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WHAT IS BOTOX?
BOTOX Cosmetic is the first and only FDA-approved prescription product that temporarily improves the appearance of both moderate to severe frown lines between the brows and moderate to severe crow’s feet in adults. Unlike a face lift or other kind of invasive facial rejuvenation procedure, BOTOX® Cosmetic takes minutes and requires zero downtime. Using a very fine needle, BOTOX® is injected into the facial muscles that are responsible for unsightly wrinkles and fine lines and relaxes the muscles. The ingredients in Botox block the signal from the nerve to the muscle, and therefore reduce it’s ability to contract, and form unsightly wrinkles.
Botox, or onabotulinumtoxin A, is used for three main purposes: muscle spasm control, severe underarm sweating and cosmetic improvement. In this article we concentrate on the third use, achieved with the product called Botox Cosmetic, which contains botulinum toxin type A (the active ingredient), human albumin (a protein found in human blood plasma) and sodium chloride. Botox Cosmetic is used for the temporary smoothing of glabellar lines (also called frown lines), which are the lines between your eyebrows that can make you look tired, unhappy or angry.
It is FDA-approved for this use and in this area only. However, it is often used off-label for horizontal forehead lines, crow’s feet, marionette lines at the corners of the mouth and smoker’s lines around the lips. Don’t confuse Botox Cosmetic with injectable fillers. Dermal fillers work differently, plumping up tissues so that lines and wrinkles diminish or disappear (Restylane, Radiesse and Juvederm are examples).
Your practitioner can help you decide which product(s) will solve your particular appearance issues, though as a general rule, Botox is used mostly in the upper portion of the face, and fillers are used mostly in other areas.
Botox® Cosmetic has been successfully used to treat severe glabellar (frown) lines and is approved for use in adult patients up to 65 years of age. Also a form of botulinum toxin type A, when Botox® Cosmetic is injected into the muscles surrounding the brow area for instance, those muscles can not “scrunch up” for a period of time. They are paralyzed. So the wrinkles in that area, often referred to as furrows or frown lines, temporarily go away.
The origin of botox
Clostridium botulinum, the organism from which Botox is derived, is found in inactive form in the natural environment, including in the forest and cultivated soils, and in the sediment of lakes, streams, coastal and untreated waters.
The bacterium can also be found in the intestinal tracts of mammals and fish and in the gills and viscera of crabsand other shellfish. Such naturally occurring instances of Clostridium botulinum bacteria and spores are typically relatively harmless. Problems only usually arise when the spores transform into vegetative cells and the cell population increases to the point where the bacteria begin producing botulinum toxin, the deadly neurotoxin responsible for botulism.
Neurotoxins target the nervous system, disrupting the signaling processes that allow neurons to communicate effectively. The neurotoxin involved in producing Botox, botulinum toxin (abbreviated either as BTX or BoNT), is subdivided into eight types A, B, C [C1, C2], D, E, F, G 18 and H.19
Of these, types A, B, E and, in rare cases, type F cause botulism in humans, while types C and D cause illness in other mammals, birds and fish.14 Although type G has been isolated from soil in Argentina, no outbreaks have been identified involving this toxin.
How Botox Injections Work
A wrinkle in the skin is typically formed perpendicular to a contracting muscle located directly beneath it. For example, the muscle in the forehead is a vertical muscle, and when it contracts (such as when you raise your eyebrows), the lines that form (wrinkles) will be horizontal.
Botox is not a dermal filler. Instead, it blocks nerve impulses that cause muscles to contract and cause forehead wrinkles.
Likewise, the two muscles that are responsible for the frown lines are positioned slightly horizontally between the eyebrows, so when they contract, the frown lines appear vertical.Botox Cosmetic is injected into muscles, where it blocks nerve impulses to those tissues. The muscle activity that causes the frown lines is reduced, and a smoother look results. Without a contracting muscle beneath it, the skin has a difficult time wrinkling.
Facial lines that exist when your face is totally relaxed are not very good candidates for Botox. These lines are better handled by the dermal fillers. Botox can frequently “soften” these lines but not always get rid of them.
The injections take about 10 minutes, and you should have no downtime afterward.
Normally you would see improvement within a few days. Botox requires two to four days for it to attach to the nerve ending that would normally stimulate the muscle to contract. The maximum effect usually occurs at about 10-14 days. Therefore, whatever effect is obtained two weeks after the injections should be considered the maximum effect that is going to occur.
