BOTOX® Cosmetic has been in use since the 1980s for the treatment of spastic muscle conditions such as strabismus, eye muscle spasms, and cervical dystonia (a painful condition in which your neck muscles contract involuntarily, causing your head to twist or turn to one side). It is a product that has been used for many years in adults and children with consistent reliability, safety, and efficacy. BOTOX® Cosmetic for cosmetic purposes was introduced in 2002 to soften frown lines and forehead furrows. More recently, it was FDA approved as a non-surgical treatment to smooth crow's feet wrinkles.
Find out if the world's most popular non-surgical cosmetic treatment is right for you. Call Desert Hills Plastic Surgery Center in the Las Vegas area at (702) 260-7707 for more information about BOTOX® Cosmetic.
What Is BOTOX® Cosmetic?
BOTOX® (botulinum toxin type A) comes from the bacteria Clostridium botulinum, which produces a toxin that contains 7 distinct serological types. Botulinum Type A is the most potent and is marketed by Allergan as Botox. Type B is marketed by Elan Pharmaceuticals as Myobloc and is FDA approved for cervical dystonia.
Other competitors have continued to populate the cosmetic market and work the same way as including Dysport® (abobotulinumtoxinA), initially marketed as Reloxin, and XEOMIN® (incobotulinumtoxinA). These are both Type A Botox, but with less protein binding, and work in the same way as BOTOX® Cosmetic with slight differences in dosing, diffusion, and onset of action. All products have the same duration of 3-6 months, so the main benefits of having newer BOTOX® products available for cosmetic use is to help keep pricing competitive among companies and consumers.
Watch Dr. Brown Perform the BOTOX® Cosmetic Procedure in Las Vegas
Safe BOTOX® Cosmetic Injection Practices
Prospective patients often wonder why pricing for BOTOX® Cosmetic treatments can vary so widely. While each state has its own specific laws about who is qualified to inject BOTOX® Cosmetic, patient safety is paramount.
Any injected medication or product should be performed by a licensed and experienced Physician, Physician Assistant, RN, or Nurse Practioner and ideally under the direct supervision of a physician. In addition, the Centers for Disease Control and Prevention clearly state that vials packaged as single-dose vials should not be administered to multiple patients and leftover contents should not be saved for later use.
Julianne Clifford, Ph.D., of the FDA's Division of Vaccines and Related Products Applications, explains "Botox is licensed for marketing and distribution as single-use vials." This means that as packaged, "each vial is intended to be used for a single patient in a single treatment session."
BOTOX® Cosmetic does not contain a preservative against potential contamination of the product through repeated use of a single vial. Once opened and diluted, BOTOX® Cosmetic must be used within four hours. Treating multiple people with one vial violates product labeling, which is stated on the package insert, the vial and the carton. So choose your injector wisely. You get what you pay for, and not everyone follows the rules. Risks and complications can arise when untrained personnel administer BOTOX® Cosmetic.
How BOTOX® Cosmetic Works
- The medical term for the action of BOTOX® Cosmetic is selective muscle denervation. Normally, to make a muscle contract, a nerve sends a signal to the muscle. The point where the nerve and the muscle meet is called the neuromuscular junction. When the signal gets to the neuromuscular junction a chemical called acetylcholine is released from the nerve side of the junction and binds to the muscle side of the junction causing more chemical reactions that make the muscle contract.
- BOTOX® Cosmetic works by blocking the acetylcholine receptors on the muscle side of the junction. Then when the nerve sends a signal to the muscle to contract, acetylcholine is released as before, but it can’t bind anywhere on the muscle. The muscle has no idea it is supposed to contract. It is essentially weakened or paralyzed, but not because it or the nerve have been damaged.
- This acetylcholine blockade begins within 48 hours. The clinical effects of a BOTOX® Cosmetic injection become noticeable between 5-10 days. Over the next 3-5 months the muscle gradually develops new receptor sites and is able to contract again. The wrinkle smoothing effects of BOTOX® Cosmetic are therefore transient, but maintaining BOTOX® Cosmetic regularly to weaken muscles that cause dynamic wrinkles over time can prevent the formation of static wrinkles, which are creases that become harder to treat.
BOTOX® Cosmetic and Wrinkles
- When BOTOX® Cosmetic is injected into a muscle that causes a wrinkle in the overlying skin when it contracts, paralysis of that muscle prevents the wrinkle from forming. The effects of BOTOX® Cosmetic are most noticeable in dynamic wrinkles, or wrinkles that are only present when the muscle contracts.
- As we get older and lose elasticity in the skin, a permanent crease can form leaving a wrinkle that is noticeable even without muscle contraction. BOTOX® Cosmetic does not get rid of these wrinkles, but may help soften them.
- BOTOX® Cosmetic not only improves the appearance of wrinkles, but can smooth skin texture, shape eyebrows, and can appear to lift and tighten the skin. It works best in the upper third of the face. It can be used in younger patients to prevent deep wrinkles from developing. Asymmetries with respect to eyebrow position may be improved with BOTOX® Cosmetic. Frown lines and an angry look can be corrected. Older patients benefit from BOTOX® Cosmetic to improve the appearance of wrinkles, creating a smoother, tighter appearance, with eyebrow elevation, and a refreshed, well-rested appearance. It is also used as an adjunct to surgery to maintain results after certain surgical procedures, such as brow lifts and facelifts. It has no associated “down-time”, it is extremely safe, and cost-effective, but expect 3-4 treatments per year.
- BOTOX® Cosmetic is FDA-approved to treat the frown area and crows feet areas, and is indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity (which gives rise to a crease along the bridge of the nose) in adult patients. “Off label” treatments are commonly and safely used to smooth wrinkles of the forehead, improve the appearance of the corners of the mouth and vertical lip lines, bunny lines on the nose, decrease fullness from prominent muscles of mastication, for sagging neck muscle bands, to improve scar quality, and many other cosmetic indications.
- BOTOX® Cosmetic results can be fined-tuned by the physician and patient desires. Some patients prefer a stronger effect for maximum smoothness, while others admire softer and more natural results with the ability to maintain movement of the muscle groups.
- BOTOX® Cosmetic can also be used to treat excessive sweating from the armpits. A 100-unit vial placed just under the skin of the axilla via multiple small injections can decrease sweating significantly and with no deleterious effects. Expect no downtime, and clean, dry shirts in the armpit area for 9 months. Both men and women use BOTOX® Cosmetic in this area to treat excessive sweating.
- In addition to cosmetic use, BOTOX® Cosmetic is used successful to treat tension and migraine headaches, muscle spastic disorders or neck spasms, writer’s cramp, swallowing problems, chronic pain, neuropathy, overactive bladders, and enlarged prostates.
Risks and Side Effects of BOTOX® Cosmetic
- Risks from BOTOX® Cosmetic injections are rare. Minor bruising or swelling from an injection site can occur but is self-limited and easily concealed with makeup.
- Longevity of the results cannot be guaranteed. A small portion of people undergoing treatment may not obtain the result they desire.
- Eyebrow shape changes or asymmetry can occur.
- Eyelid drooping (ptosis) can occur when BOTOX® is injected too close to the eyebrows.
- Other common side effects following injection were headache, respiratory infection, flu syndrome, and nausea. Less frequent adverse reactions included pain in the face, redness at the injection site, and muscle weakness. These reactions are generally temporary, but could last several months.
- There is no chance of contracting botulism from BOTOX® Cosmetic injections.
Contact Dr. Brown for more information about BOTOX® Cosmetic or other facial rejuvenation options: call (702) 260-7707 to arrange a personal consultation. Our Board-certified plastic surgeon serves Henderson and surrounding areas in Las Vegas, Nevada.