WHAT AREAS CAN BE TREATED BY BOTOX?

      Forehead Lines

      Crow’s Feet

      Glabella Lines (frown lines between the eyebrows)

      Nose (bunny lines)

      Neck Tightening

      Mouth (to raise the corners)

      Eyebrow Lifting and Shaping

      Underarms (for excess sweating)

HOW DOES BOTOX WORK?

    Botox is a trade name for a toxin produced by the bacterium, Clostridium Botulinum. Small amounts of this toxin weaken muscles when injected. Botox affects the nerve. The nerve tells the muscle to work when a small amount of a chemical is released from the end of the nerve. The chemical crosses the gap and then causes the muscle to move. When Botox is injected, it prevents this chemical from being released. Without the nerve sending the chemical to tell the muscle to move, a small part of the muscle is weakened. Injecting extremely small doses of Botox directly into specific muscles results in only the action of that one muscle to be weakened. The tiny facial muscles that are related to expression lines, and the creases that the muscle causes, like frown lines, are stopped with Botox. Botox relaxes the muscles so they do not contract. After treatment, the overlying skin remains smooth and unwrinkled while the untreated facial muscles contract in a normal fashion.
    For example, the frown line between the eyebrows is caused by the action of a muscle called the corrugator. You can feel this as a thickening just below the inside of your eyebrows, when you purposefully make yourself frown. Injecting Botox directly into this corrugator muscle stops your ability to draw your eyebrows together when you frown. Once the muscle is weakened, it cannot contract, and the frown line gradually fades away. If you have the habit of constantly frowning or raising your eyebrows to make a point, Botox may prevent the wrinkles that result. 

WHAT IS THE TREATMENT LIKE? WILL the BOTOX INJECTIONS HURT?

    Botox treatments are safe. Using a tiny micro-needle, a very small amount of Botox is injected, very precisely, into several locations on the face. Because the needle is so fine and only a small amount of liquid is used, the pain associated with the injection is minimal. Most patients compare the sensation to a bug bite. A topical anesthetic is applied to all areas that will be treated to diminish discomfort. The skin can also be cooled beforehand so that the sensation is dulled.

WHAT RESULTS CAN I EXPECT?

    Wrinkles are produced by facial muscle contraction, such as frowning, smiling, etc. Over time, these furrows make you look older than you are, and Botox treatments can prevent these contractions and give you a more youthful and pleasant appearance. However, this procedure cannot improve wrinkles that are present when your face is at rest; wrinkles due to aging and sun-damaged skin are unrelated to facial muscle contractions. Botox injections will not improve sagging skin or replace the need for a facelift or brow lift. However, when Botox is used adjunct with the surgery that repairs these problems its effects help to increase the longevity of the surgery’s results. If Botox is started early enough, it can often prevent or put off signs of aging that would otherwise be correctable only through surgery.

HOW LONG DOES IT TAKE TO WORK?

    Most patients start to see some effect three days after injection. For the final result, it often takes ten to fourteen days. 

HOW LONG DO THE INJECTIONS LAST?

    For most people starting out, the injections work really well for about three months.

IS THERE AN ADVANTAGE TO STARTING YOUNGER? OR A DISADVANTAGE?

    Usually it is to the patient’s advantage to start younger. This way you can prevent the muscles beneath your skin from wrinkling the skin so deeply that permanent, deep lines are formed even while the face is at rest. However, if you are happy about the way you look, do not to get Botox injections just because they may help you in the future. Helping your skin resist aging forces is simply a pleasant side effect of your Botox injections and should not be the main purpose of your treatment.

IS IT TRUE THAT BOTOX LASTS LONGER THE MORE YOU CONTINUE TO DO IT?

    If you have Botox injections on a regular basis for 2 or 3 years you will begin to have long-term results and require less frequent injections.

CAN BOTOX INJECTIONS REPLACE A FACELIFT OR A BROWLIFT?

    A facelift has the ability to fix problems that Botox cannot. A browlift also has different effects than Botox. However, Botox can do many of the things that a browlift does. So for the patient whose brows are just a little droopy, Botox can be a cheaper alternative. Botox can usually lift the eyebrows a bit and help you to put off surgery. Also, if Botox is used in conjunction with surgery, it can improve the surgery’s staying power.

CAN I USE BOTOX IF I AM USING A RETIN-A, GLYCOLIC ACID, OR OTHER HARSH FACIAL PRODUCTS?

    Yes. These products do not have any negative effects on your Botox injections. When properly used, they can help your skin look its best after your injection.

WILL IT WORK FOR MY SKIN?

    The starting condition of your skin does effect how well Botox will help to smooth out lines. While age factors in, it is not the single most important factor. Healthy skin responds the best and if your lines are already very deep from excessive damage, they can take longer to respond to Botox. Sun exposure, cigarette smoking, and heavy drinking all damage your skin’s ability to resist wrinkling after your Botox injection and make its effects shorter lived.

HOW CAN I FIND OUT IF I AM A CANDIDATE FOR BOTOX?

    If you would like to learn more about your cosmetic options, or find out if Botox treatments might work well for you, please call our office and schedule a consultation with Dr. Day. Dr. Day is Board Certified in Dermatology and has 20 years of dermatological surgery experience. Dr. Day is the Medical Director of the Aesthetic Dermatology Center of San Antonio at Oak Hills Medical Center (210-615-7145).

HOW LONG WILL IT TAKE?

    For an initial visit, the appointment including discussion, examination, and injection, it can take about half an hour. After this primary appointment, Botox injections usually take five to twenty minutes depending on the number of sites injected.

