Frequently Asked Questions About Botox

Is Botox really a toxin?

Yes! It is a neurotoxin that is purified from a bacterium found in soil called clostridium botulinum. The toxin is used by this organism to fight other bacteria. Botox is purified and diluted millions of times and so it can be injected safely. Botox works by attaching itself to nearby muscles so they don’t flex when stimulated. Botox only works in the muscles near where it was placed and so cannot cause muscle effects elsewhere in the body.

What is Botox used for?

Botox has found many uses in the field of medicine but is most commonly used for its cosmetic effects and less often, the treatment of migraines. Botox is a wonder drug in the treatment of wrinkles when used for the face because it provides paralysis of the muscles near the injection site. The muscles of the face that we use to make facial expressions help with communication but also have the effect of causing wrinkles to occur over time. In youth, our skin is thick and rich with elastic fibers and so when we use thee facial muscles, they have little effect on the overlying skin. Over time and with the aging process, our skin becomes thinner and we lose elasticity. Also, our skin becomes sensitive to the effects of the folding effects of the underlying muscles and the skin can become injured and develop wrinkles. Botox minimizes facial muscle movement and therefore minimizes the effect of the muscles on skin injury.

How long does it take  for Botox to take effect and how long does it last?

Once the facial muscles are treated with Botox, it takes approximately 2-5 days for the full effect. Most patients experience the full effect of Botox for three and a half months although, for some, it is shorter. Some patients report that their Botox treatments have lasted six months but it is very rare for the effect to noted more than six months.

Can Botox be used during surgery?

Patients who have cosmetic eyelid surgery or other facial plastic surgery, like a face lift can also have Botox injected at the same time.

What is Botox cost?

The cost of Botox treatment varies depending on who is treating the patient and how many areas and units are used. Some patients also may require less Botox to achieve the same effect as others. Also, some patients might want less effect than other patients and so may require less Botox. These patients want to have some muscle activity as opposed to complete immobility because they want to retain some facial expression. This is especially true when Botox is placed over the forehead muscles to soften the wrinkles that go across the forehead from side to side. Completely paralyzing these muscles can also cause the brows to fall and when this happens patients can notice that the skin of the upper lids is drooping over their eyes. Placing the Botox higher on the forehead can help to avoid this problem.

What happens if you stop using Botox?

Once the effect of the last treatment of Botox has diminished, patients have a return of full muscle function. There is no withdrawal effect related to Botox.

What happens with too much Botox?

When Botox is injected near the muscles of facial expression, it causes a paralysis of those muscles and there is no motion for approximately three and a half months on average. If more Botox is injected than the amount that requires the full effect, there is no additional effect. The excess Botox is simply broken down by the body.

Can you get Botulism from Botox?

Botox is purified from the Botulinum toxin purified from a bacterium but it is diluted millions of times to achieve the concentration necessary for medical use. Botox is not only FDA approved but there has never been a case of Botulism from Botox injection.

Are there any alternatives to Botox?

Dysport is another FDA approved substance used to treat facial wrinkles but chemically, is nearly identical to Botox. The real alternative to Botox is surgery. For example, the most common site treated with Botox is the area between the brows where skin wrinkling and folding can occur. It is also possible to remove these muscles for a permanent effect. There are other surgical procedures that overlap with the effects of Botox and they can be discussed with your Plastic Surgeon.

Dr. David Newman is a board certified facial plastic surgeon.  Want to find out if your doctor is board certified?  Go to CertificationMatters.org.

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