Botox Injection Wrinkle Therapy

Botox® Injection (Wrinkle therapy)
by Nancy Turner, with Eugene L. Alford MD FACS
Texas Center for Facial Plastic and Reconstructive Surgery
reprinted with permission from www.texasface.com

Botox® is an FDA-approved muscle-blocking agent manufactured by Allergan Pharmaceuticals which, among other uses, treats overactive facial and eye muscles. The original form of the medication is genetically engineered and synthesized from the bacterium Clostridium. The medicine was developed in the late 1970s and has been used clinically since the early 1980s with few side effects. Botox® works by blocking nerve transmission to specific muscles, putting those muscles to rest for up to nine months. This produces a smoothing of the skin and loss of involuntary wrinkles, especially frown lines, crows feet, and horizontal forehead wrinkles. Botox® is usually not used around the mouth because lower facial weakness may cause drooling. The expertise and experience of your physician is necessary to avoid temporarily paralyzing the wrong muscles. Treatment of cosmetically noticeable wrinkles is an off-label application of Botox® that has become extremely popular in the United States in recent years. Patients find the relatively long effect, smoother skin surface, fewer injections, and lower cost to be more appealing than collagen, fat, and other related injections or treatments.

The Botox® protein is so delicate that it is shipped in a freeze-dried state and must be reconstituted immediately prior to use. Outside the body, Botox® remains active for only a few hours. The effects of Botox® usually start 4-12 days after the injection and typically last for 4-6 months. Ninety-five percent of our patients who receive Botox® elect to return for follow-up treatments because of their satisfaction with the results.

Relatively painless injections (3-18 depending upon the areas treated) are administered in the office with an acupuncture-size needle. Local anesthesia is not used because it is more uncomfortable than the Botox® injections themselves. Some tiny spots of blood may appear at the injection sites (typically between and over the eyebrows). These resolve after a few minutes of pressure. Patients may resume their normal activities, exercise, and diet within fifteen minutes.

A "relaxing" effect is noted by the end of the first week and continues for about 3 to 6 months. There is no change in sensation and no numbness. Many patients report a decrease in tension-type headaches and brow aches. In the treated areas, Botox® provides a diminution in the deeper muscle wrinkles and softening of dynamic lines that occur during facial expressions. Facial expression is maintained except for the vertical furrowing between the eyebrows.

Complications are rare. Occasionally (less than 5%), a slight drooping of the eyebrow or upper eyelid may occur, but this resolves once the medicine diminishes at the injection site.

Botox® injection is the perfect compliment to Dr. Alford’s philosophy that "less is more" when considering facial plastic surgery procedures. In many patients, the rejuvenative improvement gained by this painless, highly efficacious and safe treatment is dramatic, especially when measured against other more costly procedures.