Botox Cosmetic is a procedure used to improve the appearance of "worry lines", "frown lines", "crow's feet" and other so called dynamic wrinkles.
Dynamic wrinkles occur when we smile, laugh or frown and the delicate muscles underlying the skin contract. When using Botox Cosmetic Botox toxin (also known as "BoTox") is injected into these muscles. Botulinum toxin works by weakening these tiny facial muscles. By weakening these tiny muscles, the overlying skin will smooth out while untreated facial muscles contract normally, allowing facial expression to be unaffected. Hence,
those severe frown lines between the eyes, forehead creases, & crow's feet around the eyes can be smoothed out.

Though cosmetic denervation is a relatively new treatment for dynamic wrinkles, botulinum toxin injections were FDA approved in 1989 & have been safely and effectively used for over a decade for many neurological and ophthalmologic disorders. Thousands of Botox® injections are performed
each year for a variety of conditions including the temporary amelioration of facial tics & lid spasms and, more recently, for pain control of muscular tension headaches. No irreversible clinical effects have been reported. Today, paralleling an exponential increase in our knowledge of the science of aging, cosmetic denervation has emerged as an exciting new treatment for erasing the visible consequences of aging skin.

How is Cosmetic Denervation Performed?

Cosmetic denervation is a simple and safe procedure. A small amount of diluted botulimum toxin is injected with a very fine needle into several locations of the muscles of the face (particularly the area of the frown-creases of the forehead and the crow's feet lateral to the eyes). We don't recommend the treatment around the mouth, as this may hamper fine muscles involved in speech and used to pucker the injections is usually tolerable without anesthesia. We try to minimize the discomfort by applying cold compresses before each area is treated. The medicine stings during the injection, and has been likened to the sting of an insect bite, but clears rapidly within minutes. You will be able to drive and engage in your normal daily activities immediately after your injections. A small number of people will have some temporary bruising of the skin at some injection sites which fades over several days. Foundation can be applied immediately if this occurs. Otherwise there will be no visible signs of your Treatment.

Who Should NOT be treated with BoTox?
Botox® is NOT recommended for:

Persons allergic to human albumin or botulinum toxin, Pregnant or breast-feeding women, And Persons with neuromuscular disease such as Myasthenia gravis.

Are There Any Side Effects?

Mild, temporary bruising may occur. Very slight droopiness of the upper eyelid occurs in about 2 % of people who have their frown lines injected. About 5% of people who have their forehead immediately above the eyebrows injected may notice this effect. A much smaller number of people will notice slight asymmetry of the lower face after injections of the crow's feet muscles. These effects are not usually noticeable by others and fully recover after 3 to 5 weeks. An extremely rare side effect, please be sure to follow the post-treatment instructions. A very small percentage of people are minimally responsive to the treatment. A rare patient may even develop antibodies against Botox® & develop resistance over time.

What Kind of Results Can I expect?

If dynamic wrinkles are making you look older & more "severe" than you should, cosmetic denervation can smooth these out and give you a more youthful and rested appearance. However, this treatment will not improve the more common "static" wrinkles that are unrelated to facial muscle contraction and does not improve loose or sagging skin. Results are typically seen within 24-72 hours of the treatment and last for 6 weeks to 6 months (typically 3-4 months). Occasionally, there is a muscle that does not respond and a "touch up" may be needed in 2-3 weeks.

How Long do the Results Last?

Initially, most people require a repeat injection every 3 months to maintain the effect. However, after 3 to 5 injections the effect may last longer and a repeat injection may only be required every 6 to 12 months.

What Instructions Should I Follow After Treatment?

Do not rub the injection sites, as this may spread the solution to adjacent muscles. Do not like down for 4 hours, for the same reason. Exercise the muscles by doing the full range of animated facial expressions (raise your brows, furrow your brows & frown deeply, smile, etc..) every 15 minutes for 1-2 hours. Botulinum toxin attaches better to active muscles. A small number of people will require a higher does than that given with the first treatment to obtain an effect. If you have seen no improvement after 2 weeks please call us and a "touch-up" can be scheduled.

BEFORE	AFTER