The promise of a more youthful look can be very tempting. Botox is regarded by some as the ultimate fountain of youth. BOTOX® Cosmetic was released in 2002 by the FDA for the treatment of frown lines between the eyebrows. In the U.S., Botox injections have become the most popular and least expensive cosmetic procedure to regain a more youthful appearance. In this article, you’ll find out what Botox is, and how and why it’s used.
The cosmetic benefits of Botox were found quite accidentally. In 1987, ophthalmologists, Drs. Jean and Alastair Carruthers, were treating patients with Botox for an eye muscle disorder that causes involuntary blinking. The doctors noted that Botox also smoothed the lines between the patients’ eyebrows – lines that tend to make one look tired, angry or displeased. In 1992, they published the first manuscript on the use of Botox for treating frown lines and opened a new era in the field of minimally invasive cosmetic surgery.
Anatomy of a Wrinkle
There are two types of wrinkles, ‘dynamic’ and ‘static’. When a person is young, they don’t have wrinkles because the skin does a great job of stretching and staying firm. There’s not a magic age when everyone suddenly gets wrinkles.
Dynamic wrinkles can develop from years of facial movements that result from squinting or smiling like the little wrinkles around the eyes called “crow’s feet.”
Static wrinkles are formed by sagging skin. As skin loses its elasticity with age or spending too much time in the sun, it does not rebound from the constant forces of stress placed upon it. Skin gets thinner and loses collagen. As this plump appearance begins to disappear, the skin starts to sag, and wrinkles form.
The facelift has been the gold standard for treating static wrinkles. However, treating dynamic wrinkles was always difficult until the advent of Botox.
How It Works
Botox is very safe to administer. It has been used for the past twenty years to treat involuntary muscle spasms and more recently, migraine headaches and excessive sweating. Botox diminishes wrinkles by blocking the release of the chemical substance that causes muscle contraction. It also blocks the same chemical signal responsible for embarrassing excessive sweat.
No long-term adverse effects have been described with the cosmetic use of Botox. In skillful hands, side effects are minimal and results are highly predictable. The procedure may be repeated as often as desired and can be used in combination with other treatments for a more youthful appearance.
Botox is injected relatively painlessly with a micro-needle directly into or around facial muscles that your individual needs require. Improvement in wrinkles can be seen within days and can last up to four months. Benefits can last even longer with repeated use. If you are pregnant, taking certain medications or have a neuromuscular disease, you are not eligible to receive BOTOX® Cosmetic treatments.
Treatment of the Upper Face
Doctors use Botox most often on the upper face. Dynamic wrinkles in this area are caused by repeated movement in the face. Wrinkles appear when the muscles contract, creasing the overlying skin like an accordion. This leads to a “persistent frown” and a more aged appearance.
The most common areas that are treated are frown lines, the horizontal bands of wrinkles across the forehead and crow’s feet. Other areas of the upper face can also be treated. These include bunny lines’ across the bridge of the nose and ‘under eye’ creases. Botox can also be used to elevate the mid and lateral eyebrow for eyebrow shaping.
Treatment of the Lower Face
The lower face is subject to both dynamic as well as static forces and therefore can be more challenging to treat. Botox can be used as a primary treatment or in conjunction with dermal fillers to rejuvenate the lower face. Injections into the upper and lower lip treat the radial lines around the mouth, also known as ‘lipstick lines’ or ‘sunbeam wrinkles’. Botox can correct dimpling of the chin and ‘marionette lines’ by softening irregular folds on the chin and on either side of the mouth.
The entire procedure takes about ten minutes. Treatments consist of a few tiny injections in the group of muscles at the desired treatment area. Anesthesia isn’t necessary but some of our patients choose to numb the site with a cold pack. Discomfort is minimal and brief, so patients may resume normal activities immediately.
New patients require about 25 units of Botox for frown lines, 10-15 units for forehead lines and 10-15 units per side for crow’s feet. Men require higher doses because they have larger and stronger facial muscles.
Botox has revolutionized the world of cosmetic dermatology. It is used routinely as an adjunct to surgery, soft tissue fillers, laser resurfacing and pulsed light therapy for skin rejuvenation. The list of cosmetic uses continues to grow.