Botox

Botox Cosmetic (onabotulinumtoxinA) is a prescription medicine made from a purified protein produced by bacteria. It is one brand of botulinum toxin type A. Injected into a muscle, it blocks the nerve signal that tells that muscle to squeeze.

Its first FDA cosmetic approval came in 2002 for frown lines between the eyebrows. It is now approved to temporarily improve the appearance of moderate to severe frown lines, forehead lines, crow’s feet, and vertical neck bands in adults. The neck bands are called platysma bands.

The other FDA-approved cosmetic brands are Dysport, Xeomin, Jeuveau, Daxxify, and Letybo. They work the same way. Their approved uses differ. Units cannot be compared across brands.

Horizontal lines across your forehead deepen when you raise your eyebrows. The lines between your brows deepen when you frown. Crow’s feet beside your eyes deepen when you smile or squint. These are the movement lines Botox is used to treat.

A crease that remains when your face is still needs a closer look. Replacing lost volume and treating sun spots are outside Botox’s FDA-approved cosmetic uses.

The consult should cover your health, medicines, past injections, and the specific line that bothers you. Bring a list of supplements too. Tell the person holding the syringe about previous facial surgery and any problems after earlier treatments.

Your provider watches your face move and may mark the injection points. Your skin is cleaned. A fine needle delivers small amounts into the selected muscles. The injections usually take less than 15 minutes. Allow separate time for the exam and questions.

You may feel a pinch or sting with each injection. Numbing is not usually required. Numbing cream or ice may be offered.

A check at about two weeks is a chance to discuss remaining movement or unwanted changes.

Botox usually starts working within a few days. The full effect takes about two weeks to assess. An appointment on the day of an event leaves no time to judge the effect or deal with bruising.

The effect lasts about three to four months. Keeping it up means repeat appointments. Include the follow-up check when you count the time each treatment will take.

Redness, swelling, soreness, and bruising can follow the injections. Headache can happen too. Most people return to everyday activities immediately. That does not mean your skin will show no signs of treatment. Written aftercare instructions should cover when to exercise.

A brow or eyelid can droop. Dry eyes and changes in vision can occur. Contact your provider promptly about these symptoms.

Rarely, the toxin’s effects can spread beyond the injection area. Trouble swallowing, speaking, or breathing needs immediate medical attention. These symptoms can appear hours to weeks after treatment. Breathing and swallowing problems can be life-threatening. Serious allergic reactions have also been reported. Ask who handles a complication after office hours.

The FDA label rules out Botox Cosmetic if you have an allergy to any botulinum toxin product or an ingredient in the injection. It also rules it out if the planned injection site is infected.

Pregnancy and breastfeeding need a separate discussion. There is not enough evidence to establish safety for a pregnancy or breastfed baby. Cosmetic treatment is generally deferred.

Certain muscle or nerve conditions can increase the risk of serious effects. Existing swallowing or breathing problems also matter. Tell your provider about these before treatment. Some antibiotics and muscle relaxants can strengthen Botox’s effects. Bring your medication list for review.

• Who will be doing the injecting, and what is their license?
• How much experience do they have treating the area that bothers me?
• Which brand will you use, and is this use FDA-approved?
• What is the total price, and does it include a follow-up check?
• Who will assess me if something goes wrong after I leave?

The price depends on the number of units, the area treated, and your provider. Your ongoing cost also depends on how often you return. Ask for the proposed unit count and the full appointment price. Compare the total for the same brand and treatment plan.

This is a guide, not medical advice. Whether a treatment is right for you is a decision for a licensed provider who has examined you.