Botox® is short for Botulinum Toxin. It is one of the deadliest paralytic toxins obtained from the bacteria Clostridium Botulinum. Small amounts of this toxin when diluted and injected carefully can reduce weakness and stiffness in diseased muscles. Initially Botox was tried and approved for use in conditions like blepharospasm or uncontrolled blinking, strabismus or lazy eye and dystonia or muscle spasms. Over the years Botox has also found use in cosmetic surgery in smoothening of facial wrinkles especially around the mouth and eyes, between brows and over the forehead.

Procedure and Considerations

Botox paralyses the muscles of the face underlying the injected area and prevents contraction and thus gives an appearance of wrinkle free skin. The major disadvantage with the use of Botox is that it is not permanent and also that it is ineffective for all wrinkles. There is an associated risk of pain, bruising, bleeding and headache. Headache usually resolves win 1 to 2 days.

Alternatives to Botox include surgical correction of wrinkles like facelift, chin or brow lift or liposuction. Chemical peels, laser therapy and injection of dermal fillers are other alternatives for removal of wrinkles.

Botox takes only a few minutes and does not require an anesthetic injection. Very fine needles are used for Botox injections into the muscles that minimize pain and discomfort

The face is cleaned with an antiseptic. Then with a fine needle the Botox is injected into the underlying facial muscles of the marked areas.

Before going in for Botox you need to have a general health checkup. Botox injections do not need any anesthesia. This therapy can be done in the day care. Stop smoking and alcohol consumption before the procedure. You may be asked to discontinue drugs like Aspirin or Warfarin before the operation to decrease the risk of bleeding.

If you are pregnant, nursing or have any neurological illness, you may need to forego this treatment.

The areas of the face that need to be treated are demarcated. The areas between the brows, nose to mouth line folds, chin folds, nasal folds, wrinkles in the upper lip and wrinkles of the neck are the common areas where Botox injections can be helpful.

You will be made to lie on your back or be comfortably propped up. The face is cleaned with an antiseptic. Then with a fine needle the Botox is injected into the underlying facial muscles of the marked areas.

Application of ice before and after the operation reduces the risk of swelling and bruising due to the injection. Do not massage the face or apply make up after the therapy. The spread of the Botox with massage can paralyze other small muscles of the face like the eye lids.

The effect of Botox is observed within 3 to 7 days after injection and lasts for 4 to 6 months. After the effects have worn off the wrinkles reappear but are less severe than before because the underlying muscles relax better than before the operation.

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