With the near-ubiquitous use of Botox® these days, shouldn’t everybody know everything about it by now? Well, no. I have been using the product since 1996, when hardly anyone had heard of it. Now it is a household word, similar to the word “Kleenex®” being used to describe any facial tissue, even though Kleenex is a brand name. Currently, there are two “Botox-like” FDA-approved products available in the US market: Botox and Dysport®. Like Kleenex, the word Botox is often used to refer to either. Because of the internet, many patients come into my office with a wide range of misconceptions about Botox. Hopefully this article will help you decide if Botox is right for you. It is by no means comprehensive, and I could easily go on for another 5 pages, but I only intend to shed light on common questions I hear in my practice.
Botox is the brand name given to a purified but dilute form of a protein derived from the bacteria Clostridium botulinum. It is made by Allergan, Inc. (Irvine, CA). It paralyzes muscles by temporarily blocking the release of signals from nerve endings. As a result, Botox reduces the appearance of wrinkles that are caused by muscular movements.
Dysport is the brand name that competes with Botox. It is made by Medicis (Scottsdale, AZ). Chemically, Dysport and Botox are nearly identical, and act the same way to block the transmission of nerve signals to muscle. Dysport is just a different subtype of protein also derived from the C. botulinum bacteria.
Botox is certainly not new. Research began in the 1960’s. It has been used since the 1970’s for the treatment of various medical conditions. Doctors noted then that a pleasant side effect of Botox was that it improved the appearance of wrinkles. However, Botox did not receive FDA approval for the cosmetic treatment of wrinkles until April 2002. It was then approved in 2010 for treatment of chronic migraine headaches.
Botox is most effective for crow’s feet, frown lines between the eyebrows, and forehead wrinkles. Injections into other areas often have disappointing results.
Usually 3 to 6 months, depending on the patient.
Of course! Botox only affects the muscles immediately surrounding the injection, not the entire face.
No long-term adverse effects have been noted thus far. However, we do not recommend Botox for women who are pregnant or who intend to become pregnant within 6 months.
Botox must be mixed with saline and then used in a short time period. Accordingly, physicians often schedule Botox patients in groups. This led to the birth of “Botox parties,” where physicians administer Botox to a group of patients in an informal setting outside of the office.
Physicians most commonly inject Botox. Nurses and physician assistants may administer the drug under the direct supervision of a physician. Just be cautious of whom you choose to give the injection. Find someone with proper experience and training. There are many practitioners who offer this only as a way to supplement their income, but who do not have the detailed knowledge of facial anatomy and physiology. Your face is your identity.
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