The Beauty of Botox

The Beauty of Botox

by Dr. Diane Gibby • M.D., P.A., F.A.C.S

Whenever we frown, squint or even smile, we gather tissue between our eyebrows into a fold. For many of us, this causes a chronic furrow, producing a frustrated and angry appearence. Now, it's possible to make frown lines, crows feet and forehead creases improve without surgery or scars, by a simple treatment of Botox. Botox, the trade name for Botulinum Toxin Type A, has been used since the early 1980s for the treatment of strabismus (lazy eye) and blepharospasm (uncontrolled eye blinking) as well as facial spasms. Botox is now being used with success by cosmetic surgeons to help achieve a younger appearance for their patients. Recently much attention has been given to Botox, because of its ability to paralyze muscles that form wrinkles on the face. Most people are intimidated by the thought of a toxin being injected into their muscles. The truth is that the protein from the toxin, and not the toxin itself, is actually being used. So there is no chance of developing Botulism from the injections. Botox works by weakening the muscles that control facial expression . Once the resting tone of these muscles are weakened, the pull of the muscles relax and the skin flattens out. This is an entirely different approach than those used previously for treating wrinkles. In the past, collagen and fat injections have been used to fill in or plump up a wrinkle. These fillers are not as effective as Botox in improving the frown wrinkles on the forehead and between the eyebrows. Researchers have found that the type of lines and wrinkles that respond best to Botox injections are those caused by the muscles--specifically those muscles that are repeatedly over-contracted during facial expressions, such as frowning or squinting. By physiologically weakening the muscles, these wrinkles are removed naturally. This treatment may also be effective for wrinkles in the neck. Botox injections block the transmission of impulses from the nerve cells to the muscle, which causes a temporary muscle weakening. By selectively interfering with the muscle's ability to contract, existing lines are smoothed out over time and future lines may be prevented. After the procedure, these lines will be improved at rest, and facial movements will no longer create as deep a furrow. The procedure takes only a few minutes to administer and is performed with the patient in a sitting position. During the injection, which is performed with a tiny needle, the patient is asked to contract the muscle in the area being treated so the physician can determine the proper location for injection. The patient may feel a small amount of discomfort when the Botox is injected but usually no anesthesia is required. The full effect of the injection is generally not seen for 2 to 7 days, after which a noticeable decrease in facial creases will be seen. The results from this simple procedure are often fairly dramatic. The lack of recovery time adds to the increasing popularity of this procedure. Botox injections also decrease the patient's ability to frown or squint, which prevents the progressive worsening of these lines over time. Therefore, the method can be considered both corrective and preventative. However, the results are not permanent. Over the next three to five months the Botox gradually looses its potency, eventually restoring the muscle to its original condition. When frown lines begin to appear again, another dose of the Botox is all that is needed to maintain the desired result. Some physicians have noticed that the duration of muscle "relaxation" is cumulative and lasts longer with each treatment, although there is no scientific data to support this theory. To date, no systematic complications associated with Botox injections have been documented. As with all biologic products, there is a rare possibility of an allergic reaction. Among the most common side effects are local numbness, swelling, bruising, or a burning sensation during injection. These are usually temporary and typically disappear within a few hours. Currently, there are no known long-term effects of repeated Botox injections.

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