Facial Plastic Surgeon / Procedures / Skin / BOTOX
Botulinum toxin type A or BOTOX® Cosmetic is a neurotoxin that originally comes from a bacteria that causes muscle paralysis. This toxin has been used since the 80’s for the treatment of various conditions that involve muscle spasm. By the early 90’s the benefits for the treatment of facial wrinkles was recognized, and today injection of BOTOX® Cosmetic has rapidly become the most frequent nonsurgical aesthetic procedure performed.
BOTOX® Cosmetic is most commonly used to treat the vertical frown lines just above the nose, horizontal lines of the forehead, and crow’s feet. However, it also has many other applications. BOTOX® Cosmetic can be used to treat vertical lip lines, neck bands, chin cobblestoning, and the bunny lines on the side of the nose. It can reshape the face by lifting the eyebrows, the corners of the mouth, and the lips. It can also be used at the same time as other treatments and surgical procedures. Botox is an alternative to facelift surgery
The muscles of our face are responsible for facial expressions like frowning or smiling. As we age, the repeated contractions of these muscles along with other changes in the skin result in the wrinkles that we see.
When BOTOX® Cosmetic is injected into a muscle, that specific muscle relaxes and becomes unable to contract temporarily for 4-6 months, thereby eliminating its pull on the skin and softening the wrinkles over this muscle.
With continued treatments of BOTOX in San Francisco, new wrinkle formation is also prevented as repetitive muscle contractions that deepen facial lines over time are blocked.
Aside from treating wrinkles, BOTOX® Cosmetic can be used to reshape and rejuvenate facial features by altering the balance of muscles. An example of this is lifting the eyebrow or the corner of the mouth.
Patients are advised to remain upright and to avoid lifting, bending, or straining for 3-4 hours after treatment. After this time, all activities are unrestricted. A cold compress can be used immediately after injection to reduce swelling. Makeup can be applied at any time after the procedure. The effects of treatment can be seen within a few hours, but the full effect will take 7-14 days. Muscle activity will begin to gradually return 3-4 months after the treatment. With repeated timely treatments, many have noted a slightly longer duration of action around 6 months.
Injections are performed with a very fine needle that delivers small amounts of the toxin in liquid form. It is very important that injections are targeted towards the appropriate muscles as the toxin only works at the specific point of injection. This requires that the injector have a very thorough knowledge of facial muscle anatomy. The injections are quite tolerable; commonly no anesthetic is used or a topical gel is applied on the skin to provide a temporary numbing.
In general, BOTOX® Cosmetic is very safe and there are no major internal side effects. Pregnant or lactating women should not receive BOTOX® Cosmetic. Allergic reactions are very rare. There is no reason to believe it cannot be used safely for one’s entire life.
There is a risk of mild bruising, redness, and swelling that can occur with injection, but this is usually not a big problem. The biggest problem can be an abnormal appearance from the inhibition of an unintended muscle or the over-activity of untreated adjacent muscles. Examples of this are a droopy eyelid, over-elevated eyebrow, or crooked smile.
Although rare in the hands of a well-trained injector, these problems can occur and can often be treated with additional injections. Occasionally, patients may need to wait a few weeks until a small portion of the BOTOX wears off.