The tremendous popularity of the facial wrinkle treatment, Botox, is simply due to its effectiveness. It consistently achieves good results, has few complications, is simple to perform, has no recovery, and patient satisfaction is quite high. However, many misconceptions exist as to how it works, what facial problems it is good for, and when, where, and whom should perform it.
Here are some basic concepts about Botox:
– The majority of its use is in the forehead and crow’s feet areas. While there are
some limited uses around the mouth and neck, weakening of the muscles between
the eyebrows, in the forehead, and at the sides of the eyes produces the desired
effect of less frowning, a more relaxed forehead, and less lines around the eyes.
– The effects of Botox are not instantaneous. As a general rule, it takes one week
for it to ‘kick in’. What you see at 2 weeks after injections is what it is, touch-ups
of Botox treatments should wait until after this time.
– The pain of injections can be decreased by applying small dots of numbing cream
(e.g., EMLA cream, 4% LMX) to the sites of injection. They should be applied
about 15 minutes before the treatment. Most injectors never perform this simple
step to reduce our discomfort. Ask for it!
– Find the least effective dose of Botox that produces the desired result. (Minimum
Effective Dose) More Botox than necessary does not make it work better or any
Longer. Since Botox is administered in units, make note of the number of units
given each time so you can figure eventually figure out how little you need to
create the effect that you desire.
– The effectiveness of Botox can be affected by how it is reconstituted (mixed) and
how old it is. (when was it mixed) The most consistent results are achieved when
your doctor mixed it according to the manufacturers recommendation (2.5ml of
saline per vial) and it is used within one week after it has been prepared. Old
Botox or diluted mixtures can be a waste of your money and injection pain.
Finding this out, however, can be difficult for a patient. If you are not getting
good results from one doctor, find another provider.
– The results of Botox lasts about 4 months. Repeat treatments does not build up
tolerance or immunity to Botox. Repeat treatments does not make it last longer or
shorter. To the best of current knowledge, Botox can be given over a lifetime
without a change in its effectiveness or duration of action.
– Botox is remarkably safe. There has never been a reported allergic reaction to its
injection for cosmetic purposes.
Dr Barry Eppley
Indianapolis, Indiana