Dr Babak Babsharif, Ophthalmologist, Subspeciality in Cosmetic Eye Surgeries (Oculoplastics), & Strabismus
Member of American Academy of Ophthalmology (AAO)
Member of European Society of Cataract & Refractive Surgery (ESCRS)
Certificate of Ophthalmology from International Council of Ophthalmology (ICO) Cambridge, UK
Medical Degree 1989
Board of Ophthalmology 1997
Subspeciality Degree 2006
Complementary Education in University of Texas, USA
Botulinum Toxin - Botox
The injection of botulinum toxin, commonly known as Botox, has become very popular for reducing wrinkles and rejuvenating the aging face. The effects are only temporary, but the injections can be done quickly, require no recovery time, and are not as complicated as many other cosmetic procedures for the face.
Botulinum toxin is produced by Clostridium botulinum bacteria. When a small amount of Botox is injected into a muscle, it blocks nerve signals that tell your muscles to contract. The effect is that it temporarily weakens or paralyzes the facial muscles and smooths or eliminates wrinkles in the skin for a few months.
Getting a Botox injection takes just a few minutes.
What To Expect After Treatment
For the first 2 to 3 hours after treatment, take it easy and do not rub the treated area. After that, you can return to your regular activities.
It can take 3 to 4 days before you notice an effect from the Botox. The full effect may take up to 1 week. The results may last from 3 to 4 months on average but sometimes up to 6 months. After that, you will begin to see the wrinkles return.
Why It Is Done
Botulinum toxin has been approved by the U.S. Food and Drug Administration (FDA) for treating frown lines in adults younger than 65. Botox injections also are frequently used to reduce other wrinkles on the face and neck, such as crow's feet, brow furrow, and forehead lines.
Botulinum toxin is also approved by the FDA to treat a wide range of problems, such as chronic migraine headaches, eye muscle disorders, and muscle stiffness.
How Well It Works
Within 72 hours after treatment, the injection of Botox partly or completely smooths wrinkles for most people. But the results are temporary, typically lasting only 3 to 4 months. You will have to return for injections every 3 to 4 months to keep the effect. The dose of Botox usually is the same each time you get an injection.
The most common side effects are:
Drooping eyelid that may last a short time.
Other side effects include flu-like symptoms, nausea, temporary facial pain, redness at the injection site, reduced blinking, and weakness in the muscles of the face. In extreme cases, this muscle weakness can limit your facial expressions. In rare cases, a sore may develop on the white of the eye (corneal ulceration).
Very serious problems can happen if the botulinum toxin spreads from where it was injected. It may cause dangerous swallowing and breathing problems. These problems can happen hours to weeks after the injection and can cause death. The risk is greatest in children who are being treated for muscle spasticity in their necks. But adults who already have swallowing or breathing problems are also at risk for problems from a Botox injection.
The risks of repeated Botox injections are not known.
What To Think About
Botox injections are more convenient and less painful than other procedures for reducing wrinkles and making your face look younger (chemical peels, dermabrasion, laser resurfacing, face-lift). Keep in mind that the effect of an injection may last only a few months. To keep the effect, you will have to get injections several times a year. A single injection may seem inexpensive, but the cost of repeated injections can quickly add up.
Cosmetic Uses of Botox
Doctors have been using Botox for years to successfully treat wrinkles and facial creases. Botox is a brand name of a toxin produced by the bacterium Clostridium botulinum. There are also other brand names, such as Dysport and Xeomin.
How Does Botox Work?
Botox blocks signals from the nerves to the muscles. The injected muscle can't contract. That makes the wrinkles relax and soften.
Botox is most often used on forehead lines, crow's feet (lines around the eye), and frown lines. Wrinkles caused by sun damage and gravity will not respond to Botox. It can also be used for lip lines and for the chin and corner of the mouth and neck.
How Is a Botox Procedure Done?
Getting Botox takes only a few minutes and doesn't require anesthesia. Botox is injected with a fine needle into specific muscles with only minor discomfort. It generally takes three to seven days to take full effect, and it is best to avoid alcohol starting at least one week before the procedure. You should also stop taking aspirin and anti-inflammatory medications two weeks before treatment to reduce bruising.
How Long Does a Botox Injection Last?
The effects from Botox will last four to six months. As muscle action gradually returns, the lines and wrinkles begin to reappear and need to be treated again. The lines and wrinkles often appear less severe with time because the muscles are being trained to relax.
What Are the Side Effects of Botox?
Temporary bruising is the most common side effect of Botox. Headaches, which end in 24 to 48 hours, can happen, but this is rare. A small percentage of patients may develop eyelid drooping. This usually ends within three weeks. Drooping usually happens when the Botox moves around, so don't rub the treated area for 12 hours after injection or lie down for one hour after the procedure.
Who Should Not Receive Botox?
Patients who are pregnant, breastfeeding, or have a neurological disease should not use Botox. Since Botox doesn't work for all wrinkles, you should consult with a doctor first.
Will My Insurance Pay for Botox?
Botox is not generally covered by insurance when used for cosmetic purposes. Check with your health insurance company for coverage details.