WHAT IS BOTOX?

Botox is a new concept in treating facial wrinkles in the forehead, between the eyes, and in
the "crows feet" areas (upper third of the face). Botulinum toxin, or Botox works by
weakening the muscles of facial expressions. Once the resting tone of the treated muscles
are weakened, the pull of the muscles relaxes and the overlying skin flattens. This approach
is different than the other local treatments for the aging face. Silicone, Collagen,
Autologous Fat Transfer, Alloderm, Softform, etc. all work by filling in wrinkles or
depressions. These fillers are frequently not as effective as Botox in treating wrinkles in the
upper third of the face. By physiologically weakening the muscles, wrinkles are lessened
naturally.

HOW LONG DOES IT LAST?

Injection of this material into the small muscles between the brows, in the forehead, and at
the corners of the eyes causes those specific muscles to halt their function (be paralyzed),
thereby improving the appearance of the wrinkles. This paralysis is temporary, and reinjection
is necessary within three to ten months. Options for alternative treatments include
injection of either collagen or free fat, or the surgical excision of the muscles, usually
through a brow lift.

HOW IS IT USED?

Botox is freshly prepared on the day of injection. Once prepared, the medication needs to
be used within 12 hours, as the potency diminishes with time. Because of the short shelf life
and the cost, Botox is not available every day in our office. In order for the treatment to be
cost effective, more than one patient must be treated on the same day. Using a very tiny
needle, small amounts of Botox are injected into the muscles to be paralyzed. Depending on
the areas being treated, 5-15 needle pricks (or more) may be required. Discomfort is
minimal and lasts only a few seconds.

SIDE EFFECTS

Occasionally, the needle may puncture a small blood vessel during the injection and a black
and blue area may develop. Such an area can last 5-10 days and may require make-up to
cover.
If any of the Botulinum toxin reaches a facial muscle not being treated, partial weakness of
that muscle may last for several months. (For this reason, you are requested not to massage
the injected areas for 12 hours following the injection.) If an untreated area experiences
muscle weakness, the only "treatment" is to wait for the effect of the toxin to wear off in
several months.
There are no recognized permanent side effects of Botox. Complications are rare but may
include paralysis of a nearby muscle, resulting in its temporary loss of function (e.g., a
drooping eyelid). Botox has been used safely in the treatment of muscular facial spasms for
approximately 15 years.

BOTOX IN COMBINATION WITH FACIAL SURGERY

Botox injected in conjunction with nearby facial surgery has caused unwanted facial
weakness in at least one patient. For this reason, we will inject Botox only as an isolated
facial procedure or treatment.

NOTES

The specific risks and the suitability of this procedure for a given individual can be
determined only at the time of consultation. All procedures have some degree of risk.
Minor complications that do not affect the outcome occur occasionally. Major
complications are rare.