“What is Botox?” is one question I hear all the time, followed in short order by, “Why do I need it? What are the side effects?” and finally with, “How can it help?” In the right hands Botox can stave off a major procedure when started early and maintained.

Botulinum toxin type A is a toxin produced by the bacteria that causes botulism, and it affects the nerves. When injected into a muscle, it produces a reduction in the activity of the muscle by inhibiting the production of a neurotransmitter, named Acetylcholine.

Botulinum toxin type A is used in the treatment of strabismus (a condition in which the eyes do not point in the same direction). An astute ophthalmologist recognized that patients who were treated for strabismus with Botox also showed a reduction in crow’s feet (lines beside the eyes). An entire industry was born!
Soon other uses were discovered. It is used to reduce abnormal head position and neck pain in patients with cervical dystonia (spasms of the neck muscles), and spasms of the eyelids or uncontrollable blinking (blepharospasm). One use, which many men like, is its treatment of severe underarm sweating. Botox reduces the sweating to a minimum and in some cases eradicates it completely. I personally have experienced the luxury of wearing dark shirts in the summer and not sweating.

We sell Botox by the unit or as a package deal. The package is a yearlong and allows you to come back for touch ups and monthly, bimonthly or trimonthly depending on the severity of your wrinkles.

I am always asked, “When should I start Botox?” My reply is, “When you start seeing dynamic (movement) wrinkling that begins to turn into static (full time) wrinkling.” It is well known that Botox when started early (early to mid 30s) used in conjunction with sun block, moisturizer and a smoke-free life, can keep your skin in great condition, often negating the need or want of a facelift (early 40s). Most of the major Hollywood stars keep their static lines from forming by early administration of Botox and maintenance thereafter.

After two years of constant injections Botox must be spread out to only two or three times a year to avoid Botox resistance. The body inevitably forms antibodies (blood serum responsible for fighting foreign substances in the body) after a certain period of time.

There are cases where some patients, who have never had Botox do not respond to the injections. The reasons these primary nonresponders do not experience success are varied. Patients with rhytides (wrinkles) that are not dynamic in origin eg, photodamage, age-related changes do not respond. It is also possible the injection technique was inadequate or the toxin denatured. Theoretically, some patients may have neutralizing antibodies from prior subclinical exposure, or individual variations in docking proteins may exist. A test dose of 15 units in the frontalis (forehead) muscle should indicate whether the patient experiences a physiologic response (weakness) to toxin.

Having said this, it is a problem when patients do not respond. Using the lowest dose possible will decrease your chances of forming antibodies.

Botox has very few side effects. Some of the minor effects include pain at the injection site, redness, and mild swelling. Ask your provider for a complete list if necessary. People are also unaware that one side of the face is not equal to the other side. Everyone has a big side and small side to their forehead, eyes, cheeks, jaws, and deep folds! Botox is not the magical cure for asymmetries (different sizes) of the face. Nor does it get rid of deep folds, which is accomplished by fillers, Co2 fractional resurfacing and facelifts.

I hope this helps. I have been on Botox for five years. I have not had any problems with it. Should you want to learn more, stop by and we’ll talk about it.