What is Botox?

      Everyone has heard about Botox, a drug derived from a certain bacteria that has the effect of decreasing the nerve stimulation of a muscle.  It’s one of the most popular cosmetic procedures done today.  The reasons for this are simple: in the right people it works great, and secondly, it’s extremely safe.


Where is Botox used?

      Botox is most frequently used for wrinkles due to muscle motion between the eyebrows, as well as for excessive crow’s feet wrinkles.  Between the eyebrows, the “11” shaped, vertical lines make people look angry, too serious, unfriendly, or unhappy.  Treating this area goes a long way to make people look relaxed, happy, and approachable, (not to mention younger). Studies have shown that patients actually feel better simply by reducing the appearance of these wrinkles.

      Another very popular location for Botox is the “crows feet” wrinkles at the sides of the eyes.  It’s worth being somewhat conservative here since these wrinkles are associated with smiling and laughing.  Reducing, but not eliminating, these lines is a good goal here.

      Forehead lines are also easy to treat and work well.  Having excessive wrinkles across the forehead makes one look worried, or overly concerned. Again, I don’t think it’s a good idea to completely freeze the muscles just under the forehead, since they do contribute to natural facial expressions.

      Using Botox for the lower face is less frequently done than on the upper face.  Using very low doses around the lips can decrease the lip wrinkles and give lips a fuller look. Fillers are also used here.  There is a very small risk of Botox causing some temporary mouth assymetry which could be quite annoying for a couple of weeks to a couple of months.

      In addition to these areas, it seems just about every other muscle in the body has been injected with Botox to try to treat any number of problems.  The serious complications due to the use of Botox are almost always in patients who have medical conditions such as cerebral palsy where large doses are used to relax larger muscles such as those in the neck. 

      Botox for excessive underarm or palm sweating is excellent. It takes a fair amount of Botox in these areas, but the benefits can last up to a year.  Of course, using a topical medicine, like DrySol  for this is the first line of treatment.


Is Botox safe?

     As an example of the safety of Botox, one study used different doses of Botox to try to treat women with overactive bladder. While in treating the area around the eyes you might use a total of about 25 to 40 units of Botox, the women in the overactive bladder study were tested with as much as 1,400 units of Botox!  The fact that they weren’t harmed by these high doses shows how great the safety margin of Botox is.  It seems to me that, since 1,400 units of Botox would cost about $7,000, this use isn’t really pracitcal.
      Another reason why Botox is so safe is that it eventually wears off.  So if you don’t like the effect, the changes will always reverse.


How long does Botox last?

      Usually treatments are done at least 3 to 5 months apart, when it starts to wear off. Some patients come back  at 3 months to get another injection, before it wears off, while others prefer to wait 4 to 6 months and come in after it wears off. 
      People who are the best candidates for Botox are those with wrinkles that are mainly due to muscle action, as opposed to those whose wrinkles are more permanent.   If you have creases in the skin that don’t easily reduce with separating the skin on each side of the wrinkle, then using one of the many fillers is a better choice. 


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