Botox® Cosmetic FAQS

Q. What is Botox® Cosmetic and where is it used?

A. Botox is a purified protein that relaxes small facial muscles. It is most often used for cosmetic purposes in the small muscles of the face which contributes to frown lines, crow’s feet, forehead or lip lines, and down-turned corners of the mouth.

Q. I have heard of something called Botulism. I understand it is a very serious illness. Is Botox® related to Botulism?

A. This is a very important question. The active ingredient in Botox is the same one, which, in much larger amounts can cause Botulism. Knowing what Botulism is and how different it is from the way Botox works, will remove any concern you may have. Botulism poisoning, although rare, can occur if a person eats food which is contaminated with the Clostridium Botulinum bacteria. This bacterium makes large amounts of toxin, which circulate throughout the body. This can lead to respiratory paralysis and is sometimes fatal. In one experiment with mice, the lethal does is about 3,000 units in one injection. However, because extremely small units of Botox are used (under 50 units), it can be injected into specific muscles of the upper face very safely. Other areas and functions are not affected.

Many drugs in common use can be harmful, if given in large enough doses to affect the entire body, even Tylenol or aspirin. Given in the appropriate way and the right amounts, medications are valuable allies in fighting diseases and suffering. Clinical studies of over 20 years have shown Botox to be effective and safe.

Q. How do I know my doctor won’t give me too much Botox®?

A. The production of Botox is carefully controlled at every stage to ensure that it is safe for medical use. Our doctors have been trained to administer it safely with many years’ experience.

Q. Are there patients who should not receive Botox®?

A. Botox should not be given to pregnant women, nursing mothers, or people who have myasthenia gravis or muscle diseases.

Q. Do Botox® injections hurt?

A. When injected, Botox does not cause irritation or inflammation. Occasionally there may be a very mild sting. Certainly no anesthesia is needed prior to injections. The smallest possible disposable needle is used to minimize any discomfort. If needed an ice pack can be applied.

Q. Does Botox® interact with other drugs?

A. It is always important to let your doctor know if you are taking any other drugs, especially antibotics such as amino glycoside. These types of antibiotics may increase the effect of Botox.

Q. How long does Botox® take to work? How long does Botox® work? Will I need more injections?

A. Experience tells us, it takes 7 to 10 days for most patients to see the effects. Some patients notice the effects in as few as 3 days. Most patients get 90% relaxation of these muscles. A recent study in the USA showed that Botox lasted from 3 to 8 months for upper facial wrinkling, in most patients it lasts 3 to 5 months. Yes, injections are performed to maintain a benefit over a long period of time often three times a year. The treatment can be performed for as long as is required. Sometimes a patient will want Botox for a one time special occasion such as their child’s wedding or a reunion.

Q. Are there any side effects?

A. Because of the tiny doses that are used for facial wrinkling, no significant side effects have been reported. Patients sometimes have a feeling of stiffness or numbness in the area injected; however, as the nerves of touch are unaffected this sensation is transient and disappears in a few days. When much larger amounts of Botox (more than 10 times) are used for other muscle conditions, other transient mild symptoms may be noticed. In summary, Botox is safe.

Q. Are there any disadvantages? Will it freeze my forehead or will it make me look like a deer in the headlights? Will it completely smooth out my wrinkles?

A. The only disadvantage is the need for repeated injections. However, my patients have found that injections every 4 or 5 months are beneficial and do not adversely affect their time schedules. No, it won’t freeze the muscles, but instead give about 90% relaxation thereby preserving positive expressions. Occasionally, patients’ muscle take up Botox unevenly or react more than anticipated. This will diminish quickly over days to a couple of weeks. The lines between the eyebrows soften and in some will disappear significantly, but some lines are so deep that they will not fill enough. If so, filler such as hyaluronic acid maybe used. Occasionally, patients will be able to use nearby muscles to move their eyebrows to simulate a frown, this is not a natural movement and can’t be done without significant concentration.


If you would like more information on Botox® Cosmetic, please contact our offices and schedule an appointment with any of the providers, who perform this procedure.