Living Columns & Blogs

Want to help put a fresh face on 2019? What to know about Botox injections

The New Year always brings thoughts of a fresh start. This January, you may be considering Botox injections to help reduce fine lines and wrinkles. But what is Botox, and is it safe?

Botox is a form of botulinum toxin, which is produced by the same microbe that causes botulism, a form of food poisoning. When injected, purified Botox blocks chemical signals from nerves, temporarily causing treated muscles to relax. In the 1980s, an ophthalmologist looking for a treatment for eyelid spasms realized that Botox also smoothed facial wrinkles. This realization led to a significant amount of research on the cosmetic use of Botox. In 2002, the U.S. Food and Drug Administration approved the drug for cosmetic use, giving people a new way to turn back the aging clock without surgery.

Botulinum toxin is available under several brand names, although Botox remains the most well-known. The drug is approved to treat three types of wrinkles that develop from years of normal facial expressions and become etched into the skin over time:

  • Furrows that run horizontally across the forehead

  • Frown lines between the eyebrows, commonly known as “the 11s,” because they resemble the numeral

  • “Crow’s feet” wrinkles that radiate from the outside corners of the eyes

Botox injections can soften these lines, especially those that become more prominent with facial expressions. This makes the face appear younger while still allowing for regular expressions, from smiling to frowning to raising the eyebrows. Both men and women opt for the treatment, and the age to begin is a matter of personal choice. Some have their first treatment while in their 20s.

While most patients can receive Botox treatments, individuals with various neuromuscular disorders are at increased risk of side effects and should not receive Botox injections. Also, the treatment is not recommended for pregnant or nursing women.

Choose a provider carefully

When injected properly by a trained provider, Botox typically has few side effects, and allergic reactions are rare. Avoid “Botox parties,” where guests at a social gathering receive assembly-line injections, often without taking their medical histories into consideration. To achieve the most natural-looking Botox results, the provider needs to consider the patient’s individual facial muscles and appearance and tailor treatments accordingly.

Look for a doctor with specialized training and enough experience in cosmetic treatments to personalize the treatment. Start with a consultation about your goals and how Botox might help to achieve them. Be sure to inform the physician of all the medications you take, both prescribed and over the counter, as well as any previous surgeries or cosmetic treatments.

Botox treatment is typically done in the physician’s office and involves multiple injections using thin needles, similar in size to those used for insulin. The physician can numb the site before the injections using a topical anesthetic, but many patients find they don’t need this step. Treatment usually takes between 10 to 15 minutes, and most patients return to work or their daily routine right away. Minor redness might be visible at the injection sites immediately after the injections are performed, but this fades quickly. No special care is required after treatment.

The results of Botox injections start to appear within three to seven days and last about three to four months. Treatment can be a one-time practice or ongoing for years. Some people time the injections so that the maximum effect, which is visible about two weeks later, coincides with a wedding or other major social event.

The most common procedure

Botox is also used for treating medical conditions such as lazy eye, involuntary muscle contractions, excessive sweating, overactive bladder and migraine headaches. Still, the drug’s most frequent use is cosmetic. In 2017, more than 7 million procedures involving botulinum toxin for cosmetic improvement were performed in the United States, according to the American Society of Plastic Surgeons, making Botox injections the most common minimally invasive cosmetic procedure.

Cassandra Simonetta, MD, is a dermatologist and Mohs surgeon with Penn State Health Medical Group at Colonnade.