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Botulinum Toxin (Botox)

Treatment Overview

The injection of botulinum toxin, commonly known as Botox, has become very popular for reducing wrinkles and rejuvenating the aging face. The effects are only temporary, but the injections can be done quickly, require no recovery time, and are not as complicated as many other cosmetic procedures for the face.

Botulinum toxin is produced by Clostridium botulinum bacteria. When a small amount of Botox is injected into a muscle, it blocks nerve signals that tell your muscles to contract. The effect is that it temporarily weakens or paralyzes the facial muscles and smooths or eliminates wrinkles in the skin for a few months.

Getting a Botox injection takes just a few minutes.

What To Expect After Treatment

For the first 2 to 3 hours after treatment, take it easy and do not rub the treated area. After that, you can return to your regular activities.

It can take 3 to 4 days before you notice an effect from the Botox. The full effect may take up to 1 week. The results may last from 3 to 4 months on average but sometimes up to 6 months. After that, you will begin to see the wrinkles return.

Why It Is Done

Botulinum toxin has been approved by the U.S. Food and Drug Administration (FDA) for treating frown lines in adults younger than 65. Botox injections also are frequently used to reduce other wrinkles on the face and neck, such as crow's feet, brow furrow, and forehead lines.

Botulinum toxin is also approved by the FDA to treat a wide range of problems, such as chronic migraine headaches, eye muscle disorders, and muscle stiffness.

How Well It Works

Within 72 hours after treatment, the injection of Botox partly or completely smooths wrinkles for most people. But the results are temporary, typically lasting only 3 to 4 months. You will have to return for injections every 3 to 4 months to keep the effect. The dose of Botox usually is the same each time you get an injection.

Risks

The most common side effects are:

  • Drooping eyelid that may last a short time.
  • Headache.
  • Bruising.

Other side effects include flu-like symptoms, nausea, temporary facial pain, redness at the injection site, reduced blinking, and weakness in the muscles of the face. In extreme cases, this muscle weakness can limit your facial expressions. In rare cases, a sore may develop on the white of the eye (corneal ulceration).

Very serious problems can happen if the botulinum toxin spreads from where it was injected. It may cause dangerous swallowing and breathing problems. These problems can happen hours to weeks after the injection and can cause death. The risk is greatest in children who are being treated for muscle spasticity in their necks. But adults who already have swallowing or breathing problems are also at risk for problems from a Botox injection.

The risks of repeated Botox injections are not known.

What To Think About

Botox injections are more convenient and less painful than other procedures for reducing wrinkles and making your face look younger (chemical peels, dermabrasion, laser resurfacing, face-lift). Keep in mind that the effect of an injection may last only a few months. To keep the effect, you will have to get injections several times a year. A single injection may seem inexpensive, but the cost of repeated injections can quickly add up.

Complete the special treatment information form (PDF)special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.

Credits

By Healthwise Staff
Anne C. Poinier, MD - Internal Medicine
Keith A. Denkler, MD - Plastic Surgery
Last Revised July 31, 2012

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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