SINCE 2004

Frown lines and crow's feet - The lines we know as frown lines and crow's feet are lines of facial expression. They are created by the repeated action of very specific facial muscles and the lines become more apparent over time. The muscles creating the frown lines are called the corrugator muscles and the procerus muscles and they are located above the eyebrows and in the middle of the bridge of the nose. The orbicularis oculi muscles create the crow's feet at the corners of the eyes. These muscles are easily identified and their movements can be minimized with the technique of Botox injection.

What is Botox? - Botox is a purified protein toxin produced by the clostridium botulinum bacteria. Although Botox is technically a toxin, there have been no serious side effects. This is because, for the treatment described, it is used in extremely small amounts and does not spread throughout the body.

How is Botox used? - First, the muscles to be treated are identified by observing the patient making different facial expressions. Botox, which comes frozen and dried, is reconstituted and diluted to a very specific strength. A few drops of Botox are injected with a tiny needle into the muscle that creates the wrinkle. When Botox is injected into a muscle, it blocks the nerve impulse from reaching that area, and as a result, the muscle weakens. As the muscle weakens, the skin overlying the muscle relaxes and the wrinkle in the skin gradually softens and often disappears.

Does a Botox injection hurt? - When Botox is injected there is an initial minor sting for a few seconds. Once the injection is complete, there is minimum discomfort.

Where can Botox be Injected? - The most common areas for the use of Botox are the frown lines between the eyebrows, the horizontal forehead lines, and the crow's feet. On occasion, some other areas may be treated as well.

How fast does Botox work? - There is no immediate response to the Botox injection. It may take several days for the muscles to be affected, at which time, one can notice the gradual loss of ability to frown or to create the lines affected by the treated muscles.

Does Botox affect other facial expressions or create numbness? Botox doesn't affect the sensory nerves, so there is no numbness in the area of the injection. Also, the effect of the Botox is only in the immediate area of the injection. Therefore, the muscles related to other expressions are unaffected.

How long does a Botox treatment last? - The effects of Botox usually last three to five months, at which time another injection is required. After several treatments, the effects of Botox may begin to last longer, sometimes up to six to eight months. We recommend treatment every three months for the first year, then repeat treatment as needed.

How safe is Botox? - Botox has been used safely and successfully in ophthalmology for over 20 years and for wrinkle therapy for over 10 years. In the amounts used for wrinkle therapy, the only possible side effects are temporary and localized to the area of injection. In rare cases this may cause a droopy eyelid or eyebrow. This seems to occur because some of the material injected finds its way into those muscles unknowingly. The problem usually goes away in two or three weeks and may be expedited by taking eye drops. Allergic reactions to Botox are extremely rare.

Is the treatment for everyone? - There are very few restrictions regarding Botox treatments. Patients who are pregnant, have a neurological disease, or are taking antibiotics should not be treated.