Botox for cosmetic use has been approved for 20 years this year. It has a long safety record.  Complications are rare and most are temporary.  Botox is Allergan’s name for the botulinum toxin type A, although there are 4 products approved by the FDA.  Be careful because some injectors use other botulinum toxins that are not approved for cosmetic use.  I only use approved brands. 

 By now, most patients know that botulinum toxin is injected to reduce wrinkles by temporarily decreasing facial muscle contractions.  But let’s talk about wrinkles and how to best use the injections to PREVENT them.  Wrinkles are classified as dynamic or static.  Dynamic wrinkles are not seen until the face smiles, frowns, scowls or has other expressions.  Over time, as skin ages and people continue to smile, frown, or scowl, the wrinkles appear more permanent even when the face is not expressing emotion. These are called static wrinkles.  The forehead, crow’s feet, and “11” lines between the eyes may be seen even when the face is at rest.  Botulinum toxin does not remove these wrinkles.  While fillers and other skin tightening methods can remove the static wrinkles, Botox is best for the wrinkles that appear as the face moves.  The best time to start the toxin injections is before the static wrinkles form.  Toxin use to prevent the formation of the static wrinkles and aging of the face is very effective if the toxin is started earlier.  Over time, the skin ages without the deeper creases thus maintaining a youthful appearance.

What should you expect?  At the initial consult, I will evaluate your skin and your goals.  Together, with realistic expectations, we take time to plan the injections.   The simple injections in the muscles under the skin require no anesthesia and are done in less than 10 minutes .  There is no downtime and rarely visible side-effects.  If the injection sites are visible, this fades the same or next day and routine activity can be expected soon.  We will review some precautions, but the very small needles leave no permanent marks, and the initial site fades quickly.  The effect of facial muscle relaxation peaks in about 7 days and then gradually tapers off over the next 3-4 months.  Most patients will have 3-4 visits per year and each visit gets easier, because the plan and injection sites don’t change much and the muscles get weaker over time, usually requiring less product. 

Even though some question the logic of injecting the face with a toxin, the temporary nature, low side effects, and minimal down time are an excellent, affordable trade off to avoid more invasive plastic surgery.

 When started younger, the treatments can maintain a youthful, wrinkle-free face and prevent the need for future plastic surgery by preventing the deeper static wrinkles.  Older patients can combine the botulinum toxin with safe, temporary fillers to treat the deeper wrinkles.  Ask your friends and you may be surprised how many patients use Botox.  Come see if it is right for you and explore the range of skin care offered from a trusted surgeon.