Botox Cosmetic Injection

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Jill Daniels, Freelance Medical Writer

Jill Daniels is a freelance health writer based in New York City. She spent several years writing for WebMD, including their Weight Loss Clinic and Fertility Center programs. Jill has also written/reported for publications including InStyle, People and Women's Own. She received a degree in journalism for Northwestern University's Medill School of Journalism.


April 21 2008

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Some people believe that a face has more character with a few wrinkles. Other people see those wrinkles as something to eliminate – quickly. If you fall into the second camp, you've likely considered Botox┬« Cosmetic. With 4.6 million procedures performed in 2007, Botox injections remain the #1 most popular minimally invasive cosmetic procedure in the United States, according to the American Society of Plastic Surgeons. A bit of Botox can reduce those telltale signs of aging for many people. But, if you're thinking about indulging in a Botox injection here and there, it's important to know all the facts.

What is Botox?

Botox is the brand name of a purified form of botulinum toxin. Taken in large quantities by mouth, the toxin can cause botulism, which is often associated with food poisoning. While one of the most dangerous complications of botulism is paralysis, scientists found a way to use small amounts of the toxin to benefit humans – and to make them look younger! The Food and Drug Administration (FDA) approved Botox for cosmetic use in 2002.

How Does Botox Work?

Botox injections block signals from nerve endings to muscles, which forces muscles to stop contracting and ultimately forces wrinkles to relax and soften. Because the muscles can no longer tighten, the skin flattens and looks a lot smoother. Your degree of wrinkling, your skin type, and your skin thickness all affect how well Botox will work for you.

Where Botox Should – and Should Not – Be Used

Botox is most frequently used on frown lines between the eyebrows, lines in the forehead and crow's feet around the eyes. Lines around the mouth are not an ideal spot for Botox injections because the muscles in this area are required for talking and eating. In addition, wrinkles that have been caused by sun damage and gravity will not respond optimally to Botox.

How Do You Prepare for a Botox Procedure?

In order to lessen possible bruising, it's recommended that you eliminate alcohol for about a week before treatment, and stop taking aspirin, ibuprofen, and other anti-inflammatory medications 2 weeks prior to Botox injections.

As with any procedure, you should plan to meet with your doctor beforehand to discuss whether Botox is right for you, whether it will work on your particular type of wrinkles and what you anticipate the results of the Botox injections to be. It's important to have realistic expectations concerning what Botox can and cannot accomplish.

What Is Involved and What Can You Expect?

Botox is injected into specific muscles of the face using a fine needle. The number of injections into each particular area depends on your facial features, the extent of your wrinkling and what area of the face is being treated. No anesthesia is required with Botox and the procedure should take only a few minutes to perform.

There is no downtime with Botox and you should be able to continue with your daily activities right after the procedure is performed. You should be able to notice some results within a few days, but it can take up to 2 weeks or so for the full effects of Botox to appear. The results will typically last for 3 to 4 months, but may last as long as 6 months before repeat injections are needed to maintain the results. Wrinkles often appear less severe through continued Botox treatments because the muscles are being trained to become less active.

Botox Side Effects and Risks

When performed by an experienced doctor, Botox injections carry relatively few risks and the discomfort should be minimal. The dosage of Botox used to treat wrinkles is very low and typically a very small amount of the botulinum toxin is actually absorbed into the bloodstream. While Botox is generally not associated with serious side effects when it is used in adults for facial wrinkles, the drug has been in the spotlight recently because of potential dangers associated with it. It is important to be aware that certain Botox side effects such as the following can occur:

  • Bruising or stinging around the site of the injection
  • Temporary redness
  • Nausea
  • Headaches (these usually resolve themselves within 24-48 hours)
  • Flu-like symptoms
  • Temporary facial weakness or drooping (this is typically caused by migration of the Botox and resolves itself within a few weeks)

In the most severe cases, the toxin can spread beyond the desired area causing botulism-like symptoms such as muscle weakness, difficulty swallowing, breathing problems and slurred speech.
To avoid migration of the Botox into other areas, it's recommended that you don't rub the site for 12 hours or lie down for about 4 hours after the procedure.