Botox is a drug made from a neurotoxin produced by the bacterium Clostridium botulinum called botulinum toxin. It is used medically to treat certain muscular conditions and cosmetically remove wrinkles by temporarily paralyzing muscles.
Botulinum neurotoxin is the most poisonous substance known. It exerts its effect by paralyzing striated muscles or the autonomic-innervated muscles. The muscle paralyzing feature of botulinum toxin, when used beneficially, has proven to be useful in more than 50 pathological conditions, including cosmetic applications. Today, botulinum neurotoxin injection is the most commonly performed cosmetic procedure in the world.
Botulinum toxin is a polypeptide produced by the gram-positive anaerobic bacterium Clostridium botulinum.
Botulinum toxin has been used for more than 20 years to treat a variety of conditions including:
• cervical dystonia
• muscle spasticity
Cosmetic use of Botox:
• treat glabellar complex muscles that form frown lines
• treat lateral orbicularis oculi muscles that form crow’s feet 8
• It has become the treatment of choice for wrinkles occurring in the upper one-third of the face:
o frown lines
o horizontal forehead lines
o crow’s feet
• It is also used in the lower two-thirds of the face, but this is more technically challenging and is an advanced application.
1. Be transparent with Doctor akbari For your safety, tell as much about your medical history as possible so he/she can determine whether you are a good candidate to receive cosmetic Botox. Tell Doctor akbari
• What medication, supplements, herbs, etc. you are taking
• What allergies you have
• If you have any medical conditions, illnesses, or diseases
• If you have or will have any medical procedures (i.e. recent Botox, surgery, other treatments, etc.)
• If you are pregnant, breast-feeding, or trying to conceive
• Anything else you can think of
If this is your first time getting Botox, tell Doctor akbari
2. Make sure Botox is the right treatment for you – A reputable and experienced Botox injector will know what Botox can do for your skin and what it can’t. For instance, you may be better off getting fillers instead of Botox for certain wrinkles on your face, so make sure you and your Doctor akbari discuss the best therapy for your skin issues.
3. Have realistic expectations about what Botox can do – Botox results can be drastically good, but your post-Botox results may not be as perfect as you expect them to be. Having realistic expectations about your results will save you from unnecessary disappointment.
4. Stop taking medication that can thin the blood – A week before you get Botox injections, stop taking:
• Ibuprofen, either generic or Advil, Aleve, or Motrin
• St. John’s Wart
• Vitamin E
• Fish oil or Omega-3s
• Ginko Bilboa
This will minimize any potential post-Botox bruising. If you have to take pain medication, Tylenol is okay. Also, avoid drinking alcohol a few days before you get Botox.
In preparation for botulinum toxin treatment, or any injectable procedure, bruising can be minimized by advising patients to discontinue aspirin and any medication or dietary supplement that has anticoagulant effects two weeks before treatment. Anesthesia is not typically necessary for botulinum toxin treatments.
Getting Botox takes only a few minutes and doesn’t require anesthesia. Botox is injected with a fine needle into specific muscles with only minor discomfort.
Botox blocks signals from the nerves to the muscles. The injected muscle can’t contract. That makes the wrinkles relax and soften.
Botox is most often used on forehead lines, crow’s feet (lines around the eye), and frown lines. Wrinkles caused by sun damage and gravity will not respond to Botox.
What you do during Botox is not as important as what you do before and after Botox, but here are some things you should keep in mind for a good treatment session:
Go au naturel – Your skin will be cleaned with rubbing alcohol or an antiseptic before you get Botox, so feel free to show up to your appointment with nothing on your skin. If you wear makeup, they will take it off anyway.
Stay still but pay attention – If you are afraid of needles, don’t make yourself writhe with discomfort by thinking about them. Set your mind on something random, like monkeys juggling pineapples. The Botox will be over before you know it. Stay still but pay attention and follow your doctor’s instructions. He/she will tell you to smile, relax, frown, etc. during the injection process.
Use an ice pack – Ice before, during, and after Botox can help reduce any potential signs of bruising.
What you do after Botox and how you take care of your skin is very important. Here are some things you should and shouldn’t do after getting Botox injections:
Don’t touch your skin where the Botox was injected. Avoid rubbing and massaging the treated area for 24 hours because you don’t want to make the Botox spread to other unintended muscles.
• Avoid strenuous physical activity.
• Avoid consuming large amounts of alcohol.
• Avoid getting facials, chemical peels, microdermabrasion, etc. for 24 hours.
• Avoid taking the blood thinning medications mentioned above.
• If you get a Botox bruise, topical vitamin K and arnica can help. Or you can get v-beam, pulsed-dye, or KTP laser treatments to make the bruising go away faster. Green or yellow concealers can also help cover up the bruises.
• Go back for touch-ups if you need it or are unsatisfied with your results.
• Call your doctor or seek medical attention if you experience any side effects or complications from the Botox treatment.
• Schedule your Botox appointment 6 weeks prior to any big event. It takes about 5 days for the Botox to take full effect.
Partial reduction in function of the targeted glabellar complex muscles is seen by the third day after botulinum toxin injection, with maximal reduction visible two weeks after injection. Reduction of dynamic frown lines one month after treatment of the glabellar complex muscles with 20 units of onabotulinumtoxin A can be seen. Return of muscle function is gradual, typically three to four months after treatment. Subsequent treatment is advised when muscle contraction is visible in the treatment area before facial lines return to their pretreatment appearance. After multiple treatments, botulinum toxin effects may be prolonged and for some patients, treatment intervals can be extended beyond three to four months.
• Body dysmorphic disorder
• Dependency on facial expression for livelihood (e.g., actors, singers)
• Dermatoses in the treatment area (e.g., psoriasis, eczema)
• Gross motor weakness in the treatment area (e.g., Bell palsy)
• Infection in the treatment area
• Keloidal scarring
• Neuromuscular disorder (e.g., amyotrophic lateral sclerosis, myasthenia gravis, Lambert-Eaton syndrome, myopathies)
• Pregnancy or breastfeeding
• Sensitivity or allergy to constituents of the botulinum toxin product (e.g., cow’s milk protein allergy with abobotulinumtoxin A)
• Unrealistic expectations