Watch Dr. Stewart explain and perform the Botox procedure

How does botulinum toxin work?

botox-cosmeticBotulinum toxins is a neurotoxin produced by Clostridium botulinum. There are different commercially available products under the name of Botox, Dysport, or Xeomin. Cosmetically, it is used to induce temporary and reversible paralysis of target facial muscles to reduce dynamic wrinkles (caused by facial movement – i.e. frown lines, crow’s feet, forehead lines, bunny lines, smoker’s lines, etc.). The procedure is performed by injecting small amounts of the toxin directly into specific muscles. Therefore it is very important to have someone qualified and knowledgeable in facial anatomy to perform the procedure. Botulinum toxin can also be used in facial re-contouring as in lifting eyebrows, decreasing hypertrophic masseters, or treating hyperhidrosis of the hands or armpits.

When will I see results and how long does it last?

The initial effects of botulinum toxin appear 24-72 hours after injection with a maximum effect occurring at around 1-2 weeks. Temporary muscle paralysis lasts anywhere from 3-6 months, therefore injections must be repeated every 3-6 months to maintain results. If botulinum toxin is used for the treatment of hyperhidrosis, the effects usually last 6-9 months.

Who should not receive botulinum toxin?

Botulinum toxin is contraindicated in patients with the following conditions:

  • Known allergy to the ingredients
  • Neuromuscular diseases as myasthenia gravis, Eaton-Lambert, Bell’s palsy, or neuropathy
  • Taking medications as calcium channel blockers, penicillamine, aminoglycosides, anticholinesterase inhibitors, quinine
  • Pregnancy or breast feeding

What are some possible complications?

  • Bleeding and bruising , temporary redness and swelling, or infection
  • Rare diffusion to other sites resulting in temporary eyelid droop (1-2% of patients and lasts 1-2 weeks), facial droop, lip droop, swallowing or breathing difficulties depending on sites of injection
  • Systemic symptoms of muscle weakness all over the body, spasticity, double or blurred vision, speech difficulty, or loss of bladder control with systemic toxin spread are possible. However, there have NOT been any confirmed serious cases of toxin spread when used for cosmetic purposes.

Pre-Treatment Instructions

  • Discontinue any unnecessary blood thinners, unless medically indicated, as aspirin 1 week prior and ibuprofen/naproxen 5 days before the scheduled procedure to reduce risk of bleeding.
  • Supplements (i.e. vitamin E, ginkgo biloba, St. John’s wort, garlic, ginseng, fish oil) can increase bleeding. It is recommended that you stop your supplements 1 week prior.
  • Have a clean face the day of the procedure.

Post-Treatment Instructions

  • Do not lie down or perform physical activity 4 hours after the procedure.
  • Every person responds differently, therefore follow-up in 2 weeks is recommended for further evaluation and “touch-up” if needed.