Botulinum Toxin is a neuromodulator protein which is purified from Clostridia botulinum and most commonly marketed under the trade names Botox®, Dysport®, and Xeomin®. This purification process yields a sterile product suitable for specific therapeutic uses. Once the diluted neuromodulator is injected, it causes temporary paralysis of target muscles by preventing the transmission of nerve impulses to the muscle. These neuromodulators generally are effective for 3-4 months.
Treatment with botulinum toxin can cause your facial lines to become less noticeable or essentially disappear by paralyzing the underlying muscles. The areas most commonly treated for cosmetic purposes include: 1) the glabella (frown lines between the eyebrows); 2) forehead; 3) crows’ feet (lateral to the eyes); 4) smokers’ lines around the mouth; 5) other head and neck muscles. These neuromodulators are injected into the muscle with 31-guage needles (these are the same as diabetic insulin needles), which are almost painless.
How much Botox® do I need?
Using Botox® as an example: The amount of Botox® used varies greatly from patient to patient. However, according to Allergan (the producer of Botox® Cosmetic), approximately 15 to 20 units are required to effectively treat an area. This means that 15-20 units are often needed to treat the glabella (the area between your eyebrows), 15-20 units for the forehead, and another 15-20 units for the crow’s feet.
Botox® works by blocking the release of acetylcholine from nerves that interact with adjacent muscles. Normally, acetylcholine is released from nerves, travels to the muscle, binds to its receptor there, and causes the muscle to contract through what is known as a “signaling cascade”. When Botox® inhibits the release of acetylcholine, the muscle will no longer contract in response to acetylcholine released from the nerves. Therefore, the overlying skin won’t wrinkle due to muscle contraction, and patients normally appear more relaxed and younger.
What Are The Risks?
No procedure is without risk. The risk of an adverse effect due to neuromodulator injection is very small, but not zero, and every procedure has its limitations. Although the majority of patients do not experience any complications, you should discuss these with your provider in order to make certain that you understand the risks, potential complications, limitations, and possible consequences of neuromodulator injections. Risks include, but are not limited to:
- Incomplete Block
These risks are even further minimized by stopping blood thinners (aspirin, ibuprofen, etc) one week prior to your procedure, and making sure that a well trained and experienced professional provides your treatments.