Botox® is a brand name for the purified form of a plant bacterium called botulinum toxin type A, which is produced by the bacteria, clostridium botulinum. Botox® functions as a therapeutic muscle-paralytic agent. According to the American Society for Aesthetic Plastic Surgery, Botox® is the fastest growing cosmetic procedure and is the second most common procedure after face peels.
Botox® has been used for various conditions for over 10 years in 60 countries. Last year over one million Botox® treatments were performed for aesthetic purposes.
When we laugh or frown, the brain sends a signal to the muscles to make the expression lines appear in the face. Botox® blocks the signals from the nerve to the facial muscles to stop them from contracting, leaving the skin looking smooth. Botox® is not a wrinkle remover; it can only work on expression lines that are controlled by muscles. It will only work on the specific muscles that have been injected leaving the surrounding muscles to work normally. It cannot make the lines disappear completely but it will make an improvement to areas being treated.
The Botox® powder is re-constituted in a saline solution. It is then injected using a disposable syringe with a fine needle.
The whole procedure usually takes 15 minutes but no more than half an hour. Normal activities can resume immediately but read the after-care instructions carefully.
You will be asked to frown hard so the areas that need to be injected can be visualized. The sites will then be injected (some patients say this resembles an ant sting). Anesthetic is not generally required.
The effects can last approximately three months depending on the individual. If you like the effects, you will need repeat treatments at 12 week intervals for the first year. Clinical trials have shown that over time the duration of the effect increases, resulting in less treatments being needed to maintain the result.
Botox® was originally used for eye spasms, called blepharospasm. It was noticed that while treating patients with this condition, their crow’s-feet began to disappear. Botox® is also used to correct crossed eyes in children, to help muscle disorders, and to treat cases of bad sweating (a condition called hyperhidrosis).
It usually takes 2 to 3 days to begin working, with the full effect coming at 7-10 days. Use lots of facial expressions to work the Botox® into the muscles for the first day. Do not massage or rub the area as this can cause the toxin to spread beyond the treated area. Do not lie down for six to eight hours after the injections. Hold head upright for 4 hours. Do not exercise for 24 hours.
Do not use Botox® during pregnancy. It is not recommended that pregnant women and those breast feeding use Botox®, as there are insufficient trials to show that it does not harm the baby. Eyelid droop is rare and can last for up to 4 weeks. Bruising of the injection site. Taking Arnica can reduce this. Avoid Botox® if there is an existing drooping of the eyelid. Always disclose current medication at every appointment, particularly antibiotics. Always declare muscle disorders.
A very small percentage of patients are resistant to Botox®, probably because they have unknowingly had a slight bout of botulism leaving them with antibodies to it. Some patients will require a larger dose if the results are not satisfactory with the standard 25 units. It is better to start with a smaller amount and then increase to a larger dose, than to give too high a dose in the first instance.