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Botox® Therapy

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Facial wrinkles occur due to an intimate combination of aged, sun-damaged skin and the chronic action of the underlying muscles. Until recently, methods of renewing the skin abounded, but no treatment was available for the over-dynamic muscles. Through a series of precise, usually painless, injections, Botulinum Toxin will relax the facial musculature, especially in areas such as the forehead, frown lines (between the eyebrows) and around the eyes. The result is softening or disappearance of wrinkles. This concept has revolutionized treatment of wrinkles in the upper third of the face.

 


Before & After BotulinumToxin and Restylane for frown lines
Photo Niels Krejci, MD

 

Non-surgical jaw reduction: injection of Botulinum Toxin can soften a square jaw and push the angle of the jaw visibly forward (large arrow). Click HERE for more information.
Photo Niels Krejci, MD

Although Botulinum Toxin is sufficient in many cases, ideally it is used with skin resurfacing to optimize results. Botulinum Toxin is one of the most popular methods of facial rejuvenation in the US today and has recently been approved by the FDA for cosmetic indications. Other uses include treatment of neckbands, chin and excessive sweating.

How does Botulinum Toxin work?
Botulinum Toxin works by selectively and temporarily paralyzing the muscles into which it is injected. The rationale for its use is that one can inject a chemical which selectively inhibits the action of muscles in certain hyperdynamic areas (like the forehead), then this in turn will eliminate the wrinkles which are caused by that muscle action. In the case of excessive sweating, Botulinum Toxin prevents signaling to sweat glands and normalizes sweat production.

How long do the Botulinum Toxin injections last, and are additional treatments required?
The effect of one Botulinum Toxin treatment usually lasts 3 to 4 months, after which re-treatment is required. After three to four simultaneous treatments, however, the Botulinum Toxin effects become more long lasting, as the muscles that cause the wrinkles begin to lose their strength and develop atrophy. Minimizing the use of treated muscles by controlling animation will help Botulinum Toxin last longer. The best time to re-treat is as soon as the muscle is starting to move. In the case of excessive sweating, re-treatments are usually needed after 6-9 months.

What are the possible side effects?
Temporary bruising is possible and is minimized by avoiding aspirin-like products and Vitamin E for 1 week before injections and alcohol for 3 days before injections. Mild headaches can occur and usually resolve with Tylenol. A slight change in the shape of the eyebrow is possible. Drooping of the eyelid is rare and usually resolves within a few days.

Are there any post-Injection precautions?
You should keep your head elevated for 3 hours if you have the frown lines treated (so pick up your bag while bending at the knees, after treatment). It is important to utilize the treated area for the first 3 hours to help the drug diffuse well. Mild exercise is allowed 4 hours after the treatment.

How quickly does it act?
Botulinum Toxin usually works within 2-4 days. The maximum benefit is seen at 14 days.

Does it hurt?
We use the smallest possible needles and ice to maximize patient comfort. Most people tolerate Botulinum Toxin extremely well. When treating palms and soles for excessive sweating, a nerve block may be needed. Fees:
Our fees are carefully selected to be reasonable. Each cosmetic area requires a different amount of Botulinum Toxin. In addition, within any given cosmetic area (e.g. lateral eyebrows and underneath the eyes) additional areas can be treated. A small additional fee applies to these small extra areas.