Botulinum toxin (Botox, onabotulinumtoxinA) is a substance that has been known for over 100 years and has actually been used for medical purposes for more than 50 years. The first uses for Botox where for an ailment called “lazy eye” where the patient would not be able to move the eyelids in certain ways or even keep the eyelid open to be able to see properly. Once Botox was administered, the muscles in the eye would relax allowing the patient to move their eyelids normally. Since then it has come in use as a treatment for a variety of other physical problems and ailments. In 2002 the FDA approved Botox for helping improve “frown lines” between the eyes and the forehead. It has been used successfully now in more than 12 million patients and in 2004 Botox was again approved for sweating and in 2010 Botox was approved to help migraine sufferers.
A common belief or actual misconception is that Botox paralyzes the muscles in the face. This can happen with extreme amounts of Botox but most surgical specialists only administer just the right amount that allows the patient to have some limited activity of the muscles instead of using so much that it causes over activity in the applied mobile area. Patients of Botox should be aware that Botox is not intended to keep them from making the normal expressions but to stop them from making facial frowns or grimaces that have become unintended habits. When done correctly the face will look more rested and the patient will even look happy.
The substance “Botox” is a crystalline material that comes from the manufacturer. The largest of these manufacturers is Allergan. This crystalline material then needs to be remixed or reconstituted with saline liquid or another liquid substance. Surgical specialists add different amounts of the liquid to the crystalline Botox as there is really no wrong or right way of how much liquid to add. Most specialists use 2 mL-3mL of liquid to each vial of Botox. Getting the Botox ready for injection differs from specialist to specialist.
The procedure or Administration of Botox
When a patient is ready for the Botox injections they are usually in a raised position on either a table or exam chair. The areas to be injected are cleaned with a cleanser that should be non-alcohol such as Betadine or Hibiclens. Some surgical specialists will apply a topical anesthetic. The Botox is then injected into the desired areas.
Once the injections are done, the patient is put in an upright position for about five minutes to make sure that everything is OK and they feel fine after the injections. At this point it is mentioned to the patient that she should not lay down for two to four hours after. Bruising can happen with the Botox procedure and it’s important to not take any type of aspirin related products including Ibuprofen or Naproxen if there is a belief that bruising will be a concern.
Results can be seen in as early as three to ten days. The patient may have photos taken before the Botox injections so that they can check the results on their own. Botox does not actually erase the lines in your face. It simply relaxes them.