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What is Botox?

Botox® is the trade name for Botulinum Toxin, a neurotoxin in the form of a purified protein. The mechanism of action for Botulinum Toxin (Botox) is really quite simple; it is injected into facial muscles but really doesn’t affect the muscle at all. Botulinum Toxin (Botox) works by blocking the transmitters between the motor nerves that innervate the muscle.
The areas typically treated with Botulinum Toxin (Botox) for wrinkles are the forehead, between the eyes (glabellar region), around the corners of the eyes (crow’s feet) and around the lips (smokers lines or gummy smile). There is no loss of sensory feeling in the muscles. Once the motor nerve endings are interrupted, the muscle cannot contract, causing wrinkles in the skin to smooth. The effects of Botulinum Toxin (Botox) last approximately three to four months, at which time the patient will require retreatment.
Botulinum Toxin (Botox) has important clinical uses as an adjunct in facial pain and bruxism cases for patients with chronic TMJ and orofacial pain. Botulinum Toxin (Botox) is also used to complement esthetic dentistry as a minimally invasive alternative to surgery.

Procedures

Botulinum Toxin (Botox) is used esthetically to decrease the appearance of aging by reducing muscle movement. Areas of treatment include; the glabellar area (the 11's/frown lines between the eyes), frontalis muscles (forehead lines), crow’s feet, chin dimples, radial lip lines (smoker’s lines) and nose lines. Botulinum Toxin can also be used to reduce the muscle mass in the masseters (jaw line) for a slimming facial esthetic result.
Receiving Botulinum Toxin takes only a few minutes and there’s no need for anesthesia or down time. The injections are made using a very fine needle and are virtually painless.
Generally, results are visible within two to ten days. To reduce the possibility of bruising/swelling, it is recommended to avoid alcohol for at least 24 hours and aspirin/anti-inflammatory medications for a period of two weeks prior to the procedure. As always, consult your physician before stopping any medications.
The most common side effects of Botulinum Toxin injections are bruising, redness, and swelling. Other, rare side effects are possible and will be reviewed by the treating physician. To avoid adverse reactions/results, do not manipulate the treated area for 2 hours after injections and maintain an upright position.
The esthetic effects of Botulinum Toxin typically last three to four months. As the treated muscles regain movement, lines and wrinkles will begin to reappear and require retreatment. Over time, these lines and wrinkles should appear less noticeable due to training the treated muscles to relax.

Pre-treatment Instructions

In an ideal situation it is prudent to follow some simple guidelines before treatment that can make all the difference between a fair result or great result, by reducing some possible side effects associated with the injections.  We realize this is not always possible; however, minimizing these risks is always desirable.  
  • Patient must be in good health with no active skin infections in the areas to be treated
  • Patient should not be needle phobic
  • Avoid alcoholic beverages at least 24 hours prior to treatment Alcohol may thin the blood which will increase the risk of bruising.  
  • Avoid anti-inflammatory / blood thinning medications ideally, for a period of two (2) weeks before treatment.  Medications and supplements such as Aspirin, Vitamin E, Gingo Biloba, St. John’s Wort, Ibuprofen, Motrin, Advil, Aleve, Vioxx, and other NSAIDS are all blood thinning and can increase the risk of bruising/swelling after injections.
  • Schedule Botox® appointment at least 2 weeks prior to a special event which may be occurring, i.e., wedding, vacation, etc. etc.  It is not desirable to have a very special event occurring and be bruised from an injection which could have been avoided.  

Post-treatment Instructions

The guidelines to follow post treatment have been followed for years, and are still employed today to prevent the possible side effect of ptosis (drooping of the eyelids).  These measures should minimize the possibility of ptosis.
  • No straining, heavy lifting, vigorous exercise for 3-4 hours following treatment. It is now known that it takes the toxin approximately 2 hours to bind itself to the nerve to start its work, and because we do not want to increase circulation to that area to wash away the Botox® from where it was injected.
  • Avoid manipulation of area for 3-4 hours following treatment. (For the same reasons listed above.)  This includes not doing a facial, peel, or micro-dermabrasion after treatment with Botox®.  A facial, peel, or micro-dermabrasion can be done in same appointment only if they are done before the Botox®.
  • Facial exercises in the injected areas is recommended for 1-hour following treatment.  This is to stimulate the binding of the toxin only to the localized area. 
  • It can take 2 -10 days to take full effect.  It is recommended that the patient contact the office no later than 2 weeks after treatment if desired effect was not achieved and no sooner to give the toxin time to work.
*Makeup may be applied before leaving the office.
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