How to Know if You Are a Candidate for Botox
In the United States, the FDA has approved Botox Cosmetic for people aged 18 to 65. But you shouldn’t use it if you:
• Are allergic to any ingredients in Botox or Botox Cosmetic.
• Are allergic to another botulinum toxin brand (such as Myobloc, Xeomin or Dysport) or had any side effect from these products in the past.
• Have a skin infection or other condition in the injection area.
• Have ALS (Lou Gehrig’s disease), myasthenia gravis, Lambert-Eaton syndrome or another disease that affects your muscles or nerves.
• Have breathing problems, such as asthma.
• Have difficulty swallowing.
• Have bleeding issues.
• Plan to undergo surgery.
• Have had facial surgery.
• Have weakness in your forehead muscles.
• Have drooping eyelids.
• Are taking or have recently taken certain medications, vitamins or supplements.
Botox Cosmetic is not expected to travel far enough through the body to affect a fetus or breastfeeding infant. However, for ethical reasons, clinical studies have not been done on expectant or new mothers, so nobody knows for sure.
Therefore, the manufacturer (Allergan) advises that you should not have Botox injections if you are planning or trying to conceive a child, are pregnant, are planning to breastfeed or are currently breastfeeding. It’s better to be safe, and you can always have Botox later on.
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[box_title font_size=”28″ font_alignment=”center” border=”double” border_color=”#e1e1e1″ animate=”fadeInLeft”]FREQUENTLY ASKED QUESTIONS[/box_title]
COMMON QUESTIONS ABOUT BOTOX
Here are the most common questions we receive about Botox.
[accordion title=”How is Botox given ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]Botox injections should be given only by a trained medical professional, even when used for cosmetic purposes. Botox is injected into a muscle. A doctor, nurse, or other healthcare provider will give you this injection. Botox injections should be spaced at least 3 months apart. Your Botox injection may be given into more than one area at a time, depending on the condition being treated. While receiving Botox injections for an eye muscle conditions, you may need to use eye drops, ointment, a special contact lens or other device to protect the surface of your eye. Follow your doctor’s instructions.[/accordion]
[accordion title=”Is BOTOX® safe ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]Botox Cosmetic is FDA-approved and injections are relatively safe when performed by an experienced injector. It has proven to be a successful and valuable therapeutic protein when dosage, frequency of treatment and variety of treated clinical conditions are considered. The best way to ensure you receive the results you are looking for is to only receive injections from a highly experienced provider, such as the medical and nursing professionals at Ideal Image.[/accordion]
[accordion title=”When will I see results ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]You may begin to notice results within 24 to 48 hours with the maximum effect visible at 30 days. Results may vary.[/accordion]
[accordion title=”How long does BOTOX® last ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]The effects of BOTOX® can last anywhere from 3-6 months. Many factors can influence how long the effects last. As the product wears off, muscle action returns gradually, and the previously treated lines & wrinkles may begin to reappear, and need to be treated again. With repeated treatment, the lines and wrinkles often appear less severe than before, as the muscles are being trained to relax.
Some of these factors that may shorten or lengthen the effects include:
• Your age
• The condition of your skin and level of sun damage
• Your facial structure and expressions
• Your diet
• Whether or not you smoke
• Past experience with BOTOX® or other wrinkle relaxers [/accordion]
[accordion title=”Who should not receive BOTOX® injections ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]While most people aged 18 to 65 are excellent candidates for BOTOX® and wrinkle relaxers, you should not use BOTOX® if you meet any of the following:
• Are pregnant or breastfeeding
• Have a skin infection or other condition in the area to be treated
• Are allergic to any ingredients in BOTOX®, DYSPORT®, or any other botulinum toxin brand
• Have had facial surgery
• Have difficulty swallowing
• Have weakness in your forehead muscles
• And more…
If you have any concerns as to whether or not you may be a good candidate, one of our consultants will be happy to answer any questions you may have. With any medical procedures, it is best to discuss the procedure with your doctor before starting treatment.[/accordion]
[accordion title=”Are Botox injections Painful ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]Any injection can hurt, but the needles used for Botox injections are very small, so pain is usually minimal. The area can be numbed with a topical anesthetic cream or cold pack 10-20 minutes before the injections are given, so you may not feel much pain, if any. You may feel a little discomfort later, once the anesthetic cream has worn off. Other side effects are listed below.[/accordion]
[accordion title=”How long does a Dermaplaning treatment take to perform ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]A Typical Dermaplaning treatment is 30 – 40 minutes long.[/accordion]
[accordion title=”How Often Should You Get Botox Injections ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]You’re probably wondering how long Botox lasts. Most people see effects for three to four months, but several factors may shorten or lengthen that period:
• Your age. Older people with less muscle tone may see results diminish sooner than those with younger, firmer facial muscles.
