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BOTOX® Cosmetic
Botulinum Toxin type A


Botox Cosmetic In an effort to reduce the appearance of fine lines and wrinkles, many people are turning to BOTOX® Cosmetic. The cosmetic form of botulinum toxin, simply called BOTOX® Cosmetic, is a popular non-surgical injection that temporarily reduces or eliminates frown lines, forehead creases, crows feet near the eyes and thick bands in the neck. The toxin blocks the nerve impulses, temporarily paralyzing the muscles that cause wrinkles while giving the skin a smoother, more refreshed appearance. BOTOX® Cosmetic has also been shown effective in relieving migraine headaches, excessive sweating, and muscle spasms in the neck and eyes.

"In an effort to reduce

the appearance of fine lines and wrinkles,
many people are turning to BOTOX®."

Have you ever looked in the mirror and studied those lines around your brow? You may ask yourself, is it a result of aging, change in weight, or too much sun? What about stress? How skin ages is a combination of many factors. The lines that appear between your brows are the result of repetitive muscle movement over time. The more you have frowned or squinted your eyes, the more these muscles have contracted, causing the skin to crease. Over time the creases remain on the face and can become more pronounced. For women, whose faces tend to be more dynamic and active than men's, and whose skin is typically more delicate, these lines may appear overstated and more permanent.

It is strange to think of a toxin as a cure for wrinkles. But it makes sense once you understand what causes wrinkles and how BOTOX® Cosmetic works. There are two types of wrinkles. Dynamic wrinkles, or muscle wrinkles, form where muscles move the face the most (around and between the eyes and around the mouth), and Static wrinkles are lines and crinkles that appear at the corners of the eyes and in other areas on the face. Dynamic wrinkles go deep. As they develop, they create grooves in the skin, which are apparent even when you are not moving your face. Static wrinkles are more superficial and are most noticeable when the face is moving, such as when you smile or frown. Because it affects the facial muscles, BOTOX® Cosmetic can help ease or prevent both types.

The Benefits of BOTOX® Cosmetic

"BOTOX® Cosmetic has been used

to treat millions of people in the United
States since it was approved by the FDA in 2002."

  • In clinical trials, nearly 90% of men and women surveyed rated the improvement in the appearance of frown lines between their brows as moderate to better 1 month after treatment. Results vary.
  • Results can last up to 4 months.
  • BOTOX® Cosmetic has been used to treat millions of people in the United States since it was approved by the Food and Drug Administration (FDA) in 2002 for the temporary treatment of moderate to severe frown lines in people ages 18 to 65.
  • According to the American Society for Aesthetic Plastic Surgery, BOTOX® Cosmetic was the most popular nonsurgical cosmetic procedure in 2011, with 2,619,739 procedures performed by a qualified physician over the course of the year.

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Are you a Good Candidate for BOTOX® Cosmetic?

BOTOX® Cosmetic has been used to treat adults of all ages. Though the results have been excellent in all age groups, they are most dramatic in those with minimal signs of aging. It is recommended for patients who botox
  • Have neck or facial wrinkles
  • Are in good physical condition
  • Are motivated to improve their appearance
  • Have realistic expectations
  • Don't drink, smoke, or use recreational drugs

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What are the Side Effects of BOTOX® Cosmetic?

"There are very few side effects

associated with BOTOX® Cosmetic
injections. Small bruises or red marks may appear but usually fade within a few days."

There are very few side effects associated with BOTOX® Cosmetic injections. Small bruises or red marks at the sites of the injection may appear but usually fade within a few days. Mild headaches and nausea, though rare, have been reported by patients who receive forehead injections. Some injections can cause mild muscle aches. It is also possible for an adjoining muscle to experience weakness, although this is usually temporary (one to three weeks).

Swelling, though rare, may occur in the area around the injection. If the swelling lasts more than a few hours, simple massage should help reduce it. (Caution: Do not massage the area in the hours immediately following your injection, since this could cause the toxin to spread to adjacent muscles.


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Preparation Before the BOTOX® Cosmetic Procedure

Good communication between you and your physician will yield the best results. Discuss any concerns with the doctor before the procedure. List all medical conditions you have and any medications you are currently taking, in particular if you are taking an anti-inflammatory like Aspirin as this can lead to increased bruising. Be sure to discuss any food, drug, or other allergies.
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The BOTOX® Cosmetic Procedure:

For any BOTOX® Cosmetic procedure, your doctor might have you apply ice to the area a few minutes before treatment. This is for two reasons: it causes the vessels in the skin to constrict which helps reduce bruising, and it helps decrease the small amount of pain associated with multiple injections. Ice can be beneficial for the same reasons after the BOTOX® Cosmetic treatment.

Once seated upright, the doctor will have you contract the muscle in the area being treated so that he or she can better target the injection into the muscle. Thus, if you're receiving injections for wrinkles between the eyes, you will be asked to frown. For some procedures, the doctor may use an electromyelogram - a devise that helps your doctor locate the area of the muscles greatest contraction. Using this devise helps ensure that you will receive the right amount of toxin in the right place.

