Ten Things You Should Know About Botox®
Before You Seek Treatment

1. Botox® has FDA approval for use in treating frown lines between the eyes. It also been approved by the FDA for a number of years for the treatment of medical conditions such as blepharospasm and extraocular muscle balance.

2. Botox® works by binding to the connection between nerves and muscles and preventing the transmission of the message for the muscle to contract. In this manner, it helps to alter habitual expressions that we often adopt subconsciously. These expressions can make us look tired or angry when we really are not feeling this way.

3. Most patients in our practice return every three to four months for repeat injections. Usually the effect has only partially warn off, but most people prefer to seek retreatment before there is a complete return of muscle function. The reason for this is that this helps the patient to retrain his or her habits of facial expression. A smaller number of patients obtain a block, which lasts considerably longer and some last shorter. Occasionally it will not work at all.

4. Part of the success of Botox® therapy comes from the retraining of facial habits. It is also our impression that the facial expression muscles treated by Botox® become weaker over time when a patient undergoes several injections. In our opinion, the main reason for this is that the muscles are used less so they become smaller. This is similar to the difference between the arm muscles when an individual works out regularly at a gym versus the smaller less toned muscles that occur when an individual gets out of the habit of working out.

5. A precise understanding of the intricate anatomy of the muscles of expression is essential to success Botox® therapy. There is a significant variety in facial expression patterns in different people. This must be recognized and incorporated into the treatment plan if a nuanced approach to the therapy is desired.

6. The goal is not the complete elimination of facial expression. This looks weird. The goal is to soften and retrain the patterns of facial expressions. Overdone Botox® looks no better than overdone facial surgery.

7. Don’t settle for Botox® therapy in anything less than a medical office environment. Beauty Salons and hotel suites are not good settings for this. There are important issues of cleanliness and safety.

Alcoholic beverages and Botox® can be a dangerous mix. Herding a group of people into a “Botox® party” compromises individualized and nuanced therapy.

8. Avoid “booster” doses less than one month from the last injection. These may provoke antibodies to the Botox® molecule, which will weaken the effect of future treatments.

9. Don’t settle for treatment unless the individuals in the practice are highly experienced and have a serious commitment to artistic principles of facial rejuvenation.

10. Botox® may be only part of the answer. “Memory creases,” folds and creases in the skin that persist even in the absence of muscle contraction, will not be eliminated by Botox® alone. They do sometimes soften over time, especially after several injections. A variety of treatment options exist for the critical zones around the eyes, and the person who evaluates you should have the experience and knowledge

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