What is Botox®?

Botox® has become the most popular and fastest growing non-surgical procedure in the nation. Botox® is the brand name of a purified formulation of botulinum toxin type A, just one of seven different types of toxins derived from the bacterium Clostridum botulinum. This formulation blocks the release of acetylcholine and relaxes muscles, which successfully treats conditions caused by overactive muscles for more than ten years. More recently, Botox® has been used to treat facial wrinkles due to overactive muscles in Boston and Worcester, Massachusetts.

Am I a good candidate for Botox®?

Almost everyone with “dynamic rhytids”, or facial lines due to overworked muscles is considered a good candidate. Botox® works especially well with “frown lines”, forehead lines, and “crow’s feet.” Although there is no evidence that clinical doses of botulinum toxin type A have any effect on the unborn baby, BOTOX® should be avoided if you are pregnant. It should also be avoided in patients with neuromuscular disorders.

How long do results last?

The effect of Botox® typically takes three to seven days to develop and lasts three to six months.

What can I do to prepare?

Avoiding Aspirin and NSAIDs, such as ibuprofen, for ten days prior to your treatment will decrease the risk of bruising. Topical vitamin K preparations may be helpful after treatment.

What are the risks?

In general the risks are few, and include:

  • Ptosis: drooping of the eyelid is the most significant complication. It is usually seen within one to two days and lasts only one to two weeks. This has been rare in our practice but if this happens, you should contact our office for eye drops that may help minimize this condition.
  • People that receive large doses (100 units or more) for neurological conditions may develop neutralizing antibodies that lead to a lack of response. Spacing injection sessions at least one month apart and keeping volumes low can avoid this. It is uncommon with cosmetic users, and we typically use 50 units or less given four months apart.
  • Injection pain is usually mild. It can be decreased by using small needles, small syringes, and ice packs, as we do in our office.
  • Some patients may develop localized reactions such as hives, redness, or minor swelling, which can easily be treated with icepacks, antihistamines, and hydrocortisone cream. There have been sporadic reports of temporary headaches. More commonly, chronic tension headaches are improved after the injection and some studies now suggest that Botox® is actually helpful in the treatment of certain types of migraines.
  • Flu-like symptoms

What should I expect during recovery?

Dr. Hall has not found it necessary for patients to stay upright for several hours after the injections, and there has been no proven enhancement of effect when patients are instructed to use the (injected) muscles for one hour after the procedure. Most patients can resume their normal routine immediately after treatment.