Botox (Botulinum toxin) Wrinkle Blocker injections are the most common cosmetic procedures performed in the US and continue to grow in popularity. Dr. Burroughs has performed thousands of Botox injections since 1997.
Shown to the below in our slide show are photos showing deep glabellar “frown lines” and the post-Botox result. Botox is a purified protein that relaxes muscles by blocking nerve impulses. Tiny doses are injected under the skin to eliminate wrinkles and expression lines. Areas treated with Botox include the forehead, frown lines, crow’s feet, lips, chin, and neck bands. Many patients get Botox injections over the lunch hour and return to work with no sign of having been treated. The combination of topical anesthetic and a tiny needle makes Botox injections a painless experience that requires no recovery. It takes Botox 3 days to begin to relax the wrinkles, with maximal effect usually by the 3rd week and a 3-6 month duration.
Botox is also used to treat patients with spasms of the eyelids, face, and neck. In addition, it has proven very useful in treating excess sweating of the hands, feet, and armpits, as well as an excellent treatment for migraine and stress headaches. Many insurance companies are even beginning to participate in payment for Botox to treat headaches that are resistant to conventional therapy.
- Is Botox popular?
For the last several years, Botox has been the most popular medically-administered cosmetic procedure in the US. More than 3 million treatments with Botox are administered per year.
- Why is Botox so popular?
A number of factors account for the popularity of Botox. First of all, Botox causes a consistent beneficial improvement in appearance that is noticeable, yet subtle, and natural. Botox has been used in millions of patients and found to be safe. Finally, Botox does not require time off of work or out of the public view to recover.
- What is Botox?
What is Botox? Botox is a pure protein that is isolated from a microorganism. Many of the most important drugs we use today, such as antibiotics, were first isolated from microorganisms.
- Is Botox new?
Botox has been used in humans for more than 35 years but did not gain approval from the FDA for cosmetic indications until 2002. Botox was purified in the 1940s. The FDA approved testing it on human subjects in the 1970s. In 1989, it was approved for clinical use in patients with spasm of the eyelid, face, or neck muscles, as wells as treatment for some forms of double vision. Most of the initial work leading to FDA approval was done by ophthalmologists. In 2002, the FDA approved Botox for use in wrinkles between the eyebrows. Botox is also approved for the treatment of excess sweating termed hyperhidrosis.
- Is Botox a type of filler?
Unlike fillers, Botox doesn’t fill in facial lines. Botox relaxes the muscles underneath the skin that cause undesirable facial area wrinkles. Given the depth of the wrinkles, we may wish to fill those lines to give you a softer appearance as well. Dr. Burroughs will make his recommendations when he sees you. If you want to read more about fillers, click here.
- How does Botox work?
In order for a muscle to contract, it requires a nerve signal. Botox blocks this signal at the junction between a nerve and a muscle.
- Does Botox work on all wrinkles?
No. Botox works only on wrinkles that are made worse or change with contraction of the muscles of facial expression. Classical examples are the wrinkles between the eyebrows that become deeper with frowning. Other areas where Botox is commonly used to reduce wrinkles include the forehead and the crow’s feet. Examples of wrinkles that do not respond to Botox include wrinkles caused by sagging skin in the upper eyelids or neck.
- Who should not use Botox?
Botox should not be used in the presence of an infection at the injection site and in individuals known to be allergic to Botox. Botox should be used with caution in patients with a few rare neurological conditions including: amyotrophic lateral sclerosis, myasthenia gravis, and Lambert-Eaton syndrome.
- Is Botox treatment only for rich and famous?
According to a recent survey, working mothers between the ages of 40-55 who want to look less stressed are the most common users of Botox. Those with an annual income of less than $150,000 per year account for 2/3rds of Botox users. Botox is one of the least expensive, most effective, facial plastic procedures.
- Why is Botox diluted?
Botox is shipped from the company as a powder, so it is necessary to add sterile saline in order to inject it. The manufacturers recommend using 1-4 ml of saline per vial of Botox, and Dr. Burroughs follows these recommendations. The amount of sterile saline is important but not as important as the number of units of medication injected. The doctor will discuss how many units are required to treat you. It is not a good idea to try to spread a low number of units across too many areas of the face. When this is done, the injections are not as effective and do not last long. If your budget is limited, only treat the area that bothers you the most.
