What’s Botulinum Toxin?

Many people have wrinkles in their skin. While some of the wrinkles are caused by sun damage or other external factors, many wrinkles are caused by the contraction of certain facial muscles. Examples include “frown lines” between the eyebrows, horizontal wrinkles across the forehead, and “crow’s feet” beside the eyes. If only those muscles didn’t contract, then people wouldn’t have wrinkles in those areas. But there’s no way you can just decide never to have certain facial expressions, so how can you prevent those muscles from contracting?

Enter botulinum toxin. Also known as botox, and sold under brand names including Dysport and Botox, this is a chemical derived from bacteria. It acts to paralyze muscles by interrupting the communication between the nerve and the muscle cells. In large doses, it’s dangerous; but when injected in very tiny amounts into precise locations in certain small facial muscles, it can act to reduce the contractions of those muscles that cause wrinkles. It’s the most common cosmetic dermatology procedure, with over six million people per year choosing botox injections.

If you’re choosing botox, make sure you’re choosing it because you really want it, not to please someone else or to fit an imagined ideal. No one else can make the choice for you; it’s your body, and you’re in charge of it. After you do your research and understand the procedure, if you believe that botox is right for you, then proceed. To help you in your decision-making process, we have some information about the risks and benefits of having botox injections at Botulinum Toxin: Risks and Benefits.

Please note that this page is for informational purposes only, and is not a substitute for qualified, individualized medical advice. You should discuss your potential elective procedure with your own doctor(s), including your primary care physician and the doctor who will perform your procedure if you decide to proceed.

 

The procedure

How it’s done

The injection of botulinum toxin is done through a very thin needle. Because the procedure is minimally invasive, there’s usually no anesthesia or sedation necessary. Injections of local anesthetic, a numbing agent like those used in dentistry, would not make sense, because the needle for the anesthetic is larger than that for the botox. Many people are surprised to find that botox injections are not very painful; in fact, they’re much less painful than an injection of vaccine into the arm. However, if you’re very concerned about pain, you can apply a numbing cream to the area to be treated about an hour before your procedure. You cover it with saran wrap or another plastic covering and leave it on for a while, then wipe it off just before your injections. This is not necessary for most people, but is an option if you’re afraid of injections.

Your provider will examine your face and determine which muscles should be injected to reduce the wrinkles that most bother you. Then, the skin is cleaned to reduce the risk of infection, and the very small needle is used to inject minute amounts of botulinum toxin into precise locations. A skilled provider is able to cause paralysis only of the muscles that are causing the wrinkles, preserving your natural facial expressions. This process of examination and injection usually takes about 15 minutes.

 

Preparing for the procedure

Choosing your doctor

While cosmetic dermatology procedures may be offered at spas and beauty salons, they’re actually technical procedures that should be performed by qualified medical professionals. Your provider should have the degree MD (Medical Doctor), or should be an RN (Registered Nurse) or PA (Physician’s Assistant) who is under the direct supervision of an MD. Ideally, this doctor should be trained and board-certified in either plastic surgery or dermatology. In some states, only the doctor him- or herself can legally inject botox.

When you go to a doctor’s clinic for botox, be aware that the doctor whose name is on the clinic may not be directly involved in your treatment; you may never even meet him or her. Sometimes, the doctor doesn’t even stay at the clinic during the day! For safety reasons, it’s best to have an MD on-site who has examined you personally. This is because while the risks from these procedures are small, adverse reactions can and do happen, so you want someone present who can deal with problems if they do arise. When you call to schedule an appointment, ask who will be performing the procedure and whether a qualified physician will be present in the clinic during the procedure.

For more help in your search for a cosmetic dermatologist, visit our How to Find the Best Cosmetic Dermatologist page. At Doctor Review, you can also search providers for patient reviews to help you find the very best.

 

Getting ready for the procedure

There’s essentially nothing you need to do to get ready for your botox injections. If you prefer to numb the area, then you need to remember to apply your numbing cream about an hour before the procedure.

 

Recovery

Because this is a minimally-invasive procedure, and there is no anesthesia or sedation involved, there is virtually no recovery time necessary from botox. You could have botox injected on your lunch hour and then go back to work. The only caution you should be aware of is that you shouldn’t rub the treated parts of your face. If you do, then you might cause the botox that was targeted to one location to move to another, which could lead to your expressions being unnatural for a while.

The effects of your botulinum toxin injection will be temporary. They usually last between four and six months. After that, if you want to maintain your results, you should plan to get another injection of botox.