Botox

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Botox (botulinum toxin)

Botox is purified botulinum toxin and is used to soften facial lines and wrinkles. It has been safely used by physicians for many years. Botox is most commonly used for forehead lines, crows feet, and frown lines, however it is now being used in other facial areas as well. It has been quite successful in treating facial wrinkles around the mouth and neck bands.

Procedure:  Botox is injected into the muscle in these areas and works by weakening the muscle, which in turn lessens the ability of the muscle to contract. Although Botox affects the ability of the muscle to move, it does not impair sensory function. The results can last 4-6 months, and repeat treatments are needed for maintenance.  However, studies have shown that individuals who have had multiple treatments had results that lasted longer .

Recommendations: A patient should not have Botox if the patient has any of the following conditions:

  • myasthenia gravis
  • neuromuscular disease
  • allergy to human albumin
  • an allergy to botulinum toxin
  • pregnant or breast feeding
  • has had alcohol in the past 48 hours
  • has have taken aspirin or anti-inflammatory medication in the last 2 weeks

After Treatment:  Do not lie down for 4 hours after the treatment. Do not massage the treated muscles as this can cause the botox to spread to the muscles around the eyes. Exercise the muscles very 15 minutes for 1 hour after treatment.   This allows the Botox to attach better to active muscles. Expect the treated areas to take 5-10 days to soften.

Possible side effects:  Although side effects are rare and there are no known long term problems with Botox, a patient could experience any of the following:

  • mild bruising
  • temporary nausea
  • temporary headache (some patients have reported temporary disappearance of tension headaches and migraines). More research is being done on this.
  • double vision, although extremely rare, has been reported (this can last 3-6 months).
  • drooping of the eyebrow or eyelid is rare, but can last 3-6 months.
  • an injection that did not take. This sometimes occurs and a touch up treatment is necessary. Touch up treatments may cost 25% to 50% of the cost of the initial treatment fee.

Contributed by Earl H. Parrish, M.D., Medford, Oregon

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This page was last updated on Monday, February 11, 2008