Botox

Botox®Cosmetic

Introduction: Beverly Hills Advanced Laser offers BOTOX® injections that will rid your face of crow's feet, forehead lines and frown lines. This has quickly become our most popular cosmetic procedure, because it is safe and patients love the results. BOTOX® is a powerful medicine used to treat facial expression lines and neck banding, as well as down-turned smiles and drooping eyes. Best of all, the procedure only takes a minute!

What is BOTOX®Cosmetic? BOTOX®Cosmetic is a purified protein produced by the Clostridium Botulinum bacterium. BOTOX® is not alive, but is a protein that weakens and inactivates muscles. It is a non-surgical, physician-administered treatment that can temporarily reduce moderate to severe frown lines between the brows. The brand name BOTOX®Cosmetic is short for Botulinum toxin A. Botulinum toxin A is a neurotoxin, produced by the bacteria called Clostridium Botulinum. These toxins bind to nerve endings and prevent muscles from contracting, by blocking the release of acetylcholine, which causes muscle contractions from the nerve. This is basically how BOTOX®Cosmetic works, but within much smaller and safer parameters. BOTOX®Cosmetic was approved by the FDA for non-cosmetic use in 1989 and approved for cosmetic use in 2002. For over 11 years it has been used to treat over 1 million patients worldwide.

Background of the cosmetic use of BOTOX®: Cosmetic BOTOX® injections were pioneered in 1988 by a Vancouver ophthalmologist and her husband, a dermatologist. Since that time, this team of doctors has performed over 10,000 sessions on its patients. The ophthalmologist noted that the wrinkles disappeared in her patients with eyelid spasms who were treated with BOTOX® . This led to further research, which confirmed the effectiveness and safety of the BOTOX® vaccine for improving wrinkles due to overactive muscles of the face.

In 1996 at the annual meeting of The American Academy of Dermatology in Washington, a presentation by dermatologist Dr. Nicholas Lowe showed that BOTOX® was useful for improving facial expression lines. Significant improvement was noted on both forehead frown lines and crow's-feet. No significant side effects were noted beyond the expected injection discomfort. For 30 patients, only one experienced a mild drooping of the upper eyelid, which cleared spontaneously. The length of effective improvement for the forehead frown lines was approximately 18 weeks. The degree of improvement of the crow's-feet was generally less than the forehead frown lines. BOTOX® Cosmetic is not 100% effective in all patients.

First Clinical use of BOTOX®: In 1973, BOTOX® was used as a treatment for patients with crossed eyes. By weakening the overactive eye muscles, this medicine provided an alternative to surgery. After this "breakthrough," BOTOX® quickly gained acceptance for other ophthalmologic disorders, including nystagmus and blephospasm (involuntary spasm of the eyelids). Extensive BOTOX® research confirmed repeatedly a high success rate, with minimal side effects using a minuscule amount of this new found "medicine."

How does a BOTOX®Cosmetic treatment work? Moderate to severe frown lines between your brows form over time as the result of muscle activity. During treatment, very low doses of BOTOX®Cosmetic are administered via a few tiny injections directly into the muscles between your brows that cause wrinkles. It works by blocking the transmission of nerve impulses to the injected muscles, thus reducing the activity of those muscles. When those muscles become paralyzed, they make the wrinkles invisible. The treatment is usually done in about 10 minutes and no recovery time is needed.

When will I see results and how long will they last? Results are visible just a short while (usually just a few hours) after BOTOX®Cosmetic is injected into the affected area. Successful therapy is signed by muscle weakness that begins at 24 to 48 hours after injection, with a peaking weakness at seven days. Paralysis after the initial injection lasts between four to seven months for most patients. Lines continue to improve for up to a month, and results can last for up to three to eight months. In clinical trials, nearly 90% of men and women rated the improvement in their appearance as moderate to better 1 month after treatment. Results may vary. If you discontinue treatment, the moderate to severe frown lines between your brows will gradually look like they did before treatment.

How often is reinjection needed? After the first set of injections, reinjection after two weeks allows for an accurate localization of any resistant functioning muscles. It is suggested every three or four months to keep the muscles paralyzed and allow the furrows to completely smooth out. Once an area is smooth, patients are instructed to return for therapy only when they notice a return of muscle movement. With this method, 90% or more patients respond to BOTOX®.

How safe is it? While BOTOX® is a potent medicine in high concentration, it is used in very small quantities, with high margins of safety. After a muscle is injected, its first effects are not seen for 24 hours and the complete effect on the muscle will not be complete for two weeks. Fifty units (one half vial) or less of BOTOX® per session is generally used. To have toxic effects on a patient, over 2,000 units (costing $6,000) would have to be injected at one time. BOTOX® effects are attracted only to muscles, and it has no effect on the central nervous system or on the body if injected accidentally into a nerve or blood vessel. BOTOX® is also safe because complete recovery of the muscle is possible. Recovery is due to the body's excellent ability to form new fibers that allow activation of the muscles.

