The most common areas injected with Botox® are frown lines, forehead lines, and crow's feet.


Frown lines are vertical lines noticed between the eyebrows and are made worse by frowning or squinting. Botox® injections of the Corrugator, Depressor supercillia, Procerus, Orbicularis Oculi and Nasalis muscles reduces the appearance of the frown lines and lines that develop over the bridge of the nose.


Forehead lines are usually horizontal lines caused by repetitive raising of the eyebrows by the Frontalis muscles. Injection of these muscles relaxes the forehead and reduces the extent of horizontal forehead lines.


Crow's feet are seen on the sides of the eyes and are worsened by smiling, which causes the Orbicularis Oculi muscle to go into spasm. Botox® treatment of these muscles reduces the severity of crow's feet.




Another area where Botox® is injected is the upper lip. By relaxing the upper lip Orbicularis Oris muscle, Botox® reduces the appearance of "smoker's lines".




Injection of BOTOX into the lower lip Depressor Anguli Oris muscle reduces the downward pull of these muscles creating a turned-up corner of the mouth.


Vertical and horizontal neck lines are also reduces by relaxing the neck Platysma muscles with BOTOX

 

The first option, which is most appropriate for active lines or age associated wrinkles that are just starting to appear, is to temporarily weaken or immobilise the muscle that is causing the wrinkle.  


Botulinum Toxin type A is a family of neurotoxins that block nerve signals that cause muscles to contract.  The toxin works directly where it is placed, and thus can be artistically used to alter facial expressions.  


Botox® (onabotulinumtoxinA) is widely recognized and was the first neurotoxin to be approved by the FDA for cosmetic use in the United States.  Other manufactures are producing variant toxins that will likely be approved for use in the near future, including Xeomin, Reloxin (Dysport) and PurTox.  These toxins will be differentiated by their time to onset, duration of effect (the clinical effects of Botox® are typically 3 to 4 months), and the distance of effect from the injection site.  Risks include bruising at the injection site, rare chance of an infection, and the possibility of unintentionally affecting nearby muscle groups.  Specific risks should be discussed with your injector when considering treatment.

In addition to its cosmetic applications, Botox is currently used in the treatment of:


  1. •Cervical dystonia (spasmodic torticollis) (a neuromuscular disorder involving the head and neck)

  2. •Blepharospasm (excessive blinking)

  3. •Severe primary axillary hyperhidrosis (excessive sweating)

  4. •Achalasia (failure of the lower oesophageal sphincter to relax)

  5. •Local intradermal injection of Botox® is helpful in chronic focal painful neuropathies. The analgesic effects are not dependent on changes in muscle tone.

  6. •Migraine and other headache disorders, although the evidence is conflicting in this indication


Other uses of onabotulinumtoxinA that are widely known but not specifically approved by FDA (off-label uses) include treatment of:


  1. •Pediatric incontinence, incontinence due to overactive bladder, and incontinence due to neurogenic bladder.

  2. •Anal fissure

  3. •Spastic disorders associated with injury or disease of the central nervous system including trauma, stroke, multiple sclerosis, Parkinson's disease, or cerebral palsy

  4. •Focal dystonias affecting the limbs, face, jaw, or vocal cords

  5. •TMJ pain disorders

  6. •Diabetic neuropathy

  7. •Wound healing

  8. •Excessive salivation

  9. •VCD Vocal cord dysfunction a spasming of the vocal cords

  10. •Reduction of the Masseter muscle for decreasing the size of the lower jaw


Treatment and prevention of chronic headache and chronic musculoskeletal pain are emerging uses for botulinum toxin type A. In addition, there is evidence that Botox® may aid in weight loss by increasing the gastric emptying time.


What exactly is Botox®?


Botox® is a purified protein produced by the Clostridium botulinum bacterium. It is a non-surgical treatment that can smooth moderate to severe glabellar lines between the eyebrows, worry lines located on the forehead, and periorbital lines around the eyes (also knows as crow's feet). During treatment, very low doses of Botox® are administered via a few tiny injections directly into the muscles that cause those stubborn lines. The treatment is usually done in about 10 minutes, and no recovery time is needed. Within days, you may see an improvement that can last up to 4 months. Results may vary.


