BOTOX® - Still the #1 non-surgical treatment
Most known for reducing crow’s feet, frown lines and wrinkles, BOTOX® is the leading non-surgical cosmetic medical procedure
globally1 and its popularity continues to skyrocket. During 2007, more than 4.5 million BOTOX® treatments were performed in the U.S. alone, according to the American Society of Plastic Surgeons.1
BOTOX® works by relaxing the facial muscles. It is a purified protein produced by the clostridium botulinum bacterium, and has been approved by the FDA since 2002 for treatment of glabellar lines – commonly known as frown lines – between the eyes and above the nose. Many plastic surgeons, dermatologists and other physicians who use BOTOX® employ it for a
wider spectrum of facial lines and wrinkles that includes forehead lines, bunny lines (across the top of the nose), marionette lines (below the corners of the mouth), smile lines and smoker’s lines.
Not only for crow's feet and frown lines
In the hands of an experienced injector, BOTOX® can produce even greater effect by lifting facial features and contouring the face. There is a constant tug of war between the facial muscles that pull up (levators) and those that pull down (depressors). Using BOTOX® to relax the depressor muscles allows the levators to win the contest, producing a gentle lift in the treated facial area.
For decades before its enthusiastic adoption as a cosmetic wonder therapy, BOTOX® was used to treat the medical condition blepharospasm (twitching in the eye area). Medically indicated use has expanded to include headaches, excess sweating and disabling muscle spasms. <
Such use requires much stronger doses than cosmetic applications, and physicians dilute BOTOX® with a saline solution before administering it for cosmetic treatment. By using a dilution technique that enables the BOTOX® to provide more subtle action on the target muscles, an experienced physician can optimize therapy outcomes.
No recovery time required
A BOTOX® cosmetic treatment typically takes just a few minutes of injecting the fluid into the targeted area with a fine-gauge needle and requires virtually no recovery time. Since the needle is so tiny and the procedure so quick, physicians do not usually numb the area being treated. In sensitive areas such as around the lips, however, some physicians may apply local anesthesia just prior to the treatment. Within days, most patients experience noticeable improvement in moderate to severe facial lines.
Combination therapy improves outcomes
As a revolutionary method to improve outcomes, manage costs and maximize effectiveness for their patients, several leading physicians in the U.S. now combine BOTOX® with other cosmetic dermatology procedures such as dermal fillers.
By including BOTOX® in the combination therapy, the reduced muscle movement helps to slow down the dissipation of the dermal filler and lengthen its benefits.
To sustain the effect gained by a BOTOX® treatment, a patient can initially expect to require maintenance treatments every three to five months – depending on the person, the physician technique and the area to be treated. Patients may be able to reduce the amount of BOTOX® needed for each treatment by returning for follow-ups as soon as they see or feel excess movement in the treated area..
Post-marketing reports indicate that the effects of BOTOX® Cosmetic and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, blurred vision, ptosis, dysphagia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults treated for spasticity or other conditions, particularly in those patients who have underlying conditions that would predispose them to these symptoms. In unapproved uses, including spasticity in children and adults, and in approved indications, cases of spread of effect have occurred at doses comparable to those used to treat cervical dystonia and at lower doses.
No definitive serious adverse event reports of distant spread of toxin effect associated with dermatologic use of BOTOX®/BOTOX® Cosmetic at the labeled dose of 20 Units (for glabellar lines) or 100 Units (for severe primary axillary hyperhidrosis) have been reported.
BOTOX® Cosmetic is contraindicated in the presence of infection at the injection site(s) and in individuals with known hypersensitivity to any botulinum toxin preparation or to the components in the formulation. Risks resulting from administration at higher dosages other than those approved by the FDA are unknown. Individuals with pre-existing neuromuscular disorders should only receive BOTOX® Cosmetic with caution. Co-Administration of BOTOX® Cosmetic and aminoglycosides or other agents interfering with neuromuscular transmission should only be performed with caution as the effect of the toxin may be potentiated. BOTOX® is not recommended for use during pregnancy.
For additional information, please refer to the BOTOX® Package Insert and Medication Guide. Consult your physician to determine if BOTOX® is right for you.
(Related topics: Wrinkle Correction - Facial Contouring - Botox® or Dermal Filler - How to Extend Results - Physician Selection Tips - Find a Physician - What are the Risks - Get Answers)
1 Source: American Society of Plastic Surgeons and Allergan, Inc.
BOTOX® is a registered trademark of Allergan, Inc.
Contributing Physicians:
Devinder Mangat, MD, Cincinnati, OH–Vail, CO ~ Peter Malouf, MD, Dallas, TX ~ Margaret Weiss, MD, Baltimore, MD
Francis Palmer, MD, Beverly Hills, CA ~ Terry Perkins, MD, Oxnard, CA ~ Alan Brackup, MD, Philadelphia, PA
Pamela Carr, MD, Houston, TX ~ Gregory Buford, MD, Englewood, CO ~ Kenneth Steinsapir, MD, Los Angeles, CA
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*This web site is designed to educate individuals about dermal filler and botulinum toxin procedure options being used by various physicians in the U.S. and abroad. The information is not intended to be medical advice or endorsement of any particular product or procedure. Consult your physician for medical advice. Companies who manufacture FDA-approved dermal fillers and botulinum toxins typically do not seek FDA approval for use of products in all facial areas or procedures. Other uses are known as off label. Both on-label and off-label uses are presented on this web site, and are widely used by plastic surgeons, dermatologists and other physicians in the U.S. and abroad. The LFLA is an association of experienced dermal filler medical practitioners and is not affiliated with any medical device manufacturer.
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