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BOTOX® Cosmetic Frequently Asked Questions

  1. Introduction to BOTOX® Cosmetic
  2. What is BOTOX® Cosmetic?
  3. How does BOTOX® Cosmetic work?
  4. Does BOTOX® Cosmetic work for all kinds of wrinkles and skin folds?
  5. What is BOTOX® Cosmetic treatment like?
  6. Are there any special instructions for me to follow after treatment?
  7. How much do BOTOX® Cosmetic treatments cost?
  8. Am I "vain"?
  9. What are the possible side effects?
  10. Are there any people who should not use BOTOX® Cosmetic?

1. Introduction to BOTOX® Cosmetic

Many wrinkles are actually creases that have been worn into the skin by making the same expression thousands of times. These are called "expression lines" or dynamic wrinkles. Typical dynamic wrinkles include frown lines between the eyebrows, crow's feet around the eyes, and forehead lines. The presence of these wrinkles can add years to our appearance, often making us look angry, tired or worried when we are not.

BOTOX® Cosmetic can help you to control your facial expressions so that you don't look angry or worried when you aren't. BOTOX® Cosmetic treatments can help to prevent the unintended display of negative feelings, and in this way help some people to express themselves more accurately.

While you may have earned every one of your worry lines, you don't have to show them if you don't want to! If dynamic wrinkles are starting to make you look older or more negative, BOTOX® Cosmetic can help restore the rested, confident appearance you desire.

BOTOX® Cosmetic treatments also provide a safe, non-surgical alternative for the reduction of laugh lines, neck folds, and chin creases.

BOTOX® Cosmetic has been used safely and effectively for over fifteen years in adults and even in small children to treat many medical conditions where overactive muscles require relaxation. Each year tens of thousands of patients receive BOTOX® Cosmetic treatments for a variety of medical conditions, and BOTOX® Cosmetic has also become a leading treatment for reversing some of the visible signs of aging by relaxing the muscles which cause many of our wrinkles. BOTOX® Cosmetic is also becoming a leading treatment for excessive sweating and for migraine and tension headaches.

2. What is BOTOX® Cosmetic?

BOTOX® Cosmetic is a highly purified, naturally occurring protein which has the ability to very precisely relax the muscles to which it is applied. This relaxation lasts for a number of months, and then the treated muscles gradually return to their original condition.

BOTOX® Cosmetic does not affect the nerves responsible for sensation, so there is no numbness in the treated area.

You can stop BOTOX® Cosmetic treatments at any time and be confident that you will gradually return to your pre-treatment appearance.

3. How does BOTOX® Cosmetic work?

The benefits of BOTOX® Cosmetic on wrinkles come from ability of BOTOX® Cosmetic to selectively and precisely relax the muscles which are causing wrinkles to occur. The skin over the treated muscles gradually becomes smoother and less wrinkled as the muscles relax.

A common use for BOTOX® Cosmetic is to reduce (often by 70-80% or more) the really deep furrows and lines that many people have between their eyebrows. These lines can make people look quite angry or concerned, even when they are happy. Crow's feet around the eyes can also add years to your appearance, and make you look like you are squinting much of the time. Crow's feet usually improve nicely when the muscles which cause the crow's feet are treated with a bit of BOTOX® Cosmetic.

The treated muscles usually start to relax within a day or two, and reach their maximum degree of relaxation within a couple of weeks. About 3 or 4 months after the first treatment, the effects of the BOTOX® Cosmetic gradually start to wear off. If you liked the effect of your BOTOX® Cosmetic treatment (and almost everyone DOES like it), you will want to return for another treatment before the BOTOX® Cosmetic effect has completely worn off.

If you have a second treatment before the treated muscles have returned to their old bad habits, your second treatment will usually last longer (perhaps 4-5 months, instead of 3-4 months). Likewise, if you have your third BOTOX® Cosmetic treatment when you notice that the second treatment is starting to wear off, the third treatment may last 5-6 months instead of 4-5 months. It is common, after a couple of years, for people to go 6-12 months between treatments.

Untreated facial muscles continue to contract in their usual way, so that normal facial expression is unaffected. Because it relaxes the muscles that cause dynamic wrinkles, BOTOX® Cosmetic treatments can also prevent new lines from forming in the areas on your face, forehead and neck which are treated.

4. Does BOTOX® Cosmetic work for all kinds of wrinkles and skin folds?

Not all facial wrinkles are related only to the activity of underlying muscles. These deep creases and skin folds (also known as static wrinkles) are the ones that can still be seen when the skin is lightly stretched with your fingers. Static wrinkles are made worse by sun exposure, by the natural maturing process, and in particular by smoking. Many static wrinkles result from a combination of muscle activity and aging, and can be greatly improved when BOTOX® Cosmetic (to relax the underlying muscles) is used in combination with other fillers.

For people who have had chemical/laser peels and injections of collagen, Perlane®, Restylane® or other fillers, BOTOX® Cosmetic can prevent or delay the development of new wrinkles and furrows, and so can reduce the long-term need for additional laser resurfacing and for injection of filling substances.