How does Botox® work?


Moderate to severe glabellar lines, worry lines and periorbital lines form over time as the result of muscle activity. Botox® is injected directly into the muscles causing these lines. It works by blocking the transmission of nerve impulses to the injected muscles; this reduces the activity of the muscles that cause those persistent lines to form.


When will I see results from a Botox® Cosmetic treatment?


You may see a marked improvement within a few days. Lines continue to improve for up to a month, and results can last for up to 4 months. In clinical trials, nearly 90% of men and women rated the improvement in their appearance as moderate to better 1 month after treatment. Results may vary.


How long does Botox® last?


Results from treatment with Botox® can last for up to 4 months. If you discontinue treatment, the lines gradually will look like they did before treatment.


Is treatment with Botox® painful?


Discomfort is usually minimal and brief. The entire procedure takes approximately 10 minutes. Many people return directly to work or normal activity following Botox® treatment.


Who should not use Botox®?


Botox® should not be used in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any ingredient in the formulation. Patients with neurological disorders such as ALS, Myasthenia Gravis or Lambert-Eaton syndrome may be at increased risk of serious side effects.


Will I experience any side effects?


The most common side effects include headache, respiratory infection, flu syndrome, temporary eyelid droop, and nausea. Less frequently occurring (<3%) adverse reactions include pain in the face, redness at the injection site, and muscle weakness. These events are thought to be associated with the injection and occurred within the first week.


Will my facial expressions continue to look natural?


Although the results are visible, a treatment with Botox® will not radically change your facial appearance or make you look as if you "had work done." The muscle activity is simply reduced, so you can still frown or look surprised without the wrinkles and creases between your brows.


What will happen to the frown lines between my brows if I choose not to continue treatments?


If you do not continue treatments, the moderate to severe frown lines between your brows will gradually look like they did before treatment.


What are the contraindications for using Botox®?


Do not use Botox® if you:


•have an infection where Botox® will be injected

•are allergic to any of the ingredients in Botox®

•are pregnant or think you might be pregnant


Get the Medical Uses of Botox® Brochure here (PDF)


Get the Blepharospasm Brochure here (PDF)


For further information regarding Botox®, visit www.Botox.com.


For real-life patient comments, visit http://www.realself.com/Botox/reviews

Botox® neurotoxin is an effective treatment that has been studied for a long time. It has been used to treat patients for a variety of conditions for more than 15 years in 75 countries. The active ingredient in Botox® has been studied for more than 100 years. Below are key milestones in the history of Botox®.


1950s

Scientists discover that the active ingredient in Botox® can relax overactive muscles.


1960s and 1970s

Studies explore botulinum toxin (later produced as Botox®) for the treatment of strabismus (crossed eyes).


1988

Allergan begins research using botulinum toxin to treat other medical problems.


1989

The FDA approves botulinum toxin to treat blepharospasm (eyelid spasms) and strabismus (crossed eyes).


Allergan names the medicine Botox®.


2000

The FDA approves Botox® treatment for cervical dystonia (CD).


2002

The same formulation is also approved as Botox® Cosmetic. For more information about Botox® Cosmetic, visit www.Botoxcosmetic.com.


2004

The FDA approves Botox® to treat severe underarm sweating when antiperspirants don’t work. For more information, visit www.Botoxseveresweating.com.


Today

Other medical uses of Botox® continue to be investigated worldwide.

It's all about freedom of expression ...
It's all about freedom of expression ...
It's all about freedom of expression ...

The following two videos show some of the more important points that have to be taken into consideration when undergoing Botox® treatment in the upper and lower face.

In the three videos below, further important concepts regarding Botox® treatment are explained.

The two videos below demonstrate live Botox® treatment of the frown area (glabella), forehead area (frontalis) and crow’s feet (lateral orbicularis oculi).  The effects of Botox® are clearly shown after 2 weeks at the follow-up appointment.

The videos below further demonstrate and explain some of the more common uses and concepts of Botox® treatment.

The video below demonstrates and explains the use of Botox® treatment for severe underarm sweating (axillary hyperhidrosis) - this procedure can also be used for sweaty palms and soles (palmar and plantar hyperhidrosis)