Michael D. Manuel, M.D.
Jana K. Cole, M.D.

BOTOX® INJECTION

Changes associated with facial aging are frequently related to the over-activity of the muscles of facial expression. This activity will cause wrinkling of the overlying skin, particularly during active use of those muscles. Paralyzing the muscles will decrease the amount and severity of the wrinkling, resulting in a smoother appearance. BOTOX® is a medical form of botulism toxin, a very potent muscle-paralyzing agent. Injection of small amounts of BOTOX® directly into the muscle will result in a weakening or complete inactivity of the muscle. It may take several days to see the effects and the weakness will usually last 2 to 4 months.

As with any procedure, there are risks associated with the injection of BOTOX®. These reactions can be localized such as pain at the site of injection or bruising. Regional complications also are possible and may take the form of paralysis of muscles beyond those targeted for wrinkle reduction. In the area of the eyebrow, diffusion of BOTOX® may result in weakness of the muscles that elevate the eyelid causing a drooping lid. This is rare, is usually temporary and will resolve in several days. Inadequate or partial paralysis of the targeted muscles may also occur. In this situation, additional injections may be required to achieve the desired effect. Systemic effects of BOTOX® are very uncommon in the extremely low doses used for wrinkle reduction. Allergic reactions to any injected medication may occur but is very uncommon.

The FDA has approved the use of BOTOX® for a multitude of medical applications including spasms of the muscles surrounding the eye. It has not, as of yet, approved BOTOX® for the reduction of wrinkles. This does not mean that it is unsafe of ineffective, but rather that the review of the medication did not encompass its role in wrinkle reduction. It has been used effectively for this application for many years and has a strong record of safety and efficacy.

This treatment is not permanent and will need to be repeated if the results are to be maintained. This may be as frequently as every 2 to 4 months. These additional injections will incur additional costs. The risks of injections will also be present with repeat treatment.

It's an effective treatment if used in the appropriate patient and if limited to those areas in which it has been shown to have good results.

An additional finding with Botox injections has been its ability to reduce, if not totally eliminate the symptoms related to migraine headaches. The effects last only 3-4 months but have been very rewarding in certain patients.