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Botox is a drug that is used to block nerve transmission to a muscle. It was developed in the 1980s to treat muscle spasms in the face and muscular imbalances in the eyes. Botox evolved from medical use to aesthetic use when it was noticed that certain facial wrinkles would disappear or significantly improve when specific underlying muscles were injected with the drug.

Certain facial muscles create lines of expression. Look in a mirror. Notice that wrinkles appear when you smile, frown, squint, or show surprise. Those wrinkles are created by the contraction of muscle groups located just beneath the skin. After years of being folded by these muscle groups, skin in these areas will form creases or wrinkles. A microinjection of Botox directly into a muscle will prevent that muscle from moving. Without continually being folded, the skin’s natural rejuvenation process heals and repairs the wrinkles. The most common areas treated with Botox are lateral lines on the edges of the eyes (crow’s feet); vertical creases between the eyebrows (frown lines); and horizontal lines on the forehead.

For many people, microinjections of Botox have proven to be an ideal cosmetic solution for specific problem facial areas. The actual procedure takes only minutes, and there is no recovery period. Effects are not immediate. It takes four or five days for the injected muscles to be completely affected by the Botox. Initially the effects of an injection will last three to four months. However, with repeated quarterly injections, the effects of Botox may last nine months to a year.

Botox has been used to treat patients of all ages. Of course, the healing process is more rapid in younger patients, and so the wrinkles improve faster. Patients with deep lines or creases may benefit from a combination of Botox and fillers such as collagen or Dermalogen. Collagen is a purified skin protein from cattle. Dermalogen is a combination of human collagen and various other proteins and complex sugars that are part of the normal components of the skin. Both of these substances are injected to plump up creased or wrinkled skin. The body will absorb collagen or Dermalogen in three to four months.

Botox and fillers are also excellent supplements to more extensive aesthetic procedures. For example, if a patient has had a face lift or laser skin resurfacing procedure, but a few tiny lines still persist. Botox or a combination of Botox and a filler substance may be the answer.

Botox, collagen, and Dermalogen are considered safe and effective. Initial multicenter studies with Botox involved approximately 50,000 patients. No significant problems were found, and none have been reported since the introduction of Botox for patient care in the 1980s. Collagen has also been used for almost 20 years, and has a proven safety record. About four percent of the population is allergic to collagen, so skin-test screening is required. Dermalogen has been on the market for about one year. There are not reported cases of allergic reactions, and skin testing is not usually required.

In the hands of a skilled and experienced aesthetic surgeon, Botox can also be used as a nonsurgical alternative to lift and enhance certain areas of the face. Each facial muscle has an opposing muscle, and both muscles pull in opposite directions. If one muscle is injected with Botox, its opposing muscle can exercise more control. For example, by injecting Botox beneath the eyebrows, the muscles above the eyebrows experience less resistance and thus tend to lift the eyebrows without surgery. A similar procedure can be performed at the corners of the lips and above the upper lip.

Unlike a face lift or other surgical aesthetic procedures, Botox is not considered a long-term solution to wrinkles. It is, however, an ideal solution for many people who either do not have the time or the desire for aesthetic surgery. Botox injections are affordable, fast, and there is no recovery period. A patient can have Botox injections during lunch and then return to work. Many people choose to have Botox injections only for special occasions such as reunions, interviews, or important social or business engagements.

As with any medical procedure, complications are possible with Botox injections. However, complications are rare, minor, and seldom occur with experienced aesthetic surgeons. If you are considering the procedure, be sure to discuss your expectations and the possibility of complications with your physician.

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