Botox: Everything You Need to Know


Botox, also known as Botulinum toxin, or onabotulinumtoxinA is a material that has been known for over a century. Initially, Botox was used for lazy eye, a condition known medically as strabismus, and inability to move eyelids, also called blepharospasm. It was approved in 2002 for improving and relaxing frown lines in the area between the eyes on the forehead.  It has since been used successfully in million cases.
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Also, Botox was approved in 2004 for excess sweating (hyperhidrosis), and Botox was approved for the treatment of migraine headaches in 2010. A common misapprehension is that Botox paralyzes the muscles in the face. This can be a possibility, but in extreme cases, where large amounts is used.

How to Prepare Before a Botox Injection

Botox is in form of a crystalline substance from the manufacturer. However, it has to be reconstituted with saline or another liquid. Practitioners add varying amounts of liquid when reconstituting it. Although there is no right or wrong amount of liquid to add, most physicians add about 2 mL-3 mL (about a half a teaspoon) of liquid to each vial. Some add quite a bit more, which can lead patients to think they are getting more Botox when, in reality, they are getting the same or less amount of Botox than samples reconstituted in a stronger way. It is the total dose of medication that gives the desired result, not the volume of liquid used.
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The Botox Procedure

To begin the Botox procedure, the patient is placed in a slightly raised position on the exam table, and the areas to be injected are cleansed with a nonalcohol cleanser. A topical anesthetic is then applied before the Botox is injected into the desired areas. Typical injection patterns include about four or five areas on each side of the forehead and two or three areas on either eye area. More areas can be injected by skilled physicians, depending on the type of wrinkles. If an area appears to bleed after the injection, pressure will be applied.

What Happens After the Botox Procedure?

After the procedure, the patient will usually lay upright or semi-upright on the exam table for about two to five minutes to make sure he or she is okay. Practitioners do warn patients to avoid lying down for two to four hours. The patient should avoid taking aspirin or ibuprofen to ease discomfort associated with bruising.
Physicians warn the patients to avoid using the affected muscles during the next several days and to avoid vigorous activity for several hours later because of risk of bruising.

What to Expect from Botox

After the Botox procedure, the results will become evident within three to 10 days. Photographs will be taken before the procedure so that patients can check their results. It is surprising to see how many people do not recall how they looked before the procedure and are amazed at the difference when shown a picture.
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The patient should note that Botox does not really erase lines but relaxes them. This causes deeper lines to appear slightly less deep
The patient may need to have additional procedures, such as the use of filler substances to plump up the wrinkles that are now relaxed. Botox procedure may have to be done about two or three times in order to have best results. The area of the crease between the eyes is a predominantly ideal area for Botox use in conjunction with filler as these fixed wrinkles don’t always respond to Botox alone.

Risks and Side Effects of Botox Injections

For Botox procedure, the risks are very minor. The main risks may include:
  • Flu-like illness
  • Headache
  • Pain
  • Drooping eyelid or eyebrow area
The practitioner may need to examine the patient’s lids before injecting Botox because the patient may not be a good candidate if he or she has an extremely droopy lid. Ptosis, also called severe drooping of the eyelid, can occur in up to 5% of patients but is very rare.
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It is possible for the botulinum toxin to travel back to the central nervous system, a condition called retrograde botulinum toxin transmission. This can lead to long-term damage. Studies done in Italy by Flavia Antonucci have been mainly on a raw form of the toxin and not any of the commercially available preparations.

When Will Results Become Noticeable?

The results usually start to be noticed within three to 10 days or even sooner. They tend to last in most people for up to three or four months. As time passes, the muscle activity will gradually return to normal. Additionally, other areas may return to activity over time, depending on the amount injected. Filler injections like Restylane, Perlane, or Juvederm tend to last roughly six to 12 months, depending on the amount used. Also, Botox results can vary depending on who is performing the injection on the patient. It is very important to go to a physician who is experienced at performing this procedure.
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When to Seek Medical Care

It is best to seek medical care if you notice the following signs after a Botox procedure:
  • Droopy eyelid
  • Rashes
  • Difficulty breathing
  • Bruises that last longer than two weeks
Bruises generally disappear within one to two weeks after the procedure.

Disclaimer: The content provided on is purely informative and educational in nature and should not be interpreted as medical advice. Please use the content only in consultation with an appropriate certified medical doctor or healthcare professional.


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