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BOTOX
INJECTIONS: TREATMENT FOR SKIN WRINKLES
What does Botox do?
Botox injections improve the appearance of “worry
lines”, “frown lines”, “crow’s feet”, and other so-called “dynamic” or aging
wrinkles. “Dynamic” wrinkles occur when
we smile, laugh, or frown. The delicate muscles under the skin contract, causing the skin to
wrinkle. Botox is injected into
these muscles and paralyzes them to prevent them from working. By weakening these tiny muscles, the
overlying skin will smooth out.
Untreated facial muscles still contract normally, allowing most facial
expressions to be unaffected. Yet, those
severe frown lines between the eyes, forehead creases, and crow’s feet around
the eyes can be smoothed out creating a more youthful appearance. Lines
that are present at rest will not be improved with Botox injections.
Although the use of Botox is relatively new for
treatment of wrinkles, it was approved by the FDA in 1989 and has been used
safely and effectively for over a decade for many neurologic disorders. No irreversible clinical effects or side
effects have been reported. Today the
use of Botox has emerged as an exciting new treatment for erasing the visible
consequences of aging skin.
How are the injections done?
Injecting Botox is a simple and safe procedure. A small amount of diluted solution is
injected with a very fine needle into several locations of the muscles of the
face (particularly the areas of the frown creases of the forehead and the
crow’s feet lateral to the eyes).
Because the needle is so fine and only a tiny amount of liquid is used,
the pain associated with the injections is usually tolerated without
anesthesia. We try to minimize the
discomfort by applying cold compresses before each area is treated. The medicine stings during the injection and
has been compared to the sting of an insect bite, but it clears rapidly within
minutes. You will be able to drive and
engage in your normal daily activities immediately after your injections. A small number of people will have some
temporary bruising of the skin at some injection sites, which fades over
several days. Otherwise there will be no
visible signs of your treatment.
What are the contraindications? Who should not be treated with Botox?
Botox is not recommended for the following:
-
Persons allergic
to human albumin or botulinum toxin
-
Pregnant or
breastfeeding women
-
Those with
neuromuscular disease such as myasthenia gravis
-
Those being
treated at the same time with tissue fillers (collagen)
-
If you are taking
aspirin, vitamin E, or other blood thinners, it would be best not to take them
a few days before being injected. Talk
to your doctor to discuss this.
-
If you are taking
a class of drugs called “calcium channel blockers”, (e.g. Norvasc, Plendil,
DynaCirc, Cardene, Adalat CC, Procardia, Cardizem, Calan, Covera HS, Verelan)
the effects of Botox may be increased so be sure your doctor knows.
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Are there any side effects?
Mild, temporary bruising or redness may occur. Rarely there will be a headache for a few
hours. Very slight droopiness of the
upper eyelid occurs in about 2% of people who have their frown lines
injected. About 5% of people who have
their forehead injected immediately above the eyebrows may notice this effect,
too. A much smaller number of people
will notice slight asymmetry of the lower face after injection of the crow’s
feet muscles. These effects are not
usually noticeable by others and fully recover after 3 to 5 weeks. An extremely rare side effect – temporary
double vision – has been reported in the literature. To minimize the possibility of such rare
effects, please be sure to follow the post-treatment instructions.
It is important to remember that there have been no
long-term adverse effects or health hazards related to the use of Botox for any
cosmetic indications thus far. The
incidence of complications is low, the severity is usually mild, and they are
short-lived (a matter of months).
A very small percentage of people will not notice much
effect from the treatment. A rare
patient may develop resistance to response over time. Usually, just the opposite occurs -- they
respond more to the same dose as time goes on.
What kind of results can I expect?
If dynamic wrinkles (those that occur with muscle
contraction) are making you look older and more “serious”, Botox can usually
smooth these out and give you a more youthful and rested appearance. However, this treatment will not improve the
more common “static” wrinkles (those present all the time) that are unrelated
to facial muscle contraction, nor does it improve loose or sagging skin. Results from the injections are typically
seen within 2-10 days of the treatment and last for 6 weeks to 6 months (typically
3-4 months). Occasionally, there is a
muscle that does not respond, and a “touch-up” may be needed in 2-3 weeks.
How long do the results last?
Initially most people require a repeat injection every
3 months to maintain the effect.
However, after three to five injections, the effect may last longer and
a repeat injection may only be required every 6-12 months.
What instructions should I follow after treatment?
How much will it cost?
Botox is very expensive. The cost per treatment will vary depending on
how many areas you want treated and how many injections it will take. There will be a minimum charge of $305.00. Insurances (including Medicaid and Medicare)
do not pay for “cosmetic” medical care and will not therefore pay for Botox
therapy. You will need to pay at the time of your visit, by cash, check or
credit card.