WHAT WILL I LOOK LIKE AFTER MY INJECTIONS?

    A few small red dots at the areas that have been injected are typically the only sign right after treatment. These marks typically take 2 hours to disappear. For most patients there is no visible sign left to tell anyone that an injection has occurred. Some people develop a small bruise. This is something that can easily be concealed with makeup.

WILL I LOOK PARALYZED AFTER MY INJECTIONS?

    Our goal is to only partially weaken the muscles, leaving the patient with a very natural result.

WILL I FEEL NUMB?

    No. Botox does not cause numbness. There are two different sets of nerves in the body. The sensory nerves send the information that is processed as feeling from the skin to the brain. A different set of nerves tells muscles to move. Botox only affects the nerves that control muscles, not the sensory nerves. Botox cannot make your skin numb. If you were to touch these areas, you would certainly feel as you do normally.

WHAT ARE THE LIMITATIONS OF BOTOX INJECTIONS?

    The Botox injections patients receive are temporary, the effects of the injections lasting about three months. Therefore, you will need to have injections about four times a year. After two or three years of regular injections every three months, the duration of treatment for most patients increases so that you should require injections less frequently. The initial duration of effect varies from patient to patient.

ARE BOTOX TREATMENTS SAFE?

    Botox injections have been used for ten years safely and effectively to treat many disorders. Each year thousands of patients receive Botox treatments for a variety of conditions and it is quickly becoming a popular antiaging treatment to reverse or prevent the visible signs of aging.

CAN I GET BOTULISM FROM BOTOX INJECTIONS?

    There are no actual botulism bacteria in Botox injections. Patients receiving injections are being given the chemical secreted by the botulism bacteria. In the United States, there are still sporadic cases of botulism every year, usually attributed to improperly home-canned foods in adults and honey ingestion in infants. A Botox injection is a minuscule amount of the chemical and there is absolutely no bacteria, or anything alive, in a Botox injection. It gives you a small amount of the chemical that is injected precisely into selected muscles to weaken them.

HOW HAS BOTOX BEEN TESTED?

    Since 1980, Botox has been used for the treatment of “lazy” eye and uncontrolled eye blinking. Dr. Carruthers of Vancouver first performed Botox injections for the of treatment forehead wrinkles in 1989 and a major study was performed on his technique in 1995.

ARE THERE ANY SIDE EFFECTS?

    Side effects are very rare; in fact there are usually no side effects. Temporary bruising is the most common side effect. In some cases, the Botox toxin can migrate and cause a temporary weakness of nearby muscles. The number-one risk that most patients are afraid of is a droopy eyelid after injection. This side effect happens less than 1 percent of the time and there are risk factors that can be looked for that can tell if you are predisposed to having this occur. During an initial examination, these will be looked for and discussed. Some patients complain of a headache after injection. The effects of Botox are reversible; therefore any side effects are almost always temporary, and usually last only a few weeks.

IS THERE ANY WAY TO DECREASE MY CHANCES OF GETTING A BRUISE?

    Yes. There are many steps a patient can take to avoid this unwanted event. First, avoid aspirin, Advil, Motrin, Aleve, Nuprin, Vitamin E and other products that prolong bleeding time. Sometimes these medications can affect you as long as two weeks after you have taken them. 

IF I GET A DROOPY EYELID, WHEN DOES IT HAPPEN AND HOW LONG DOES IT LAST?

    The droopy eyelid usually appears about five days after injection. The duration of this side effect usually lasts for one and a half weeks. Patients begin with a slight amount of droopiness at the beginning. This minor annoyance becomes more noticeable for a few days, but then gradually gets better until it is gone. The droop often appears worse at the end of the day and is less noticeable in the morning.

WHO CAN PERFORM BOTOX TREATMENTS?

    Only a physician or nurse trained in the use of Botox should perform Botox treatments.

HOW MUCH DOES BOTOX COST?

    This depends on how many areas you will have treated as well as where you live. In general, the cost usually ranges from $150 to $1,000 depending on the amount of Botox injected.

IS THERE ANYONE WHO SHOULD NOT HAVE BOTOX INJECTIONS?

    Yes. Anyone who has a neuromuscular condition such as myasthenia gravis and Lambert-Eaton syndrome disorder should not have Botox injections. Also, patients who are on certain antibiotics should not have Botox injections. Women who are pregnant, who are nursing, or who are trying to become pregnant should avoid Botox injections.

CAN I GET BOTOX INJECTIONS IF I HAVE A COLD?

    Yes. A cold will not affect the results of your injections, and the injection will not worsen your cold or give you botulism.

I HAVE HEARD OF SOMEONE NOT BEING ABLE TO SWALLOW OR SPEAK AFTER AN INJECTION; IS THIS POSSIBLE?

    In cosmetic procedures, this has not happened. In medical procedures for certain disorders a high level of Botox may be injected into the deep muscles of the neck and in these circumstances; this unwanted complication could be possible is these instances.

HOW SOON CAN I WEAR MAKEUP AFTERWARD? 
    Patients can apply makeup as soon as they leave the treatment room.

CAN I RECEIVE A FACIAL OR MASSAGE AFTERWARD? CAN I FLY? CAN I DRINK?

    After four hours, you can do anything you wish. Therefore, you can fly four hours after injection. Because drinking increases the circulation throughout your face patients should be sure not to consume alcohol for four hours after their injection.

CAN I GO OUT IN THE SUN AFTER MY BOTOX INJECTION?

    Sun exposure does not adversely affect the Botox itself. However, sun exposure can have very negative affects on the condition of your skin, including cancer and premature wrinkling.