Articles

ASK THE DOCTOR

Dr. Lincenberg answers common questions about Botox

What exactly is Botox?

Botox is Botulinum toxin, type A, derived from the bacterium, Clostridium botulinum. It is a natural substance, a neurotoxin, which is often used to treat conditions associated with hyperactive muscle activity. Prior to its discovery, an infection with the Clostridium bacteria could prove fatal. Many deaths occurred from these infections because the bacteria would make huge amounts of the neurotoxin and release them into the bloodstream of the victim. The victim became paralyzed and could not breathe.

Office Phone

(770) 730-8222

Suggest A Topic

If you would like to suggest a topic or ask a question about a particular topic, please feel free to email us at info@gaplasticsurg.com

Originally, the neurotoxin was a greatly feared substance, until it was purified. Scientists began to study the way that it works and now we are able to make it work for us. It serves as a therapeutic muscle-relaxing agent. In the amounts used as a medicine, it can only relax very small muscles. Several years ago it began to be used to treat the muscles that create facial skin wrinkle lines. By relaxing the muscle under the wrinkle line, the skin is not repeatedly squeezed and the wrinkle eventually smoothes out.

What areas of the face can be treated with Botox?

Botox can potentially be used in every muscle group. It is most commonly used to minimize or eliminate the furrows between the eyebrows and "crows feet" around the eyes. I have also used it to treat forehead lines, bands of muscle that pop out in the neck, and puckering of the skin on the chin. It also has been used for the fine lines on the lips.

Is it true that Botox can relieve headaches?

Yes, although this usage is still under investigation, two multi-center studies have shown that some migraine headache sufferers receive dramatic relief by using Botox in the same manner that it is used to reduce wrinkles. It may be that the relaxation of the muscles helps to break a vicious cycle between the stressful situation, the tension in the forehead muscles and the beginning of the headache pain.

Botox is also being investigated for use on tremors, excessive perspiration, and other disorders.

How is it administered, how often and what are the instructions for patients for before and after Botox?

Botox is injected in precise locations and using exact amounts into the appropriate muscles, to attain the desired effect. The effect develops over the next 24 to 48 hours. To be sure that the medication is placed just right, the doctor should examine you about one or two weeks following treatment. The results will last on an average of 3 months, although a few patients get 4 months per dose. As the medicine wears off new injections can be given. It is recommended to give a booster dose just before the effect wears off. By administering more Botox before it wears off we hope that the paralysis of the muscle will eventually be a permanent state.

Are there any complications with Botox?

Some of the side effects noted after injection can include discomfort at the injection site, bruising or drooping of the eyelid, and eye irritation. These side effects are usually mild and temporary.

Why is Botox temporary?

Just as with any medication, the effect wears off as your body metabolizes the medicine. Most medicines are taken once or twice a day. Fortunately, Botox lasts for 60 to 120 days.

Could I become immune to Botox?

It is possible to become resistant to Botox, that is, the medicine would become ineffective when it is used on you. This lack of response has been seen in patients with neuromuscular disorders that have required large amounts of Botox for a prolonged period of time. A second generation Botox is currently being developed for these rare patients.

What is the cost of Botox?

Botox is quite expensive. Treatment of the average facial area ranges from $300 to $500. This averages out to about $4 per day. On a daily basis comparison, it is comparable with many common medicines.

Which other procedures can Botox be used with?

Botox can be used in conjunction with facelift, blepharoplasty (eyelid surgery), brow lift, laser resurfacing, and chemical peels. It can help to maintain the results of these procedures for a longer period of time.

Are there any contraindications?

Contraindications to Botox include pregnancy, nursing, certain medications and certain neurological diseases.

Can Botox put off the need for a facelift?

Facelift procedures are used to reposition the facial tissues into a more youthful shape. They do not do much to smooth the fine wrinkles in the skin. Neither do they address the cause of the folds when they are the result of hyperactivity of underlying muscle. If the main concern is hyperfunctional facial lines, Botox could prolong the need for a facelift.

Sheldon M. Lincenberg, MD, FACS, is a Mayo Clinic trained, board certified Plastic and Reconstructive Surgeon practicing in Atlanta, Georgia.