An illustrated guide to facial cosmetic surgery and Botox injections

What is Botox?

Brand name Botox medically known as botulism toxin purified form of botulinum toxin Type A is used in form of injections to smooth out brow furrows or frown lines and skin wrinkles around the facial area. The expression lines commonly called as "crow's feet" or "glabellar lines" are the marks that occur on the skin as a result of the completion of a muscular movement or gesture over a long period of time. Botulinum toxin, which is commercially known as Botox, has been used for over 20 years in the field of plastic and aesthetic surgeries and has been proved beneficial in treating these problems and improving the overall look and appearance of a person's face.

Botulinum toxin is a toxin purified protein produced by a bacteria called "Clostridium Botulinum". There are different types of toxins produced by this bacterium; however, the Botulinum toxin "Type A" is used for cosmetic treatment.

While we are talking about a toxin, Botox (Botulinum Toxin Type A) does not at all has any adverse side effects or complications of any kind. This is because the quantities used in the treatment of expression lines or skin wrinkles are very small and fail to spread into the rest of the body.

How Botox injection helps?

Botulinum toxin or Botox blocks the transmission of nerve impulses at the muscle. This results in weakening of the muscle and the toxin then interferes with the function of contraction of the muscles. In this way, muscle comes at rest and the overlying skin relaxes and there is softening of expression lines and skin wrinkles. The main areas treated with this toxin include the expression lines, forehead, brows, crow's feet, and neck.

How Botox procedure is performed?

The procedure is performed with the patient sitting. The technique involves injecting small quantities of Botox at the level of the muscles that produce expression lines. To achieve this, the plastic surgeon asks the patient to contract the muscles that will be treated with a shot using a very thin needle and then the surgeon injects the substance in the required area.

The effects of the toxin are felt from 5 to 10 days of injection and the effect lasts for 4 to 7 months. The expression lines improve gradually over a period of approximately 12 weeks depending on each patient.

Once the infiltration of Botulinum toxin type A is done, the patient should be kept in an upright position for about 4 hours until the toxin is distributed effectively around the connecting nerve sites within the muscles. The procedure can be repeated once the effects disappear.

Negative effects of Botox treatment

The BOTOX infiltration is really safe if it is performed by an experienced plastic surgeon and who knows perfectly all the anatomy of the face. This will prevent the patient from complications such as ptosis (abnormal dropping of muscles) or diplopia (double vision).

Some of the side effects the patients may present with treatment are:

1. Pain and inflammation at the site of Botox infiltration.

2. Headache.

3. Nausea.

These side effects are common but not all the patients may have these symptoms.

Contraindications for Botox injection

The patients with following things should not undergo the Botox procedure.

1. Myasthenia gravis.

2. Neuromuscular diseases.

3. Allergy to human albumin infusion.

4. Allergy to Botulinum Toxin.

5. At the time of pregnancy or breastfeeding.

6. Intake of alcohol on the last week before treatment.

7. Intake of aspirin or NSAIDS (non-steroidal anti-inflammatory drugs) two weeks prior to treatment.

What should I do before receiving treatment with Botox?

1. Do not drink alcoholic beverages.

2. Do not take aspirin or other anti-inflammatories.

What should I do after receiving treatment with BOTOX?

1. Keep yourself in an upright position for at least 4 hours after the procedure is done.

2. Do not touch the treated areas.

Can I repeat the BOTOX procedure again?

Definitely yes. The botulinum toxin injection may be repeated every 4 to 7 months.

How long it takes to get the full effect of Botox?

After the first set of shots, the surgeons perform a re-injection after two weeks allowing the localization of any resistance from the muscles. According to some recent studies, 90% of patients respond to Botox (Botulinum Toxin Type A). This leaves 10% who do not respond to this treatment. The success of treatment lies with the weakening of muscles that begins between 24 to 48 hours but the complete weakening of muscles could be determined after 7 days of treatment. The effects of treatment after the first injection last between four and seven months in majority of patients.

When a Botox re-injection is required?

The Botox re-injection is suggested every four or five months to keep the muscles paralyzed and allowing the wrinkles to vanish completely. Once the area is smoothed out completely, the surgeon instructs the patient to return to therapy only when there is regression of the treated muscles.

Who should not use Botox (Botulinum Toxin type A)?

Although there are no reported birth defects by using this medicine, it is not advisable for women who are pregnant or are breast-feeding their babies. Patients with a history of neuromuscular diseases such as myasthenia gravis or multiple sclerosis or other diseases related to neural transmission should avoid the use of Botox.

What other alternatives exist instead of Botox?

Other alternatives instead of using Botox are dermal filler agents including collagen fillers and Gore-Tex and Fibril procedures, which are used in the field of plastic surgery for the treatment of forehead, temporal, neck and other regions of the face. Myobloc is another new alternative for this treatment.

Allergic Reaction to Botox

According to some recent surveys, no allergic reaction to Botox cases have been reported so far in over 30,000 treatments, but people who know they are allergic to botulinum toxin or albumin should avoid the use of Botox (Botulinum Toxin Type A).

How painful are Botox injections?

The needles used for Botox treatment are small and indistinct and the infiltrated Botox medicine itself does not hurt as much as the plastic surgeon uses local anesthesia before starting the treatment. The majority of patients experience less discomfort than with collagen filler injections. However, the pain can be minimized with the use of ice by cooling off the skin area a few moments before applying the injection. Some patients have found that taking two tablets of Tylenol before the injection reduces their discomfort.