About BOTOX® Cosmetic

Botulinum Toxin is a purified toxin, used since 1980, that paralyzes all striated muscles exposed to it. Injecting very small amounts of this into a specific facial muscle blocks the targeted impulse of that muscle which cause a local relaxation and weakness. Originally minute quantities of Botulinum Toxin were used in humans to weaken eye muscles in the treatment of strabismus. This treatment is an alternative to surgery. In the late 1980's Botulinum Toxin therapy, also known as BOTOX® Cosmetic therapy, was used for frown lines, and other facial lines including brow lines, crows feet, and banding in the neck.

BOTOX® Cosmetic injections can also alleviate excessive sweating because the toxin paralyzes the sweat glands of the skin. This is effective on the underarm, palms of the hands, and soles of the hand or foot. Occasionally it may be used at the scalp line. These injections provide patients with months of relief and can be repeated indefinitely once or twice a year to maintain dryness.

before BOTOX® treatment	after BOTOX® treatment
before BOTOX® treatment	after BOTOX® treatment

Uses of BOTOX® Cosmetic

BOTOX® Cosmetic is used for treating glabella lines. These are vertical frown lines that are largely the result of over-activity of the corrugated muscles, with other muscles around the eye also contributing. The function of the these muscles is to draw the eyebrows together as an expression of emotion. BOTOX® Cosmetic treatments are commonly used for squint lines or crows feet at the corners of the eyes and brow lines. BOTOX® causes muscles to relax and weaken so that they can't contract. The lines gradually smooth out from disuse and also new wrinkles are prevented from developing. Keep in mind that the muscle action on smile lines around the mouth needed for expression and actions such as eating, may not be treated as effective with BOTOX® Cosmetic treatments.

Side Effects of BOTOX® Cosmetic Treatment

The dosage of BOTOX® Cosmetic treatment used is far below the toxic dose of the Botulinum toxin. There have been no reports of allergic or urticarial reactions. transient bruising has occasionally occurred in the injection site, or brief pain or headache has followed after the injection. Drooping of the eye lid (transient eyelid ptosis) is the most significant complication of injection in the glabella area, and occurs in 1 to 2 percent of patients. When it occurs, the drooping has been minimal and short lived, lasting from two to 12 weeks.

Contraindications

BOTOX® Cosmetic injections should not be performed on women who are breast-feeding, or have a pre-existing neuromuscular condition (myasthenia gravis), or have allergic reactions to Botulinum toxin or human albumin, or if being treated with an antibiotic known as aminoglycosides.

Before & After Therapy

BOTOX® Cosmetic therapy involves BOTOX® Cosmetic injections of very small amounts into the underlying muscles. The treatment takes about three to seven days to take effect and lasts about three to four months. After therapy, patients are asked not to handle the area of treatment, and to stay upright for four hours to prevent the Botox® Cosmetic from spreading to other near-by muscle groups. The toxin seems to have an affinity to bind to actively contracting muscles, so it is recommended that patients exercise their frown line muscles immediately after injection, and for a subsequent few hours. Muscle weakening begins 24 to 48 hours after injection and peaks at one week. Treatments are generally repeated at three to eight month intervals, as muscle function returns. However muscle weakness can last up to 12 months before re-injection becomes necessary.

Details of Treatment

Pre-Treatment:

• No preparation is required.

Anesthesia:

• No anesthesia is required.

Treatment:

• BOTOX® Cosmetic injections are administered using fine needles directly into the muscles under the skin of the affected area.

Post Treatment:

• Immediately after BOTOX® Cosmetic treatment some swelling may occur in the treated area. This swelling lasts approximately two to three hours. Occasionally bruising occurs. We request that patients do not lie down after treatment for more than four hours, since the muscles that were treated have to be constantly contracted.

Complications:

• The only major complication with BOTOX® Cosmetic treatment is a temporary drooping of an eyelid that does not last long. This complication occurs very rare.