With a target population of men and women between the ages of 30 and 60, Botox® Cosmetic injections are becoming increasingly popular in the treatment of certain facial wrinkles. Instead of plumping the problem area with fillers, Botox® Cosmetic temporarily weakens the facial muscles in that area and relaxes the skin’s surface, thereby “removing” the wrinkle. The type of lines and wrinkles that respond best to this procedure are those that are caused specifically by muscles that are repeatedly over-contracted during facial expressions, such as frowning or squinting.
Botox® Cosmetic is currently used in more than 40 medical conditions, including “urge incontinence”. The injections take effect in 3 to 5 days, with initial results lasting between 3 and 4 months. However, there is current evidence that suggests that repeated injections may ultimately lead to results lasting as long as 6 -12 months. There is also evidence that Botox® Cosmetic will prevent progression of the wrinkling while being treated.
Botox® Cosmetic started life as a treatment for eye spasms, vocal cord problems, abnormal movements of the legs, arms and face, and central nervous system disorders. Its current benefits were discovered by chance in 1987, when an ophthalmologist in Vancouver, using it to treat a patient’s eye spasms, noticed that along with the spasms, Botox® also eliminated the patient’s scowl lines. It wasn’t long before the eye doctor’s husband who was a dermatologist started using Botox® Cosmetic to eliminate signs of aging. Now it is a common form of cosmetic treatment.
There are certain risks and side effects associated with Botox® Cosmetic injections, although most are minimal and none are permanent. Some localized redness, swelling or bruising at the injection site may occur, but usually resolve quickly. Ice packs applied to the treated site before and after the injections can alleviate this problem. Sometimes, there is temporary numbness or tingling at the injection sites, which passes quickly. Occasionally, when the scowl area or forehead are treated, patients get a minor headache that lasts a few hours. Very rarely, patients can develop a migraine that lasts up to a month and is unresponsive to usually effective treatments. On rare occasions, flu-like symptoms have been reported.
When Botox® Cosmetic is used around the forehead, a temporary condition known as ptosis can develop, which causes the eyelid to droop. Ptosis occurs in 1% of all patients. Appearing 7 to 14 days after the injection, it can last from 4 to 6 weeks. To reduce the risk of ptosis, patients should obtain Botox® Cosmetic from a physician who is experienced in its use. In the unlikely event that ptosis occurs, it is usually reversible with Iodipine or Naphcon drops, which bring relief within a few hours.
Patients should not take aspirin or any other non-steroidal anti-inflammatory drugs, such as Motrin or Advil for two weeks before treatment. Aspirin increases the risk of bleeding and bruising at the injection site. Patients should also provide the physician with a list of prescribed medications and any known allergies.
When Botox® Cosmetic is injected into the skin and muscle, it binds itself to the nerve endings, in effect, paralyzing the chemical transmitters that activate muscles. It partially freezes the small muscles of the face that cause unwanted lines and wrinkles.
Recovery from this procedure is quick, since there is almost no redness or swelling. However, it is important that patients remain vertical (head above heart level) for 4 hours after the injection. This allows the Botox® Cosmetic to be absorbed into the treated area and lessens the chance of it moving to other muscles. It’s also important for patients to contract the treated muscles repeatedly (smile or squint depending on the area treated) for about 30 minutes. This helps to keep the muscles limber. Patients should not touch or rub the injected sites for 2 to 3 hours. As long as the post-procedure guidelines are followed, patients can drive themselves home or to work and resume all normal activities except for avoiding strenuous exercise for 24 hours after treatment.
Sometimes, it’s the little things that make us unhappy, such as the fine wrinkles on our face. Other times, it’s the little things that make us happy, like the Botox® Cosmetic treatment that erases those wrinkles. For a modest investment, patients can present a younger, more relaxed face to the world. Botox® Cosmetic is only temporary, requiring multiple visits to the doctor. Most patients report that a single treatment lasts from 3- 4 months initially, but may last up to 6 months after a few follow-up treatments.
Botox® Cosmetic is a safe procedure when administered by a well-trained physician to an appropriate candidate. Although it does affect the ability of the muscles to move, Botox® Cosmetic does not alter or impair sensory perception. In terms of safety, muscle biopsies taken from patients after repeated injections of Botox® Cosmetic have not shown any evidence of muscle weakness or degeneration. Furthermore, the Food and Drug Administration states that there have been no reports of systemic toxicity from injections that were properly administered. Botox® Cosmetic is recognized by the American Academy of Neurology, the American Academy of Ophthalmology and the National Institutes of Health as both safe and effective.
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