In some cases, BOTOX® Cosmetic can be used to delay or eliminate the need for a surgical procedure like a facelift, browlift or necklift; and BOTOX® Cosmetic (by reducing muscle activity which might undo the surgeon's fine work) can be used to prolong and enhance the effects of those procedures if you have already had them done.

5. What is BOTOX® Cosmetic treatment like?

BOTOX® Cosmetic treatments are gentle and quick. No sedation or local anesthetic is required, so you will be able to continue with all of your usual activities immediately after your treatment. You can certainly drive yourself home or back to the office.

BOTOX® Cosmetic treatments take only a few minutes, and performed personally by Dr. White, using the finest Becton-Dickinson II 30 gauge needles to maximize your comfort.

Dr. White uses the highest concentration of BOTOX® Cosmetic (100 units per ml) in order to minimize injection volumes -- further enhancing your comfort and safety.

Dr. White is an Allergan Certified BOTOX® Cosmetic Instructor, and teaches other physicians the art and science of BOTOX® Cosmetic treatment.

A small amount of discomfort may be felt when the needle is inserted and a few drops of BOTOX® Cosmetic are applied to exactly the muscles which need relaxation. This sensation lasts approximately 5 seconds. Many patients are pleasantly surprised by the lack of discomfort.

Occasional patients experience a slight temporary bruising, perhaps the size of their baby fingernail, at an injection site. This can be hidden with coverup, and fades away in a few days.

6. Are there any special instructions for me to follow after treatment?

  1. Exercise the treated muscles during the two hours after your BOTOX® Cosmetic treatment.

    To ensure the best possible uptake of BOTOX® Cosmetic by the treated muscles, Dr. White will encourage you to exercise the treated muscles using normal facial movements during the first 2 hours after your BOTOX® Cosmetic treatment.

    For example, so that your BOTOX® Cosmetic will work to maximum advantage:

    • frown to exercise the muscles above and between the eyebrows which frown lines,
    • raise the eyebrows to exercise the muscles which cause forehead wrinkles, and
    • squint and smile to exercise the muscles which cause crow's feet.

  2. Do not touch or rub the treated areas until two hours after your BOTOX® Cosmetic treatment.

    It is also important for you to avoid rubbing or pressing on the injected areas for 2 hours to avoid spreading BOTOX® Cosmetic out of the treated muscles and into non-targeted muscles. It is also a good idea not to lie down in bed for a couple of hours after the injection, to reduce the chance that you will accidentally move BOTOX® Cosmetic to an area where you do not want it.

    If your BOTOX® Cosmetic was moved out of the muscles it is injected into, there might less effect on those muscles, and unwanted temporary relaxation of nearby facial muscles, which could be a nuisance for a week or two. In rare cases (perhaps one case in a hundred), this unwanted relaxation of muscles could cause temporary drooping of an eyelid or slight asymmetry of facial expression. Because the effects of BOTOX® Cosmetic are completely reversible, these rare side effects are temporary, and resolve after a few weeks.

    After two hours, there are no restrictions at all.

7. How much do BOTOX® Cosmetic treatments cost?

BOTOX® Cosmetic is priced at $14 per unit. But check our specials often because we often offer savings on Botox.

BOTOX® Cosmetic treatments may be a tax deductible medical expense (similar to dental, orthodontic and cosmetic surgery bills), so save your receipts!

8. Am I "vain"?

Many people at some time before BOTOX® Cosmetic treatment for wrinkles or excessive sweating have fears and doubts. A common concern is that they are being vain. My experience has been that just about all patients who have BOTOX® Cosmetic treatment, laser hair removal, and other procedures to maintain their appearance and comfort are no more vain than anyone else. What does distinguish these individuals is a desire to get the most out of life, and to look as good as they feel.

Looking after your appearance is not a fault. After all, would you leave your house with broken gutters or peeling paint? Why do less for your body? I think you should feel proud of yourself for having the will and the ability to change something that you find unacceptable. I emphasize that you should only have BOTOX® Cosmetic treatment, laser hair removal, and other treatments if it is for you. It is a big mistake to do these things if it is just for somebody else.

As Dr. Richard Glogau of San Francisco has noted: the same self-esteem that makes our patients successful in their chosen fields, precise in their consultation questions, well groomed and well dressed, and often careful in their diet, exercise, and other aspects of health maintenance lead our patients to seek help for their wrinkles and frown lines.

These individuals are normal healthy people, and the same degree of self-interest that prompts them to exercise, be selective in what they eat and drink, and protect themselves from sun damage leads them to explore the benefits of BOTOX® Cosmetic. Our patients simply want to look their best.

9. What are the possible side effects?

There have been no long-term side effects, allergic reactions or health hazards related to BOTOX® Cosmetic use thus far. Some patients have been getting BOTOX® Cosmetic treatments for more than 10 years, with no problems.

10. Are there people who should not use BOTOX® Cosmetic?

People who are pregnant, breast feeding, have rare neurological disorders like Eaton-Lambert syndrome or myasthenia gravis, or who are allergic to albumin should generally not be treated with BOTOX® Cosmetic.