BOTOX® Cosmetic
The commercial name of a botolinum toxin is botox®. Its main action is to selectively paralyze the muscles which case wrinkles by excessive contraction.
Its first use was by an American ophthalmologist in treating strabismus; later on it became a common practice in neurology, plastic surgery and in treating excessive sweating.
Today there are two preparations available: BOTOX, which is manufactured in USA and has FDA approval for use in plastic surgery and DISPORT which is manufactured in England. The level of toxin is similar between the two and most surgeons agree that there is no significant difference between them. Although, FDA's approval of the BOTOX makes is more popular and widely used than with DISPORT.
It can be injected into the following:
The glabelar muscles of the forehead, which gives an "angry look".
The orbicularis oculi, which creates wrinkles around the eyes.
The frontalis, which creates the wrinkles of the forehead.
The injection itself takes a few minutes. The surgeon uses a special syringe and injects a small amount of botox to the muscles involved. Men usually require larger amount, due to larger muscles. The effect takes place after a day or two and reaches its maximal effect after 10 days. The pain involving the injection is usually well tolerated by most of the patients, so there is no need for local anesthetics. In selected cases a sedative drug or local anesthetics may be used.
For full effect, the duration is usually 3 months, where for partial effect it it takes around 8 months. Longer action causes muscle fibers to degenerate, therefore it is recommended to repeat the treatment after 3-4 months. After several treatments there are longer periods of time with full effect and usually much less botox is required to achieve the effect. Many patients enjoy even the partial effect for longer periods of time. There is no permanent effect.
The treatment has proved to be relatively safe. Precautions include: know allergy to botox or albumin, muscle weakness, use of aminoglicozide antibiotics, pregnancy or breastfeeding.
Common side effects include: bleeding around the injection sites, headache, flu-like symptoms and local pain. Another unwanted effect is paralysis of adjacent muscles, which may cause eyelid drop (usually partial), double vision and difficulty in swallowing. Because only a part of those muscles was paralyzed there is usually a full compensation of the remaining muscle after 2-4 weeks.
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