Everything you wanted to know about Botox

What is Botox?

Botox is a specific brand name for botulinum toxin. The toxin is derived from the bacteria clostridium botulinum. The toxin itself causes paralysis of muscles and in high doses can be fatal. However, the cosmetic industry has figured out a way to purify this toxin and give it in very small doses so it can have cosmetic benefits without systemic risk. There are currently 3 FDA-approved brands of botulinum toxin on the United States market currently (Botox, Dysport, and Xeomin), each is slightly different and from competing manufacturers. There are more brands that will also be hitting the market. Botox is the most well recognized brand since it was the first to be approved and has been used the longest. Much like “Xerox” and “Q-tip”, Botox has become synonymous with all botulinum toxin, so when people say “Botox”, they are not necessary referring to the specific brand. They are describing the class of toxins. Even healthcare professionals mistakenly use the term Botox when referring to other brands.

 

 

How does Botulinum Toxin work?

Botulinum Toxin is a neurotoxin. This means that it directly acts on nerves. Specifically, the toxin blocks the connection between motor nerves and muscles. The neve is unable to communicate with the muscle, and the muscle stops working. The result is relaxation of the muscle through partial paralysis. It is only temporary and the nerve function will return after about a few months as these connections heal themselves.

What is the purpose of Botulinum Toxin?

Botulinum Toxin injection are used to improve your looks by reducing the appearance of fine lines and wrinkles that are the result of muscle movements. By relaxing the target muscles, the lines and wrinkles disappear. Take a look in the mirror and scrunch your face.  Do you have lines that appear? Well, those are the lines that are targeted by Botulinum toxin injections.

Botulinum Toxin is commonly used throughout the face and neck to reduce the appearance of:

  • Frown lines (the “elevens”)
  • Forehead lines
  • Bunny Lines on the nose
  • Crow’s feet around the eyes
  • Lip lines (“smoker’s lines”)
  • Dimpling of the chin
  • Neck bands

Who is a Candidate?

Basically, anyone with lines or wrinkles that they want reduced can be a candidate for botulinum toxin injections. You should be in good health and without and systemic neuromuscular disease. You should also not have any active skin diseases in the area that is to be injected and have no history of prior adverse reaction to botulinum toxin injections.

You will be evaluated prior to your injections, so your injector will help determine if botulinum toxin injections will produce the result you desire. Sometimes, other treatments like fillers, lasers, or chemical peels may be more appropriate.  Botulinum toxin should not be given to pregnant or breastfeeding women.

How is Botulinum Toxin given?

The toxin comes in a liquid form and is injected directly into the areas being treated. This means that you will get a needle. We use the smallest needles available and you will get multiple small injections to the area, so that the toxin is injected directly into the muscle. This will help ensure a smooth relaxation of the muscle. These injections are very well tolerated and most people feel very little discomfort.  After the injections, you can go back to your normal daily activities.

What is the recovery time?

There is essentially no recovery time after your botulinum toxin injections. Because it is administered with needles, there can be some pain or bruising at the injection site. This is temporary. You can resume normal activities right away, but we do recommend no heavy exercise for a day or two, in order to prevent worsening bruising and swelling.

Will I see it working right away?

No. Botulinum Toxin takes time to work. There is some variation among different brands, but in general it takes a few days to a week for the muscles to be relaxed. Many people do report that Dysport brand toxin kicks in faster, with most people seeing results in about 2-3 days. Some people respond differently so the time to onset may vary.

How long will it last?

In general, the effects of Botulinum Toxin last 3-4 months. But this can vary based on the anatomic location of the injections and the brand of toxin used. There is also some variation between people. Some people are more sensitive to the toxin and require smaller doses, and some require higher doses. Additionally, there is a very small percentage of people who are resistant to botulinum toxin and it just doesn’t work on them.

Can Botox be combined with other treatments?

Of course. It is very common for botulinum toxin to be given together with other treatments. This is because many people require more than one treatment to correct what they are complaining about. Commonly, patients get botox to reduce lines and wrinkles, but also get fillers (like Juvéderm or Restylane) to fill deep folds or deep lines. Most of these different treatments can be performed at the same time.

 

 

Are there other uses for Botox?

While botulinum toxin is most commonly used to treat lines and wrinkles of the face, there are some other, less common uses.  These include:

 

  • Jawline reduction
  • Treatment of migraine headaches
  • Reducing appearance of a gummy smile
  • Treating temporomandibular joint (TMJ) disorder
  • Stopping excessive sweating

How does Botox treat sweating?

Excessive sweating, or hyperhidrosis, is a very debilitating condition. Hyperhidrosis can occur on the hands, feet, underarms, and scalp – basically anywhere that there are sweat glands. It can cause significant social anxiety, not to mention damage clothes.  Botulinum toxin has been very effective in treated excess sweating and is FDA-approved for the treatment of hyperhidrosis.

The Botox is injected into the areas being treated. The toxin actually paralyzes the tiny muscles that surround each sweat gland. Most people see significant reduction in sweating within a week and the results can last 6-12 months. Higher doses of toxin are required when treating hyperhidrosis.

If you are concerned about the appearance of your lines and wrinkles, Botulinum Toxin may be right for you. You should be evaluated by a Board-Certified Plastic Surgeon or Board Certified Dermatologist. They will be able to tell you if Botox, Xeomin, or Dysport is best for you. They will also be able to discuss other treatments that may be better to help your areas of concern. To see an experienced injector in New York City, you can contact Board Certified Plastic Surgeon Dr. Matthew Schulman.

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