A: Botox is the brand name for Botulinum Toxin Type A.
This is a protein made in the laboratory from the toxin
of a bacterium called Clostridium Botulinum. The toxin
is a potent poison. The protein is not.
During the manufacturing process, the toxin is diluted,
processed and purified. The resulting protein is absorbed
completely by the muscles into which it is injected. The
body does not absorb the protein and this is why Botox is
so safe.
Because it is not absorbed, Botox does not affect
the body, only the muscles into which it is injected.
After 3 to 6 months, Botox disappears from the body without
leaving a trace.
Q: What can Botox do?
A: Botox is injected into muscles of the face to
partially relax specific muscles and temporarily lessen
the appearance of certain wrinkles that are caused by
these muscles. Botox has been used for this purpose
for the past 15 years all over the world.
The wrinkles that are due to muscle contraction (such
as frowning or raising the eyebrows in surprise) are
called dynamic or expressive wrinkles. These are the
wrinkles that soften with Botox treatment.
Q: Which wrinkles can Botox soften?
A: Botox can soften the following wrinkles:
the vertical “11” lines between the
eyebrows that appear when we frown.
the horizontal lines on the forehead
that appear when we raise our eyebrows in surprise
the horizontal “crow’s feet” lines
next to our eyes that appear when we smile
Q: Is that all that it can do?
A: No. As an expert in Botox injection, Dr. Hunter commonly
uses certain advanced techniques. Dr. Hunter uses Botox to:
contour the position of the eyebrows via
strategically placed injections. In this way he can create
a pleasing arch, even out asymmetric eyebrows or give a
“chemical eyelift” – raising the eyebrows and opening up the eyes.
soften the “bunny lines” that appear on
the sides of the nose when, during a smile, one crinkles the nose.
decrease the flare of the nostrils
decrease the droop of the tip of the nose in
some people when they speak.
decrease the severity of a “gummy smile”
straighten the corners of a mouth that are
turning down with age
decrease the appearance of vertical lip lines
– “smoker’s lines”
smooth out the wrinkly “orange peel” chin
that some people get when they speak
eliminate neck bands
stop excessive sweating on the face, palms,
underarms or soles of the feet
Q: How do I choose a good place to get Botox injection?
A: Botox injection is a medical procedure that requires
the injector to have aesthetic training, skill and experience.
As such, it should be performed in a physician’s office, under
conditions of cleanliness by an experienced doctor or nurse injector.
Prior to getting injections, you should inquire into the specialty
and experience of the physician responsible for the facility. You
should know how often the doctor is in and you should know how
experienced the nurse is if your injections are to be performed
by a nurse.
There are a great many medical spas in Texas, some of
which are run by non – physicians for a quick profit. Some of these
are franchise chains in malls. Some of these kinds of places have
very attractive prices. Fast, cheap Botox is like fast food. It can
be bad for you. It is risky and can result in 3 months of uneven
features, droopy eyes or worse. It’s not worth it.
Q: Is Botox safe?
A: Botox is one of the safest medications we know and
it has the backing of the FDA. It is also one of the most tested
and studied drugs in medicine. Millions of procedures have been
performed worldwide and serious side effects are unheard of.
In the United States alone, 3.5 million injections are performed
each year. There are no long term or permanent side effects and
this fact has been established through extensive research. Rare
temporary side effects include: bruising, redness at the injection
site, headache or flu-like symptoms. Injecting Botox into the wrong
place can result in a temporary eyelid droop.
Q: Am I going to be numb after Botox?
A: No. Botox weakens muscles temporarily, but has no
effect on the nerves that control sensation.
Q: My friend couldn’t move her face after she got Botox.
Does that always happen?
A: Absolutely not! However it does mean that you should
not get Botox from the person who injected your friend. Botox
injection is a bit of an art, and the tough part is to make the
patient look relaxed and younger without taking away their ability
to make facial expressions.
The patient should be able to move their face. Their forehead should
not look too tight. Their smile should be natural. Their eyebrows
should not arch like Dr. Spock! The way to do it right is to
always customize the dose of Botox to the individual. That means
taking the time to watch them move their facial muscles and knowing
where and how much to inject. This is something that Dr. Hunter has
learned from experience.
Q: What happens during the treatment?
A: After a brief medical history and examination, ice is
applied to the area that is going to be injected. This is important
to prevent bruising and to make the injections completely painless.
Then several quick injections are performed using an extremely small needle.
The whole procedure takes less than a couple of minutes and really doesn’t
hurt. Really – no pain.
Q: Is there anything that has to be done after treatment?
A: We recommend that you make an effort to move the injected
muscles for the next hour more than usual. You should be making
exaggerated facial expressions for that time.
This will help more
of the Botox to get into the right muscles faster. You also should
not rub the area injected. You can lie down and you can exercise
if you feel like it (although we recommend taking it easy for a few hours).
Q: Does the Botox take effect right away and how long does it last?
A: No, you will usually start to feel the relaxation of the
muscles injected with Botox the next day or the day after. Botox takes
about a week to be maximally effective in most people.
The effects last
about 3 to 4 months. Some people who get regular Botox injections
notice that they need smaller doses of Botox and that their Botox
starts to last longer – up to 6 months.
Q: Do my wrinkles get worse if I stop doing Botox?
A:Absolutely not. After Botox wears off, your face looks
like it did before Botox. There is no loosening of the skin, no
sagging due to Botox. Using Botox for a prolonged period of time
does not cause sagging of the face due to atrophied muscles.
On the
contrary, prolonged use of Botox over several years is very common
and actually results in visible softening of the wrinkles, even
after the Botox has worn off. Whether this is due to a weakening of
the muscles that cause the wrinkles or your body reprogramming itself
to not make certain facial expressions when you want to communicate
an emotion is unclear.
Q: Who is a good candidate for Botox?
A: Botox is safe and effective for anyone who is bothered
by expressive wrinkles on their face, except:
people with neuromuscular diseases like Amyotrophic
Lateral Sclerosis, Myasthenia Gravis or Lambert Eaton syndrome.
patients with an active infection at the injection site
women who are pregnant or breast feeding
Q: Why can’t I get Botox when I’m pregnant or nursing?
A: There is no evidence linking Botox with birth defects or
infant damage. There is no reason to think that having Botox injections
would expose the baby to harm. However, there is also no evidence to
prove that Botox does not harm the baby. Therefore, we feel that the
risks outweigh the benefits and do not administer Botox to patients
who are pregnant or breast-feeding.
Q: Is it bad to receive Botox regularly for a long time?
A: Intuitively, it’s not a great idea to use any medication
for too long of a long time. In this case, however, there have
been a number of good, long-term studies of patients using Botox
for neurologic diseases. Over many years of use, Botox has shown
no side effects or toxicity.
These studies followed patients who
were receiving amounts of Botox several times higher than the highest
doses that cosmetic patients get. We therefore feel comfortable
saying that using Botox regularly over many years is not dangerous.