- What does a patient need to do to prepare for a Botox injection?
In most cases, nothing. Some over-the-counter medications and herbals such as fish oil, flax, aspirin, Motrin, vitamin E, Ginkgo, and glucosamine increase the chance that you will bruise. If you are taking these medications because your doctor has recommended you do so, then continue to take the medication. If, however, it is safe for you to stop for two weeks prior to injection, then this will reduce your chance of bruising.
- Do Botox injections hurt?
Most patients report little or no pain. Some report that they feel a “small bee sting.”
- What recovery is involved after Botox injections?
One of the great things about Botox injections is that it requires little or no recovery. Immediately after getting injections, you will have some small bumps where the injections were given. These bumps are typically gone in an hour. Rarely, a patient will get a small bruise. If this occurs and it is bothersome, one of the aestheticians at The Center for Facial Appearances can show you how to cover it with makeup. When it occurs, a bruise takes about two weeks to resolve.
- How long does it take before I notice the effects of Botox?
About 3 days before you notice anything, and the result becomes stronger for 2-3 weeks.
- How long does Botox last?
The first time you get injections, they last about 3-4 months. If you get them on a regular basis, the frequency at which you need to get injections actually decreases. In our experience, patient typically require injections 3-4 times the first year, 2-3 times the second year, and twice yearly thereafter.
- How much Botox is required to treat wrinkles?
For cosmetic purposes, this varies between about 25 and 100 units depending on the number of areas treated and the size of your facial muscles. For instance, treating the wrinkle between your brows requires up to 30 units of Botox. If the crows feet and forehead are also treated, it will require 2-3 times more units of Botox. Men often have larger facial muscles and require slightly higher doses.
- Can Botox cause me to develop botulism?
Safety questions about Botox Less than one vial (100 units) of Botox is typically used to treat wrinkles. One vial of Botox cannot cause botulism. Dr. Burroughs has treated some patients with severe forms of dystonia and debilitating neck spasms that require up to 5 vials (500 units) at a time without any breathing or other complications.
- What are the complications that can be seen with Botox?
All medications can cause an allergic reaction. Severe allergy to Botox is very rare. Transient systemic side effects such as dry mouth and flu-like syndromes are also very rare. Bruising occurs in less than 15% of patients and is typically mild and resolves after a minor time period. Problems with the eyelids or mouth are the major concerns. Drooping of the corner of the mouth or problems with speech can occur if injections are given in the area around the mouth. Drooping of the eyebrow or eyelid can occur when injections are given around the eyes. The risk of complications like a drooping eyelid for the forehead can be minimized by having an experienced physician perform the injections. When these side effects occur, they resolve when the Botox wears off, and some ophthalmic drops can improve eyelid droop if it occurs.
- Does Botox build up in the body over time?
No. Botox is broken down by the body.
- Can Botox be administered by non-medical personal?
No. Botox should be administered only by experienced medical professionals with special training in cosmetic procedures and understanding of facial/eyelid anatomy and aging changes.
- Are There Other Uses for Botox?
Botox for headaches
1. Can Botox help patients that suffer from headaches?
Yes. Both tension headaches and migraine headaches can benefit from Botox injections.
In tension headaches, it probably works by relaxing muscles. In migraine headaches, it probably works by preventing the facial muscles from triggering headaches.
3. Will my insurance company pay for Botox injections for headaches? Some insurance companies have begun to pay for this form of treatment. Many still do not.
4. How often are injections repeated for headaches? Once every 3-4 months.
Botox for excess sweating (hyperhidrosis)
1. Can Botox help with excess sweating?
Dr. Burroughs performs injections for sweaty armpits, hands, and feet and has found it to be very effective in most patients. 2. If Botox relaxes muscles, why does it also reduce sweating?
Botox blocks the nerve impulse to the sweat gland so that the nerve cannot stimulate sweating. The sweat duct and the nerve lie more superficially than the muscle so the injections for sweating are performed in a more superficial location.
3. How often do the injections need to be repeated for sweating? The injections are typically repeated one to two times yearly.