Cosmetic Dermatology: Botox

Remove facial wrinkles and frown line treatment with botox injections...Frown lines between the eyes can be particularly troublesome cosmetically since they tend to convey anger or worry to others. Many individuals frown when they concentrate and with time develop deep creases between the eyes. These individuals do not like being asked why or whether they are angry or "mad". In addition over time the effect of muscular contraction produces "Crow's feet" around the eyes and wrinkles over the forehead which many do not desire. Various treatments including surgery, collagen injections, and resurfacing techniques have been used with varying degrees of success and problems. In general surgery and resurfacing involves significant "down time" postoperatively and are more expensive. Collagen injections have produced blood vessel blockage and reports of blindness when treating between the eyes.

What is Botox?Botox is the trademark for Botulinum toxin which is a chemical produced by the bacteria, Clostridium botulinum, and this chemical binds to nerves serving muscles producing paralysis of these muscles. Since the 1980's Botox has been used in children and adults to treat muscle imbalance problems of the eyes (such as strabismus and blepharospasm).

What Areas are Treated?The most common area treated are the deep frown lines between the eyes, the lines of expression on the forehead and the wrinkles around the eyes (Crow's feet).

Who is a Good Candidate for Botox Injections?Treatment with Botox is remarkably safe. However, neurological conditions affecting the nerve/muscle junction and pregnancy are conditions where Botox should not be used.

How is the Procedure Performed?The patient is in the seated position during the entire procedure. Ice compresses are used to cool the area to produce less pain and less bruising. After cooling different expressions such as smiling deeply, frowning, and raising eyebrows are produced by the patient, and the muscles are injected during these expressions. Immediately after injection the area is compressed for a few minutes.

What Needs to Be Done After the Procedure?The patient should remain vertical (either sitting or standing) and should not manipulate the sites of injection for at least 4 hours after the procedure to help insure the injection remains in the desired treatment area. Otherwise it is possible to have eyelid drop temporarily. Aspirin products should be avoided for 7 days after and alcoholic beverages should be avoided 2 days before and 2 days after the procedure.

What are Possible Side Effects and Complications?Even though the side effects and complications are minimal, slight swelling and/or bruising may last for several days after the injections. In approximately 2% of individuals a minor temporary droop of one eyelid may last for 2-3 weeks. Occasionally, numbness of the forehead may last 2-3 weeks. Rarely, a "hive like reaction", brief headache, and less than usual effectiveness may be seen.

What is Expected After the Procedure?Beginning within 2 days and becoming apparent at 5-7 days the lines of facial expression are reduced. Subsequent injections tend to produce more marked and longer lasting relaxation of muscles. The first injections tend to last for 4-6 months. After 3 or 4 sessions many individuals have permanent relaxation. One should expect to have multiple sessions to achieve the desired result. The time to have a subsequent session will be when the brow begins to frown again.

Is This Procedure Covered by Insurance?Since this procedure is elective and not medically necessary, it is not covered by insurance.

If you desire additional information we welcome you to schedule an appointment for a FREE consultation with our Cosmetic Consultant at (828) 252-3576.

We at Dermatology Associates of Asheville, P.A. invites you to inquire about all of our cosmetic procedures and how they can help you to achieve smoother, fresher, younger looking skin.

To view PHOTOS of patients (Before and After Botox) please call our office and schedule and appointment with our Cosmetic Consultant.