Botox Injections and Treatments

Botox Injections

Facial lines are caused by the repeated movement of the underlying facial muscles which over time results in a permanent crease or wrinkle. As an alternative to surgery in younger patients, it is possible to reduce these lines by reducing the action of the underlying muscle using botulinum (Botox ). This temporarily reduces the action of the underlying muscle. Where Botox is injected it reduces the facial movements which result in wrinkling. This gives a smoother, more rested appearance to the face. Botox also has a preventative effect when used repeatedly to reduce the onset of wrinkles forming in the long term. This is partly due to the effect of re-educating the facial muscles not to make expressions which result in wrinkling. To achieve the best results Botox is injected to a level which does not cause complete freezing of the muscles but weakens them so that some movement is still possible.

What Is Botox?

Botox is a trade name for botulinum toxin A, derived from the bacteria Clostridium Botulinum. There are different preparations of Botulinum toxin, but my preference is Botox.  Botox is a neurotoxin but is safe when given in very minute doses. Botox is administered via tiny injections directly into the muscles that cause wrinkle lines. A small amount of Botox injected into a muscle will block nerve signals that instruct your muscles to contract. In doing that Botox temporarily weakens or paralyzes the facial muscles and smoothes wrinkles in the skin for a period of few months.

Is Botox Botox Safe?

Botox is has been in use for 20 years and has now been used by millions of people. It is approved by the FDA for cosmetic use.

Where can Botox Be Used?

Botox is mostly used for frown lines, (glabellar lines), horizontal upper forehead lines and crow’s feet lines (outer eyes). A combination of glabellar and lateral canthal weakening can create a brow lift effect.
It can be used in other sites, such as around the mouth but these areas are not popular and may lead to an unnatural appearance. It can also be used for weakening of platysmal bands in the neck.

How Long Does The Botox Treatments Last?

Muscle weakness is not immediate and takes between the 3rd and 10th day after injection to develop. The effects of Botox usually last up to 3 months. This can vary between people and even between treatments. With time many people automatically learn to make less use of the muscles which cause wrinkling. Hence they need fewer Botox treatments. A small number of people become resistant to Botox, so that is no longer effective.

How much does treatment cost?

The cost varies depending on the numbers of areas being injected ad the number of units used.

What Are The Risks?

As with any sort of injection, there can be some bruising and minor swelling although this is not severe and usually settles within a few days. In about 1 in 1000 cases the Botox can spread downwards and effect the upper eyelid muscle causing temporary drooping.

If drooping eyelids occur, it usually resolves over a few weeks. Special eye drops may temporarily reduce eyelid droop if it occurs.

What do I do after the treatment?

Do not massage the area of the injection. Do not lie down for a nap – keep upright for about 3-4 hours. Using the muscle intentionally makes it contract and may help to localise the Botox to the selected muscle. Do not take any aspirin for two or three days either side of the injections as this may help to reduce the chance of bruising. It is also advised not to perform any vigorous exercise for 24-48 hours after the treatment


Pregnant or breastfeeding women.

Patients with a history of neuromuscular disease (multiple sclerosis and myasthenia gravis).

Patients taking the following medicines should not receive Botox: aminoglycoside antibiotics, penicillamine, and calcium channel blockers (Calan, Cardizem, Dilactor, Norvasc, Procardia, Verelan).

Known allergy to human albumin (egg white) or Botox; currently there are no documented cases of allergy to Botox.


Dermal fillers

Restylane is an FDA-approved dermal filler made of hyaluronic acid that restores volume to the skin, lifting and smoothing out wrinkles and other fine lines. This procedure is most commonly used to treat the glabellar lines (between the forehead) and the nasolabial folds. It can also be used to add volume and shape to the lips.

Restylane® Lyft is a more robust form of original Restylane® and is FDA-approved to provide lift to cheeks and add volume to smooth the smile lines (nasolabial folds).
Restylane® Lyft is an injectable gel that uses a hyaluronic acid, a substance that naturally occurs in abundance in our skin. As with all other hyaluronic acid products, there is an enzyme available to remove the product should the rare need arise. This makes these products ideal for the anxious patient.