Botox is the brand name of the most popular injectable neurotoxin on the market. It was the first
and only injection to relax wrinkles for several years, so the brand name “Botox” is sometimes
used to describe any of the injectable neurotoxins. (Dysport and Xeomin are two other brands of
neurotoxin.)
More than 7 million Botox treatments were performed in 2017.
Despite its popularity, Botox has been known to make some people a bit uncomfortable. After
all, it’s made from a purified form of the neurotoxin responsible for Botulism. However, Botox
has proven to be an effective treatment for many medical conditions, and most of the fear
surrounding it is just due to confusion or ignorance.
Paracelsus famously said, "only the dose makes a remedy poisonous." It would be inadvisable to take any drug at 100-500 times the prescribed amount, and that's about how much Botox wouldbe required to bring about any of the symptoms of Botulism. Not only would you need a much more potent dose, but that dose would also then have to find its way into your bloodstream somehow. Botox works by being injected in tiny therapeutic doses into specific muscles, where it stays put; remaining active for three to four months.
Botox works by blocking signals from a nerve ending to an overactive muscle. The
neurotransmitter Acetylcholine attaches to receptors on muscle cells and causes them to contract. Botox prevents the release of acetylcholine. This ability to limit the contractions of muscles gives Botox a multitude of applications across medicine; from eye twitches to teeth grinding to leaky bladders.
So, how does this translate to wrinkles? Certain exaggerated facial movements are responsible
for something called dynamic wrinkles. Temporarily relaxing key muscles in the face allows the
skin to remain smooth. The skin heals and thickens, which softens and even eliminates lines and
wrinkles. Botox also has a preventative effect. Started early, it can prevent these wrinkles from
ever showing up.
A study published in JAMA Facial Plastic Surgery in 2015* showed that Botox also improves
the elasticity and flexibility of skin after treatment. “The effects of botulinum toxin A on the skin
are similar to those reported when using radio-frequency skin tightening,” according to the
experiment. These improvements in the skin lasted for the same amount of time as the
smoothing effects from the Botox. Researchers were unclear as to exactly why this occurs.
It's been nearly forty years since Botox was first used on a human being. Despite all the research and FDA approved applications, there are still many misconceptions, myths, and misgivings about the drug.
Frequently Asked Questions:
Will Botox make my face look frozen or fake?
Botox relaxes the muscles responsible for wrinkles. Botox injections done by a qualified injector
will make you look well rested and refreshed.
When Botox was first on the scene a handful of celebrities could be spotted walking around with
immobile foreheads, or stiff, forced-looking smiles. It quickly gained a reputation for causing
“frozen face.” Today, doctors have more experience with Botox and know just how much and
where to inject for the most natural-looking results. Most doctors agree it’s better to keep a bit of natural movement.
Is Botox a filler?
Fillers plump up areas of the face that have lost volume over time. They can also fill in lines that
are a result of volume loss, like lines that go from the corners of the mouth to the nose. Botox, on
the other hand, is for treating dynamic wrinkles: those formed as a result of movement, like
frowning, squinting, or raising your eyebrows. Over time the temporary lines that develop from
these expressions become etched in our skin so that even at rest they are visible. Botox doesn’t
add volume the way a filler does.
Does it hurt?
Botox is injected through a very tiny, thin needle. Most people describe it as nothing more than a
prick. If you’re very concerned, your injector can provide you with ice or anesthetic cream to
help dull the sensation. Most agree that the results are worth any minor pain from an injection.
"What if I get addicted?"
There is nothing chemically addictive in Botox. The only thing you could develop a habit of is
smooth, line-free skin. Should you try Botox once and decide never to do it again, your skin will
go back to the way it was and be no worse for wear. Technically, it would be better to do a little
Botox over a lifetime than none. Every treatment gives the underlying muscles a short
"vacation," allowing your skin a few months to relaxing and recoup.
So, no, your wrinkles won't "come back worse" after one Botox treatment. In theory, they'll be
slightly better than they would've been had you never had Botox.
The more often you get Botox injections, the longer the effect tends to last. After several
treatments the relaxed muscle has weakened somewhat, requiring more time to become as active as it once was.
When should I start getting Botox?
Botox is a fantastic preventative measure. By relaxing the muscles responsible for forming
wrinkles, it can halt them from even appearing. If you already see lines, Botox can still help. For
very deeply etched lines, it may take a couple of treatments for the skin to repair and smooth
itself out. This is why it’s always better to start getting injected before (or as soon as) you see
lines that bother you. People are getting Botox in their twenties these days, and while it may
seem quite young, it’s actually the perfect time to start a preemptive strike!
Where is Botox injected?
Botox is FDA approved for use between the eyebrows, the forehead, and for crow’s feet. There
are also some off-label cosmetic uses for Botox, depending on the experience and discretion of
the injector. Botox has been known to treat “bunny lines” (lines on the sides of the nose), down-turned corners of the mouth, a gummy smile (too much gum line showing when you smile), slim
a wide or square jawline, smooth a dimpled chin, and more. Talk to your injector and see what
they suggest. Neurotoxins can work wonders but done incorrectly or by someone inexperienced
they can cause you to look odd or distorted.
How is Botox priced?
You'll see prices for Botox listed either by the unit or by the area. A price listed somewhere in
the range of ten to fifteen dollars is a “per unit” price. (The amount will vary based on where you
live and where you go for injections.) It's impossible to know precisely how many units of
neurotoxin you'll need without the physician first examining you. He/she needs an idea of how
strong and how thick the muscles are that they’ll be injecting. You could require anywhere from
about 5 to 30 units in any given area.
If a business charges by the area, you'll pay a flat fee for each "section" of your face.
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*https://jamanetwork.com/journals/jamafacialplasticsurgery/fullarticle/2293061