Are there any side effects? BOTOX® is a remarkably safe therapeutic agent for wrinkles. Complications have been minor and only transient. The most common side effects include headache, respiratory infection, flu syndrome, temporary eyelid droop, and nausea. Less frequently occurring (<3%) adverse reactions include pain in the face, erythema at the injection site, and muscle weakness. These events are thought to be associated with the injection and occurred within the first week of certain tests conducted. Bruising may occur where injected and a brief pain or headache may follow. Bruising may be greater in patients who are taking aspirin or any blood-thinning medicines. These products should be avoided if possible prior to the injection. Ice helps prevent bruising. Muscle weakness is first noted at 24 hours; it is not immediate.

Who should not use BOTOX®Cosmetic?

Although there have been no reports of birth defects with this medicine, no pregnant patients will be treated. It is also our policy not to inject BOTOX® in nursing mothers.
Patients with a history of neuromuscular disease (multiple sclerosis and myasthenia gravis) or other types of diseases involving neurotransmission should avoid this medicine.
Patients taking the following medicines should not receive BOTOX®: aminoglycoside antibiotics (Streptomycin, Tobmamycin, and Garamycin injections), penicillamine, and Calcium Channel Blockers (Calan, Cardizem, Dilactor, Norvasc, Procardia, Verelan).
BOTOX® should not be used in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any ingredient in the formulation.
Patients with neurological disorders such as ALS, Myasthenia Gravis or Lambert-Eaton syndrome may be at increased risk of serious side effects.

Where areas does it work or not work on? BOTOX®Cosmetic is widely used as a cosmetic enhancement to temporarily reduce wrinkles and fine lines in the face, banish neck bands, and clear away crow’s feet near the eyes.

Crow's Feet are wrinkles radiating from the corner of the eyes caused by smiling, laughing, or squinting and are especially distressing to some individuals. Previously, no reasonable medical or surgical solution improved this problem, due to the strong underlying muscles. Even with the deepest chemical peels or laser resurfacing techniques, rapid recurrence of these lines around the eyes is inevitable. Now for best results, BOTOX® injections are used in conjunction with resurfacing procedures. It is the function of BOTOX® to prevent the recurrence of wrinkles by inhibiting the underlying muscles.

Nasolabial Folds This area is not ideal for correction by the BOTOX® method; it also presents a challenge in facelift surgery. This area is most dynamic when talking, smiling, and eating. As one ages, both muscle and fat are lost from this area. Replacement of fat is now possible, but the real advance in this area has been the development of a permanent filling agent with a high safety and satisfaction profile--Gortex. In addition the lips can be supplemented with these techniques. In summary for the area involving the lips and around the mouth, BoTox will not help this zone and is not recommended.

What other uses are there for BOTOX®Cosmetic? Gastroenterology and neurology have explored BOTOX® therapy for their patients. It has now become the mainstay of non-surgical therapy for spasmodic neck muscles, spasmodic laryngeal muscles, writer's cramp, certain tremors, tics, multiple sclerosis, cerebral palsy, post stroke states, spinal cord injuries, nerve palsies, Parkinson's disease, and facial spasms. BOTOX® is used in GI cases involving swallowing and ulcer problems and to treat speech problems, including stuttering. Also, treating genitourinary disorders of spastic bladder and other disorders with BOTOX® has been studied. Congential muscular disorders or acquired nerve injuries have also been greatly improved with its use .

What are BOTOX® alternatives? Alternatives to BOTOX® are filling agents including fat, Collagen, Fibril and Gortex,resurfacing procedures with acids or lasers and lifting operations of the forehead, temporal, neck, and midface regions. If not treated, the lines and wrinkles persist.

Does it hurt? Discomfort is usually minimal and brief. Prior to injecting, your physician may choose to numb the area with a cold pack or anesthetic cream. The entire procedure takes approximately 10 minutes. Many people return directly to work or normal activity following the BOTOX®Cosmetic treatment.

Will my facial expressions continue to look natural? Although the results are visible, a treatment with BOTOX®Cosmetic will not radically change your facial appearance or make you look as if you "had work done". The muscle activity that causes frown lines between the brows is simply reduced, so you can still frown or look surprised without the wrinkles and creases between your brows.

Do treatment results differ? To get the best results, it's important to go to a doctor who is experienced in administering BOTOX®Cosmetic. At Beverly Hills Advanced Laser we provide the highest quality of BOTOX®Cosmetic customized to your needs.

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