BOTOX Cosmetic and Dysport

Over 2.5 million patients received BOTOX injections in 2009 alone! It is the number one cosmetic treatment available and has changed the way we look at ourselves forever. BOTOX injections (now termed onabotulinumtoxinA to distinguish it from other products) and Dysport (abobotulinumtoxinA) are derived from a purified botulism toxin. In small, therapeutic doses, BOTOX injections and Dysport act to prevent the nerves from releasing the chemical that causes the muscles to contract. When placed selectively in the frown and brow muscles, this serves to soften and smooth the forehead, elevate the brows to improve shape and slow the aging process related to muscle movement.

BOTOX Cosmetic was first approved by the FDA in the late 1980s for its use by ophthalmologists to treat spasm of the muscles around the eye. Since that time, a number of other therapeutic uses have been found including the treatment of excessive muscle contraction, excessive sweating of the underarms and hands, migraines and the in cosmetic arena for the treatment of frown lines between the eyes. At our San Diego practice, we regularly use BOTOX Cosmetic to treat lines across the forehead and in the “crows feet” area, but this is “off label” – meaning that the FDA did not officially approve it for this purpose, but we have found it to be extremely successful to treat these areas as well. Dysport was first FDA approved introduced to the cosmetic market in 2009, and functions much the same except for differences in dosing.

How Do BOTOX injections Work?

BOTOX Cosmetic works by being absorbed into the nerve fibers after injection. Once this occurs the BOTOX Cosmetic is processed and eventually blocks the nerve from releasing the chemical (acetylcholine) that causes muscle contraction. This is a relatively slow process and is the reason for the several day delay before the BOTOX Cosmetic actually takes effect and you see the smoothing of your brow.

Your BOTOX Injections Appointment

If you schedule a BOTOX Cosmetic appointment, you will visit with Dr. Marin and discuss the areas of concern. If he determines that you are a good candidate for BOTOX Cosmetic, we can perform the treatment during that same visit. The procedure is well tolerated and only takes a couple of minutes depending upon the number of areas treated. The injection locations and how much BOTOX Cosmetic is needed will be determined at your consult and largely based upon the position and strength of your muscles. This varies from patient to patient.

There is usually no evidence of the BOTOX Cosmetic injection 15 minutes after the procedure and make-up can be applied almost immediately. You will not notice any instant change in your appearance, as it takes normally from three to five days for the product to take effect. It is usually a gradual onset and imperceptible to those around you. We recommend not exercising for one to two days after the procedure as your only precaution.

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WHAT TO EXPECT FOR YOUR

Botox & Dysport

Length:
15 minutes

Anesthesia:
None

In/Outpatient:
Outpatient

Side Effects:
Possible bruising

Risks:
Incomplete correction, eyebrow droop

Recovery:
Back to work: immediate
More strenuous activity: 1 -2 days

Final Appearance:
5 – 7 days

Duration of Results:
4 – 5 months

BOTOX injections Recovery and Side Effects

BOTOX Cosmetic should last anywhere from four to six months providing you with smoother forehead and frown lines, softened crows feet and improved brow position. However, by four months you will begin to notice that some of the product is wearing off. As a result, there will be some muscle function and forehead movement. Thus, when a patient goes from completely smooth to minimal movement – it appears that the BOTOX Cosmetic has completely stopped working. In reality, perhaps only 10% of the product has gone, and you will continue to see increasingly more movement over the next two months. This is normal and expected.

Side effects related to BOTOX Cosmetic treatments are rare and frequently mild. The biggest complaint that we get from our BOTOX Cosmetic patients is that it is not a permanent change. I find this can be beneficial in that if you don’t like the outcome it will gradually disappear and not make any changes to your long-term appearance.

Side effects, though infrequent, are commonly headache, incomplete correction, asymmetry and brow droop. The more severe complications have never been seen in cosmetic doses and only in patients who suffer from muscular contractions of the neck and upper extremities.

When Do I Come Back?

There is no set time for your next BOTOX Cosmetic appointment, but we commonly recommend to return four to six months from your last appointment. Normally, this is when muscle movement is returning and the cosmetic benefit of the BOTOX Cosmetic is less apparent. However, there is no problem with waiting until your schedule permits.

Unanticipated BOTOX Injection Benefits

When we age, the lines on our faces are generated by time, exposure to the sun and the elements and also our own muscle movement. Each time our muscles move, they cause the overlying skin to crease. After thousands and thousands of contractions, the skin will gradually weaken and thin leaving you with a crease not only when you are moving your muscles, but a crease while at rest – meaning when you ARE NOT moving your muscles. These are much more challenging to address, and additional will BOTOX Cosmetic fix the movement problem, but not the “new” lines you have at rest.

Thus, if you begin to use BOTOX Cosmetic before these lines develop, you can prevent or slow the onset of these unwanted lines at rest. If you can’t move your muscles, the skin will be less frequently creased and thus these lines take longer to appear. You will be able to preserve your youthful beauty while obtaining the simultaneous immediate benefit of a smooth forehead and attractive, elevated brows. A two-fold benefit!

BOTOX and Dysport Injections

Contact our office to schedule a BOTOX Cosmetic or Dysport injection consultation with Dr. Marin.

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