and usually lasts only 2-4 weeks and is mild. This can be partially treated using special eyedrops.

Botox can be used by almost anyone but patients who are pregnant, breastfeeding or who have a neurologic disease such as myasthenia gravis should not use Botox.

The overall satisfaction with Botox treatments is very high.

Botox® Study

A study was recently reported in the Archives of Facial Plastic Surgery demonstrating the safety and effectiveness of using Botox® over a long period of time to treat and prevent facial wrinkles. This study involved identical twin sisters one of whom received regular Botox® over a 13 year period and the other who only used it periodically in her forehead and glabellar regions (area between the eyebrows) and not at all for her crows feet area. No adverse effects or problems were encountered in either twin but the effects on wrinkle prevention in the treated twin are dramatic particularly in the crows feet area.

minimal treatment with Botox® to forehead and glabellar area	13 years of regular Botox® to forehead and glabella
twin 1 untreated crows feet area right side	twin 2 treated with Botox right side
twin 1 untreated crows feet area left side	twin 2 treated with Botox left side

Visit the Botox® Cosmetic website for more information: www.Botoxcosmetic.com