| Dr. Greg S. Morganroth is a member of the American Academy of Dermatology. Here the doctor has answered some of the common questions Bizymoms visitors have about Cosmetic Dermatology.
Q. How does Botox work?
A. BOTOX® Cosmetic injections temporarily block nerve impulses to the facial mimetic muscles (muscles of expression). Unable to receive a signal from the nerves, the muscles relax and do not contract to form wrinkles. The end result is selective elimination or reduction of facial wrinkles to create a more relaxed and youthful appearance. Over a period of three to four months, the muscles regain the ability to respond to the nerve impulses and begin to contract and reform wrinkles.
Q. For which parts of the body can Botox be used?
A. BOTOX® Cosmetic is FDA-approved since 2002 for the reduction of frown line wrinkles (glabellar lines). It is also commonly used in the upper portion of the face to reduce forehead lines and crow’s feet. Other applications include lifting the brow, reducing a "gummy" smile, reducing the bumpy appearance of the chin, elevating the corners of the mouth, reducing lip lines, and temporary reduction of sweating of the palms, feet, and underarms. Botox is also used by other specialists to treat migraine headaches, chronic pain, muscle spasms, jaw pain, anal fissures, uncontrolled blinking, lazy eye, muscle spasm conditions, and genito-urinary problems. Many more applications are being discovered in research centers around the world.
Q. What issues can be successfully treated with Botox?
A. The most common uses of BOTOX® Cosmetic in my cosmetic dermatology practice are the reduction of muscle-induced wrinkles of the face. Most patients treat the frown lines (between the eyebrows), crow’s feet (corner of the eyes), and horizontal forehead lines. Another common use is to lift the eyebrow ("Botox Browlift"). Lines related to sun damage (diffuse skin wrinkling) or gravity (nasolabial folds) will not respond to BOTOX® Cosmetic and are typically treated with laser resurfacing or wrinkle fillers.
Q. When are the results visible after Botox?
A. BOTOX® Cosmetic injections can be a "lunchtime" procedure and take only a few minutes. No anesthesia is necessary, however many patients use ice packs to minimize the needle prick sensation. It is injected with a fine needle into specific muscles with only minor discomfort. It generally takes three to seven days to take full effect. You will be able to resume most normal activities immediately, however it is recommended that you do not lie down for several hours after the procedure, refrain from massaging the treated area, and do not participate in strenuous activity for 24 hours.
Q. How effective is Botox and how long do the effects of Botox treatment last?
A. BOTOX® Cosmetic is highly effective and it is rare to have a patient who doesn’t respond. The effects from Botox will last typically from three to four months although some patients can see results for up to six months. As muscle activity gradually returns as the effect wears off, the lines and wrinkles begin to re-appear. The lines and wrinkles often appear less severe over time because the muscles are being trained to relax with repetitive treatments. Patients who initially use BOTOX® Cosmetic on a regular basis (three to four times/year) find that they can extend treatments to longer intervals of 6 months. Most important is that chronic suppression of muscle movement will prevent wrinkles from forming or will prevent existing wrinkles from worsening.
Q. Are there any side effects of using Botox?
A. Temporary bruising is the most common side effect of BOTOX® Cosmetic. Bruising can be reduced by avoiding alcohol at least one week before treatment and stopping aspirin and anti-inflammatory medications two weeks before treatment. Headaches that last 24-48 hours can occur, but are rare. A small percentage of patients may develop eyelid drooping from injections in the frown line area. This usually resolves in three weeks. This usually happens when BOTOX® Cosmetic moves around and avoidance is maximized by not rubbing the treated area for 12 hours after injection or laying down for three to four hours after treatment. Patients who are not good candidates for BOTOX® Cosmetic include pregnant women, nursing mothers, patients with neurological diseases, those who are allergic to Botulinum Toxin Type A, those with a history of botulism poisoning, and patients taking other medications that may increase the risk of bruising and bleeding.
BOTOX® Cosmetic injections may be obtained at a variety of different medical settings. To ensure that you get the best results, ensure that your treatments are provided by a physician or physician-supervised practitioner. It is important to appreciate that no two physicians will give the same result, so be selective about who you choose to be your provider.
Q. What are the drawbacks of Botox treatment?
A. BOTOX® Cosmetic has been used for years around the world with millions of satisfied patients. The most common side effect is bruising which is temporary and typically can be covered with make-up. The other side effects are rare. Treatments cost hundreds of dollars ($300-900) depending on the number of areas) and need to be repeated two to four times per year to maintain the results. Although costly, BOTOX® Cosmetic and its new competitor Dysport are the only options for the reduction or elimination of muscle-induced wrinkles of the face. For many, it is a necessary expense.
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