On average, you'll receive three injections per muscle (depending on the area being treated, more or less injections may be needed). With each injection you will feel a needle prick, then a mild stinging or burning for a few seconds as the toxin flows in to the muscle. Again, depending on the area being treated, you may be asked to gently press a gauze pad against the injection site and/or hold to it for a few minutes.

"As soon as the series of

injections is completed, you can
go back to your regular activities."

The whole process takes about ten minutes to half an hour, depending on the number of areas being treated. As soon as the series of injections is completed, you can go back to your regular activities. As stated above, the doctor will probably ask you to refrain from bending or laying down for approximately four hours after the injections until the toxin has had time to attach to the nerve-muscle connection. You will be asked not to rub the area in order to prevent the toxin from spreading to adjacent muscles.


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Recovery from the BOTOX® Cosmetic Procedure

BOTOX® CosmeticThe doctor will ask you to hold an Ice pack to the treated area for a few minutes after the treatment. This helps minimize bruising and discomfort resulting from the injections. It will also help keep the BOTOX® Cosmetic within in the injected areas. BOTOX® Cosmetic usually takes two to four days or even a week to have its full effect. You might be asked to return after two weeks so that your doctor can evaluate the results of the treatment, although you probably will not need to see the doctor until it is time for your next injections. If you feel the BOTOX® Cosmetic has not worked sufficiently, if you notice unevenness of eyebrows or other areas, or if your eyebrow is drooping, phone your doctor and request a follow up appointment.
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How Long Does BOTOX® Cosmetic Last?

"Depending on the area being treated, one series of injections generally lasts three to six months, though in some cases the improved appearance can last up to a year. As the toxin wears off, your wrinkles will gradually return, but they won't be any worse than before the treatment. With repeated injections, the effects generally tend to last longer. There is some evidence that after prolonged treatment the affected muscles may become permanently weakened, so fewer treatments will be needed." (Lautin p. 60)

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How much does BOTOX® Cosmetic Cost?

In 2010, the American Society of Plastic Surgeons estimated national surgeons' average fee was $375 for BOTOX® Cosmetic. The cost may vary based on the expertise and qualifications of the person performing the treatment, time and effort for procedure or treatment requires as well as geographic office location. Additional fees may include surgical facility costs, anesthesia fees and prescriptions for medication. To request a consultation and receive a more exact estimate, please use our
physician locator.
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What is the Road to Recovery like?

After the treatment, you should refrain from bending over or from vigorous activities for several hours to prevent the toxin from moving to an unwanted area. In rare cases, BOTOX® Cosmetic injections around the eye area can cause the eyelid to droop, though this will wear off in two or three weeks. It is even more rare, but possible, for injections in the neck muscles to cause difficulty swallowing. Be sure to discuss all the possible side effects with your doctor before beginning treatment.


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Are There Alternatives to BOTOX® Cosmetic?

Dysport has a similar molecular structure to BOTOX® Cosmetic and is considered to be an alternative. It works in much the same way, but keeps muscles in a relaxed state so that they do not contribute to the development of wrinkles.

Dermal fillers can also minimize the appearance of wrinkles. Instead of targeting the nerves and the muscles, dermal fillers like Juvederm and Radiesse will fill in the lines. These are particularly helpful for deeper lines. If you are a candidate for Fraxel Repair or Fraxel Dual, you may want to consider cosmetic lasers for fine to moderate lines that are etched into the skin. Lasers apply heat energy to help your skin create new collagen fibers. Collagen contributes to the overall firmness of the skin.
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Ten Questions every BOTOX® Cosmetic patient should ask their surgeon:

To better educate the patient about BOTOX® Cosmetic, as well as assisting in formulating realistic expectations, it is recommended that the patient look at before and after photographs, speak with previous patients, (You are always welcome to ask your doctor for referrals to previous patients and where to contact them.) and get answers to the following questions:
  1. Are the desired results I described realistic?
  2. How long will this procedure take?
  3. Is BOTOX® Cosmetic the most appropriate procedure for my case?
  4. How do I prepare for the procedure?
  5. If something were to go wrong, what are the warning signs? When and how should I receive medical attention?
  6. What is your level of experience in injecting BOTOX® Cosmetic?
  7. How much does BOTOX® Cosmetic cost, and what other elements factor into that cost? Do you charge by unit or by injection?
  8. What percentage of patients experience complications with BOTOX® Cosmetic?
  9. What should I expect, post-operatively, in terms of discomfort and healing?
  10. How is your BOTOX® Cosmetic stored, and when is it reconstituted?
In addition to the previously mentioned questions, it is important that patients relay to their surgeon information regarding any allergies and serious medical conditions they may have. Furthermore, patients should inform the surgeon of any medications they are taking. This site provides information about plastic/cosmetic surgery and is designed to help users make decisions regarding their own treatment options. But medical information is not the same as medical advice--the application of medical treatment to a person's specific circumstances. Although we go to great lengths to make sure our information is accurate and useful, we recommend you consult a qualified medical practitioner if you want professional assurance that our information, and your interpretation of it, is appropriate to your particular situation.
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Chasing Botox: Juvederm

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