Before you receive your BOTOX® treatment, please review this important information. This information will not take the place of a personal visit with Dr. Donat, but it will answer some of the questions frequently asked regarding the treatment of facial lines with BOTOX®. It can also help you to decide whether cosmetic treatment with BOTOX® injections will aid in the reduction or elimination of your facial lines, furrows or habitual negative facial expressions.
The development of lines and furrows on the face is associated with the aging of our skin, the long-term effects of gravity and sun-damage, and both our normal and hyperactive repetitive use of these particular muscles for facial expression. Creases begin to appear wherever the skin is repeatedly folded by the action of the particular facial muscles.
Any fine lines on our face may produce the appearance of aging, but the prominent lines associated with our facial muscle movements can also appear to portray the emotions we feel. Repeated conscious and unconscious use of certain muscles, especially in the forehead, between the brows, and around the eyes, may produce deep lines or furrows, which persist despite our voluntary relaxation of these muscles. The presence of these persistent lines, or habitual negative expressions, may portray to others the negative appearances of worry, anger, anxiety, disgust or sadness, despite our feeling positive.
BOTOX® injections are used to reduce or eliminate the facial lines and furrows, due to repeated facial muscle action, by reversibly weakening or paralyzing only the selected muscles associated with certain facial lines. Except for the softening of these facial creases, your resting facial appearance will remain unchanged. During the time the BOTOX® is effective, usually three to four months in duration, expressions involving the active use of these muscles will be weakened or impossible. Subsequently, full facial expressions will gradually return. BOTOX® injection treatments may be repeated at this time to restore the desired aesthetic effects
The sites best treated with BOTOX® injections are:
What is BOTOX® (Botulinum toxin type A)?
BOTOX® is a sterile, purified protein produced from bacteria (Clostridium botulinum) in the laboratory which, when injected into muscle, weakens or paralyzes the muscle for a typical period of several months.
BOTOX has been safely and effectively used for the cosmetic treatment of facial lines and furrows in thousands of patients in the United States and Canada during the past eight years. BOTOX® is now specifically FDA-approved for cosmetic facial muscle treatment. BOTOX® has long been approved for facial muscle spasm disorder treatments involving the identical facial muscles and similar treatment technique as that required for your aesthetic needs.
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How does BOTOX® work?
Injected BOTOX® protein binds to the nerve endings supplying the specific facial muscle beneath the injection site and prevents the nerve impulse from traveling to the muscle, thereby weakening or paralyzing the muscle. Without muscle movement acting upon the facial skin, previous skin creasing is reduced or eliminated and new skin creasing is avoided.
BOTOX® does not affect the major nerves supplying sensation to the face, only the nerves carrying impulses for movement of the specifically targeted facial muscles. BOTOX® typically takes 3 to 4 days to begin taking effect and the reasonable paralyzing effect typically lasts 3 to 4 months, in most persons, before full muscle movement returns.
Repeated treatments may be performed at the time muscle movement returns to prevent the renewal or deepening of facial lines. A few individuals may have effects of shorter or longer duration, but regardless of the duration of effect, all persons will regain eventual full facial movement.
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Which facial lines respond to BOTOX® treatments?
Significant improvement of the forehead creases, brow and nasal furrows, and crow’s feet eye creases may be expected with individual area or combined area BOTOX® treatments. BOTOX® treatments provide additional and complimentary aesthetic benefits when combined with another facial rejuvenation procedure such as a facelift, browlift, eyelid surgery or facial laser skin resurfacing.
Facial lines due to muscle movements on areas of the mid-upper eyelids, mid-lower eyelids or around the mouth are not available for BOTOX® treatment, since markedly undesirable difficulties with eye opening and closing, speaking and eating would likely result. Extremely deep, longstanding creases may not improve with BOTOX® if permanent skin creasing has occurred. In these cases, skin fillers, in the form of collagen injections or other substances, available in this office, may be necessary to fully correct current persistent creases and abate new crease formation.
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What is involved in the office BOTOX® treatment procedure?
Prior to treatment, you will discuss, in consultation with the physician, your specific concerns and desired goals for facial rejuvenation to determine if BOTOX® treatments are beneficial and appropriate for your aesthetic care. If so, a small volume of sterile saline with dilute BOTOX® protein is placed directly into the facial muscle sites responsible for the creasing during a subsequent 15-minute office visit procedure. We request that you remain primarily upright, either sitting or standing, avoid any strenuous exercise or lifting, and refrain from wearing any hats, headbands or from rubbing the treatment sites for at least 3 hours after the procedure. This allows the protein to bind to the muscle and to not be “washed away” from the treatment site, which could lessen the effect of the treatment, but will not otherwise cause any concern.
Initial BOTOX® doses are based on the average individual minimum starting dose for an effective result in a given treatment area. A few individuals may require higher doses for effective results if their facial muscles are unusually strong or their facial expressions unusually hyperactive.
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What are the potential side effects of BOTOX® treatments?
- Temporary local irritation or redness at the injection sites.
- Temporary bruising or mild swelling at the injection sites.
- Rarely, temporary forehead numbness or transient headache.
- Rarely, temporary upper eyelid drooping or, very rarely, temporary double vision.
- Extremely rare, potential severe allergic reactions
- BOTOX® antibody formation limiting further effective use of BOTOX® in affected persons.
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