• Your facial structure and expressions.
• Whether you smoke.
• Your diet.
• Whether you take good care of your skin; use facials, microdermabrasion or other resurfacing methods.
• How much sun you get and how much sun damage your skin already has.
• Whether you use Botox repeatedly or not. However, this seems to differ from one person to another. Some obtain a longer-lasting effect with repeated use, while others seem to develop a resistance to the drug and need more frequent treatments.
Doctors disagree on which of the above factors are the most important; it’s a good question to ask your practitioner. In any case, it is not recommended to have injections in the same injection site (such as for crow’s feet) more frequently than every three months. As with the injection of any medication, your body’s immune system can develop antibodies to the medication, which render the drug less effective or possibly cause development of an allergy to the drug. The more frequently the drug is injected or the more quantity that is injected, the higher the risk for these antibodies to be formed against the drug. [/accordion]
[accordion title=”What can I expect during the procedure ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]Before the procedure
Although most people tolerate the injection discomfort well, you may want your skin to be numb beforehand. Several options are available, including:
• Injections. Your doctor can inject a numbing medication into your skin.
• Cream. A prescription cream can be applied 60 to 90 minutes before the procedure.
• Cold spray. A blast of very cold air is directed at the skin for about 10 seconds. The numbness only lasts a few seconds.
During the procedure
Your doctor uses a thin needle to inject tiny amounts of botulism toxin into your skin or muscles. The number of injections needed depends on many factors, including the extent of the area being treated. Botox injections are usually done in a doctor’s office.
After the procedure
Expect to resume your normal daily activities right after the procedure. Take care, though, not to rub or massage the treated areas. This can cause the toxin to migrate to a different area.[/accordion]
[accordion title=”What happens if I miss a dose ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]Since Botox has a temporary effect and is given at widely spaced intervals, missing a dose is not likely to be harmful.[/accordion]
[accordion title=”What happens if I overdose ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may not appear right away, but can include muscle weakness, trouble swallowing, and weak or shallow breathing.[/accordion]
[accordion title=”What are the side effects of BOTOX ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]Potential Botox side effects include pain at the injection site, infection, inflammation, swelling, redness, bleeding and bruising. Some of these symptoms may indicate an allergic reaction; other allergy symptoms are itching, wheezing, asthma, a rash, red welts, dizziness and faintness. Tell your doctor immediately if you have any breathing issues or a faint or dizzy feeling.
Don’t get injections at a “Botox party” at somebody’s house. A medical setting is safer, and any side effects can be treated immediately. Also, dry mouth, fatigue, headache and neck pain have been reported.
You may have heard of other side effects as well, such as numbness, droopy eyelids, muscle spasms or twitching, and migration of the substance.
Numbness as an absence of physical sensation is not really an issue with Botox, because Botox is not an anesthetic. Numbness as the result of the inability to move a muscle is an issue for some people.
Muscle spasms in the area of the Botox injections do not occur while the Botox is effective. After all, Botox is used to treat spasms related to benign essential blepharospasm, hemifacial spasm, cerebral palsy, fibromyalgia and temporomandibular joint disorder.
It is possible for the Botox to spread a little beyond the intended injection site and affect surrounding tissues. For example, if you receive injections into the forehead close to your eyebrows or your upper eyelids, they could be affected and may droop temporarily.
[accordion title=”What does it cost ?” opened=”0″ class_icon_closed=”plus” class_icon_opened=”minus” border=”true”]The cost of Botox Cosmetic injections varies from one place to another and from one practitioner to another, so you’ll need to ask your practitioner what he or she charges.
Some practitioners charge by the number of units injected. One vial of Botox Cosmetic contains 100 units. Advertised specials of $6-$7 per unit are not uncommon, while some practitioners may charge up to $10-$12 per unit.
Some practices charge by the “zone.” For example, the frown lines would be one zone, the crow’s feet another zone and the forehead yet another zone.
Prices per zone may vary between $250 and $350, depending on the practitioner and/or the region of the country.[/accordion]
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