BOTOX is the product name of the cosmetic form of botulinum toxin, a purified natural protein approved by the Food & Drug Administration (FDA) in 2002 for use in treatment of frown lines and wrinkles in the forehead of adults aged 18 to 65. Migraine headaches, excessive perspiration and muscle spasms in the face are also sometimes treated with BOTOX, but the most common use of the toxin is in reduction of facial wrinkles.
Those wrinkles, known as "glabellar lines," appear after years of expressing normal emotion through furrowing of the brow.
Over time, the glabellar lines appear more drastically and for longer periods. These lingering wrinkles are generally noticed by the patient as they reach their mid- to late-30's or 40's. Women often experience more pronounced wrinkling at an earlier age, as female skin is naturally more delicate than that of their male counterparts and women tend to utilize facial muscles more actively for expression of emotion and in general conversation.
To fight these lines (and often other wrinkles around the eyes and other areas of the face), a licensed physician injects tiny doses of BOTOX Cosmetic into the affected regions. The entire procedure is generally completed in 10 to 15 minutes, with little to no discomfort. Patients are able to resume normal activity immediately following the injections.
The effect of BOTOX Cosmetic injections
BOTOX works by blocking nerve signals to the muscles. In essence, the muscles are temporarily paralyzed by the toxins, creating a smooth, youthful appearance to the once creased areas. The effect of BOTOX Cosmetic injections is most pronounced after about seven to ten days following treatment, then lasts for approximately four months, at which time the muscles regain functionality and wrinkles and lines start to reappear.
Patients may be retreated with BOTOX every four to six months, in order to maintain the more taut, younger appearance.
Although BOTOX effectively treats facial wrinkles and creases, it is not effective in improvement of lines or wrinkling caused by sun exposure or gravity.
In 2005, 3.3 million BOTOX Cosmetic procedures were performed in the United States. According to clinical trials, 90% of those treated affirmed that their face appeared more youthful, and wrinkles diminished, within days following BOTOX injections.
According to the American Society for Aesthetic Plastic Surgery, BOTOX Cosmetic has been the most popular physician-performed aesthetic procedure performed in the United States for the past four years, when compared to both surgical and nonsurgical procedures, combined.

There are some precautions that should be exercised by patients undergoing BOTOX treatment. Most important is a pre-treatment consultation by a qualified physician. That physician will generally screen the patient for information and indication of allergies or conditions that make the patient a poor candidate for BOTOX injections. Patients who are pregnant, breastfeeding patients, those with neurological diseases or neuromuscular disorders (such as ALS, myasthenia gravis, or Lambert-Eaton syndrome), or patients with other preexisting conditions or infections may be at higher risk for side effects following BOTOX Cosmetic treatment.
Preparing for BOTOX injections
A second precaution for patients preparing for BOTOX injections is that of refraining from ingestion of alcohol for one week prior to treatment. Also, aspirin and anti-inflammatory medications should not be taken for two weeks before BOTOX Cosmetic treatment, as taking those prior to injections may cause bruising. Patients should always fully disclose all antibiotics, prescriptions, and over-the-counter medications currently being taken, so their physician can safeguard the patient against the potential for drug interactions or side effects.
Some bruising may occur after BOTOX is administered. This bruising is temporary and will disappear within several days. Although it is much more rare, another temporary side effect may be eyelid drooping. This occurs in some patients, when the BOTOX migrates from the original injection site.
To prevent this drooping, patients should not rub or press upon BOTOX injection sites for at least twelve hours following treatment. Headaches are not common, but if they do occur, they should diminish after one to two days.
Studies suggest that repeated use of BOTOX injections may actually provide some long-term effects, in reduction of the return of creases and lines around the eyes and on the forehead. Although this may prove to be the case for patients with highly repetitive use over years, the average patient will note that their face returns to its original appearance as BOTOX Cosmetic results wear off. That return to pretreatment appearance will occur at about four to six months following injection.
When administered by a qualified and consultative physician, BOTOX Cosmetic offers patients the opportunity to easily, economically, and painlessly turn back the clock on their own appearance. As long as precautions are taken, medications and conditions fully disclosed to the physician, and an experienced doctor administers the BOTOX injections, patients should see marked improvement and renewed youthfulness in their face immediately following treatment. Although the results are not permanent, BOTOX Cosmetic treatment is an excellent alternative to more invasive, costly, and painful procedures.
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