Botox injections are noted primarily for the ability to reduce the appearance of facial wrinkles. They're also used to treat conditions such as neck spasms (cervical dystonia), excessive sweating (hyperhidrosis), an overactive bladder and lazy eye. Botox injections may also help prevent chronic migraines.
Botox injections use a toxin called onobotulinumtoxinA to temporarily prevent a muscle from moving. This toxin is produced by the microbe that causes botulism, a type of food poisoning.
Botox was the first drug to use botulinum toxin. Other products now include abobotulinumtoxinA (Dysport), rimabotulinumtoxinB (Myobloc) and incobotulinumtoxinA (Xeomin). Each is a little different, particularly when it comes to dosage units, so they aren't interchangeable.
Why it's done
Botox injections block certain chemical signals from nerves, mostly signals that cause muscles to contract. The most common use of these injections is to temporarily relax the facial muscles that cause wrinkles in the forehead and around the eyes. Botox injections are also used to treat conditions that affect how the body functions. Examples include:
- Cervical dystonia. In this painful condition, your neck muscles contract involuntarily causing your head to twist or turn into an uncomfortable position.
- Lazy eye. The most common cause of lazy eye is an imbalance in the muscles responsible for positioning the eye.
- Muscle contractures. Some neurological conditions, such as cerebral palsy, can cause your limbs to pull in toward your center. In some cases, these contracted muscles can be relaxed with Botox injections.
- Hyperhidrosis. In this condition, excessive sweating occurs even when the temperature isn't hot and you're not exerting yourself.
- Chronic migraine. If you experience migraines more than 15 days a month, Botox injections may help reduce headache frequency.
- Bladder dysfunction. Botox injections can also help reduce urinary incontinence caused by an overactive bladder.
- Eye twitching. Botox injections may help relieve contracture or twitching of muscles around the eye.
Botox injections usually begin working one to three days after treatment. Depending on the problem being treated, the effect may last three months or longer. To maintain the effect, you'll need regular follow-up injections.
How you Prepare
Tell your doctor if you've had any type of Botox injection within the past four months. Also tell your doctor if you take muscle relaxants, sleeping aids or allergy medications. If you take blood thinners, you may need to stop taking them several days before your injection to reduce your risk of bleeding or bruising.
Botox injections are relatively safe when performed by an experienced doctor. Possible side effects and complications include:
- Pain, swelling or bruising at the injection site
- Headache or flu-like symptoms
- Droopy eyelid or cockeyed eyebrows
- Crooked smile or drooling
- Eye dryness or excessive tearing
Although very unlikely, it's possible for the toxin in the injection to spread in your body. Call your doctor right away if you notice any of these effects hours to weeks after receiving Botox:
- Muscle weakness
- Vision problems
- Trouble speaking or swallowing
- Breathing problems
- Loss of bladder control
Doctors generally recommend against using Botox when you're pregnant or breast-feeding. And Botox should not be used in people who are allergic to cow's milk protein.
During the surgery
Botox injections are usually performed in a doctor's office. Your doctor uses a thin needle to inject tiny amounts of botulinum toxin into your skin or muscles. The number of injections needed depends on many factors, including the extent of the area being treated.
After the surgery
Do not rub or massage the treated areas for 24 hours. This may help prevent the toxin from spreading to a different area. You can return to your normal activities right after the procedure.
Before - After
Frequently Asked Questions
WHAT AREAS OF THE FACE CAN BE TREATED WITH BOTOX?
Botox can be used to address lines and wrinkles on a number of different facial areas, including the forehead, eye area (crow’s feet), and lip lines. It may be injected to soften dimpling of the chin. Botox can also be injected into the muscles of the jaw to help alleviate pain from teeth grinding or TMJ or for a jaw slimming effect. Some of these treatment areas may be considered off-label.
WHAT DOES A BOTOX TREATMENT FEEL LIKE?
Botox treatments are quick with minimal discomfort. The treatment requires no anesthesia or recovery time. Many people get Botox during their lunch hours and are able to return to work right after their appointment.
IS BOTOX PAINFUL?
The procedure is not considered painful. Most patients report a brief period of discomfort during the injection, which does not persist once the procedure is complete.
HOW SOON WILL I SEE RESULTS?
While the experience of each patient may differ, it usually takes 3-5 days to see the effects of Botox. For some, it may take up to 2 weeks to realize the final effects.
HOW LONG DOES BOTOX LAST?
The results of Botox typically last between 3-5 months from the date of injection. Over time the body metabolizes the Botox, leading to the slow return of muscle movement in the treatment area. Patients can choose to maintain their Botox results for longer periods by undergoing periodic maintenance treatments every 3-4 months.
WHEN SHOULD I START GETTING BOTOX?
Some patients may wonder if they are ‘too young’ or ‘too old’ to try Botox. There is no right or wrong age to start using Botox. Patients should be evaluated and receive a consult by a medical professional prior to treatment. Many millennials are starting to using Botox in their twenties when they first start to notice lines and wrinkles or as a preventative measure.
ARE THERE SIDE EFFECTS?
Side effects from a Botox treatment may include bruising, swelling, redness, or tenderness around the injection site, all of which will resolve without intervention after a few days to a week.
WHAT IS THE DIFFERENCE BETWEEN BOTOX AND OTHER NEUROMODULATORS LIKE DYSPORT AND XEOMIN?
While Botox, Dysport, and Xeomin treat the same symptoms in a similar manner there are differences between these products. For more details, please refer to the following blog posts: