How Does Botox Work?
In 2015, Botox© was the most common nonsurgical procedure in the U.S., being administered over 4.5 million times! It has ranked in the top cosmetic procedures for the last 6 years at least, and is common for both men and women to receive. The vast majority of patients are over 90% satisfied with their treatments (courtesy of RealSelf, a plastic surgery website and message board).
That being said, it’s important for everyone to understand how this treatment works, some pros and cons, and important questions to ask your provider.
Botox© (we will use the trade name, though many companies process comparable botulinum toxins for the purpose of reducing lines and wrinkles: Xeomin©, Dysport© to name a few), works by stopping the normal chemical transmission between nerves and muscles. This, in short, causes a temporary paralysis of the muscles that were injected. Although it sounds scary, Botox© is used in very small doses for cosmetic purposes and is injected directly into small muscle groups to achieve the reduction in lines and wrinkles in the face. Botox© lasts on average 3-4 months, though some people feel the results last closer to 6 months and others only 2-3. It is not permanent. The toxin is metabolized and the nerves regain the ability to transmit the chemical signals within a few months.
Although there are no permanent effects, there are temporary side effects that are important to know: injection site bruising or swelling is the most common-it is, after all, administered with a needle puncturing the skin! However, most practitioners use the smallest needles available to limit this risk. Avoiding blood thinners in the few days leading up to injection can also reduce the risk of bruising (vitamin E, fish oil, aspirin containing products and herbal supplements for example). A less-common side effect is drooping of the eyelid or drooping of muscles in an area not directly injected but adjacent to the area. This is certainly unwanted, so many practitioners will instruct patients to avoid strenuous activity or pushing on injected areas for several hours to avoid the treatment spreading to unintended areas.
One potential great upside (in addition to watching your lines fade with time) is that most patients who have Botox injected consistently over several months to years, see a gradual need for less treatment and less often treatment as their muscles adjust to having to contract less often. This often results also in prevention of deeper lines and wrinkles in common locations (between the brows and crow feet in particular).
Finally, Botox© is omnipresent! Dermatologists, plastic surgeons, even some dentists and spas will offer this treatment. Although it can be tempting to get your Botox© treatment done 5 minutes from your home at a spa, or for $6 a unit on sale, it can be risky. You may not know if your injector is board certified, knows the anatomy of facial muscles, knows how to achieve the results you’re interested in (and not just following a standard pattern), and knows how to counsel you if any adverse effects arise. Make the trip for consultation to a board certified facial plastic surgeon or plastic surgeon and ask how many treatments they do and what they would recommend to treat your concerns. You will be happier with the results and more likely to enjoy them knowing you went to a trusted injector!
