Botox is botulinum toxin derived from Clostridum botulinum bacteria. It is a protein that works at the junction of the nerve and the muscle, and prevents the release of a chemical which is responsible for movement of muscles. There are many different subtypes of this protein and Botox is one such subtype utilized to improve the lines between the eyebrows. It is a very safe and effective medicine when used properly.
Botox is injected directly into the muscles that you want relaxed and can be virtually injected anywhere in the body. Botox is FDA approved for the treatment of frown lines, or glabellar lines. These are also known as "elevens" and are located between the eyebrows. Botox can also be injected into other muscles such the forehead, crow’s feet, around lips, and chin. Botox can also be injected into the horizontal bands of the neck to give a smoother appearance. Other used of Botox include treatment of excessive sweating, relief of migraines, cervical dystonia, and even in people with cerebral palsy.
Botox for cosmetic uses is indicated for men and women between the age of 18 and 65 years of age. People who are allergic to any of the ingredients contained in the Botox preparation or have had an allergic reaction to the use of any other botulinum toxic product such as Myobloc and Dysport should not use Botox. Clients who have an infection at the proposed injection site should also avoid Botox until the infection has cleared.
Pre–existing medical conditions that affect your muscles and nerves such as amyotrophic lateral sclerosis (Lou Gehrig’s disease), myasthenia gravis, or Lambert–Eaton Syndrome should also avoid Botox. At Ethos Spa, one of our physicians will consult with you to determine if you are a candidate for Botox Cosmetic treatments.
Botox cosmetic procedures are not recommended for pregnant women, women planning or becoming pregnant, or nursing mothers as it is unknown if Botox can affect the developing baby or is passed in mothers’ milk.
The most common side effects of Botox injections are tiny red bumps at the injection site which typically resolve within several hours. Some clients may experience a headache or flu like symptoms after the injection. However a certain proportion of clients may actually report an improvement in headaches. There is also a chance you may have bruising at the injection site. It is important to let your injector know if you are taking any anti–coagulants, Vitamin E supplements, or herbal medications such as St. Johns Wort. Bruising, if it does occur, tends to be minor and can take a few days to 1 week to resolve. This can be prolonged if someone is taking blood thinning medications. There is also a change the Botox may spread away from the site of injection in result in relaxation of other muscles. This can lead to a droopy eyelid, especially when injections are done near the eye. It can persist for 4 to 6 seeks. It is temporary and resolves over time. A Botox injection near the eyes can also spread to the muscles responsible for movement of the eyeball and can lead to double vision. Another possible side effect is infection at the injection site. At Ethos Spa, we cleanse the skin with alcohol before and after the procedure and have not had a single case of infection, droopy eyelids, or any other serious adverse reactions.
More serious reactions such as difficulty breathing, difficulty swallowing, loss of strength of muscles in other parts of the body, or difficulty speaking are rare. This is usually a problem when large units of Botox, far greater than those utilized for cosmetic procedures, are injected. The treatment of medical problems such as cervical dystonias or muscle spasms required a greater number of units than those usually injected for cosmetic purposes. At Ethos Spa, we use a very concentrated dilution of Botox. This reduces the total volume injected and limits the spread away from the injected site.
At Ethos Spa, only board certified physician trained in the administration of Botox will perform the injections. We have three physicians on staff, one of whom is a plastic surgeon, to ensure that only experienced injectors perform the procedures.
Botox injections are measured in units. The number of units a person may need depends on the location of muscles, the severity of lines, as well as individual response to the Botox. The glabella region typically needs 20 to 40 Units to achieve a response. The forehead muscles require 10 to 20 units. Crow’s feet may require 15 to 20 units. These are general guidelines. You could require more or less units than mentioned above.
At Ethos Spa Skin and Laser Center, we charge per unit. There is never a sitting or consultation fee. The cost of Botox is $14/unit. If on your follow up visit, it is determined you need more Botox, this will be charged at $7/Unit. After that, the price of $14/unit is charged. Before any injections are performed, we will inform our clients how many units we are injecting, where we are injection, and what the cost will be.
Botox injections typically require no more than 5 to 10 minutes depending on the area(s) injected. After a complete history is performed, your Ethos physician will determine if you are a candidate. You will sign a consent advising you of the potential side effect of Botox injection. Pictures will be taken without expression to document any pre–existing asymmetry and then with expression to assess the severity of the treatment lines. Remember, Botox is indicated for dynamic wrinkles. lines that form with facial expression. While they may soften static wrinkles – lines present without expression, and appearing etched in – Botox is more effective on the dynamic lines. The area is cleansed and prepped with alcohol before the procedure. In addition, your injector may apply ice packs before and after the procedure to limit bruising. A very fine needle on small syringe (a TB syringe or one used to inject insulin) will be used to inject minute amounts of Botox® into the proposed site. There will be minimal discomfort or a pinprick sensation. Bleeding may occur in minute amounts at the injection site. After the injections, the site of Botox therapeutic administration will be cleansed again with alcohol.
Aftercare instructions will be provided to you after Botox injections. You must remain upright for 4 hours after injection to limit the potential spread of toxin from lying down. In addition, no strenuous activity or exercise is recommended after the injections. You can apply makeup or skin care provided you use upward and outward strokes especially for injections near the eyes. You can go back to your usual routine the following day. Be sure to notify your provider if you experience any side effects or concerning reactions.
Everyone is different, but results may take 7 to 10 days to become apparent. Some clients reports a relaxation of muscles as early as 3 to 5 days. Your injector will ask to see you in approximately a week to determine if you need more injections to achieve the desired results. The trend is to have a partial relaxation of the muscles, where there is still some movement left. Clients may prefer this as it gives a more natural results. However, other people may prefer a complete relaxation and may need additional units to Botox.
Individual results may vary but Botox can last from 3 to 5 months. Some clients may experience a longer or shorter duration. Initial administration of Botox typically results in duration in the lower range. After 3 to 5 months, you will notice your lines gradually return over 1 to 2 weeks. Your wrinkles will be no worse than before the Botox. Also, clients are reporting increased duration of effects with continued injections. Therefore Botox can be used as a measure to keep the deeper lines from forming.
People who are hypersensitive to Botox or any of its components including albumin should not use Botox. Also Botox should not be injected at any site where there is active infection. Caution should be exercised in patients with existing neuromuscular problems such as myasthenia gravis, Lou Gehrig’s disease, and multiple sclerosis to name a few. Botox should also be avoided in pregnant and nursing women. In general, Botox is not recommended for those over the age of 65.
There are creams on the market which are touted as producing the same results as Botox. Be wary of these as these claims have not been substantiated. There are other type of Botulinum toxin and the latest to receive FDA approval is Dysport (www.dysport.com). Other formulations have been used in Europe but have yet to receive FDA approval in the United States.
Visit Ethos Spa, Skin and Laser Center to schedule your complimentary consultation with one of our physicians to see if you can benefit from Botox.
