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 Botulinum
toxin (Botox®) is a sterile, purified protein produced in the
laboratory from a bacteria called clostridium botulinum. For decades
Botox® has been used to safely treat eye twitches, excessive
palm or armpit sweating, and headaches. In the mid-1990s, plastic
surgeons began injecting small doses of Botox® to treat dynamic
wrinkles.
When injected in small amounts into facial muscles, Botox® binds
itself to the nerve endings that supply the muscle, thus blocking
nerve impulses from reaching the muscle. After injection, the muscle
is weakened, typically for several months. The weakening effect
on the facial muscle temporarily reduces or eliminates previous
skin creases and prevents new skin creases. Botox® may need
from two days to two weeks to take effect, and the effect typically
lasts two to five months for most individuals.
No long-term, negative effects and very few short-term ones are
associated with Botox®. If Botox® is injected too closely
to the upper eyelid, temporary upper eyelid droop may result. Risk
of allergic reaction is extremely limited. Pregnant women or those
with nervous system diseases such as ALS should not receive Botox®.
You may experience brief mild discomfort as Botox® is injected,
but recovery is immediate. Some patients experience mild bruising
that improves within a few days. Wrinkles will improve within 24
hours and will continue to improve for five days. Botox® results
can last up to six months, although results normally range between
two to five months.
Ideally you will have your next injection when you start to see
movement in the treated areas, i.e., not allowing the crease to
reappear. The more you preempt muscle movement, the better and longer
term your Botox® results will be. For the first year of injecting
Botox®, you should expect to repeat injections every two to
four months. If your visits are regular, you can then move to a
four-to-six month schedule.
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