Dr. Szymanski Answers Frequently Asked Questions On Botox

Botox is an injected medication that is cosmetically used to treat unwanted lines on the face. Botox Cosmetic is the brand name for clostridium botulinum A toxin made by the pharmaceutical company Allergan. There are actually several brands and makers of botulinum A toxins for cosmetic use, so, going forward, I will use the term “B-tox” to refer to all the various clostridium botulinum A toxins available for use in the US. Each formula is slightly different, but generally, B-tox injections stop the release of acetylcholine, a neurotransmitter, from nerves. Without the release of acetylcholine, one’s muscle does not contract. Carefully limiting the contractions of specific muscles in the face can help decrease the motions that cause and reinforce fine lines and wrinkles. Some patients also find B-tox injections can help tweak their look by shifting the position of their eyebrows, altering the relaxed state of their mouth, or preventing the chin from dimpling.

Do I Want B-Tox or Filler?

B-tox and filler are both injectable medications used in cosmetic medicine. Your goals will determine if you want B-tox, filler or both. If you have wrinkles especially between your eyebrows, above your eyebrows, on your nose, or to the sides of your eyes, you may want B-tox. If you have lost volume in your lips, cheeks, or in the smile lines between your lips and cheeks, you may want filler. Patients many times balance their facial features or create a more youthful and smooth look to their face by using a combination of both injectable options in various areas. The nuance and artistry of aesthetic procedures is one of the many reasons to have your treatments performed by a trusted, board certified plastic surgeon.

Will B-Tox Make My Wrinkles Go Away?

Depending on the depth of your wrinkles, B-tox may provide enough of a relaxing effect to allow your wrinkles to resolve. If at the end of the day you notice wrinkles, but they are not present in the morning, B-tox may help your wrinkles go away. For wrinkles that are mild, these may disappear after months of regular treatment. Because the effects of b-tox are not permanent, if you discontinue treatment, it is likely that your wrinkles will return as the movement will no longer be controlled.

When Is The Right Time To Start B-Tox Treatments?

Like Ben Franklin said, an ounce of prevention is worth a pound of cure. Starting B-tox before your wrinkles no longer resolve by morning helps to improve the effects of treatments. Years of treatments with B-tox may lead to disuse atrophy leading to less treatments needed per year. We do not treat cosmetic patients under the age of 18, but I do see many 20-somethings for B-tox treatments as well as 70-somethings.

Should I Schedule A Consultation For B-Tox?

If you’re concerned about the appearance of fine lines or wrinkles, scheduling a consultation allows us to discuss your issues and goals and determine together what the best plan of action is. If you are starting to see wrinkles that do not resolve by the time you wake up in the morning, B-tox could help to decrease slow or inhibit the process of the wrinkle formation. You may also decide filler or fat transfer will better suit your desires, or settle on an enhanced skin care regime in conjunction with in office treatments or on its own.

Is B-Tox Permanent? How Long Does B-Tox Last?

B-tox is not permanent. The effect usually lasts 3-4 months for most patients. For people who have been using B-tox for years, the treatment effects may last for up to 6 months with consistent treatment. If you discontinue treatment, movement will eventually return and lines will begin to reappear.

When Will I See Results With My B-Tox Treatment?

Most people see a difference in 48-72 hours after injection. The maximum effect usually occurs at 10-14 days. If you have a big event coming up, we recommend you have treatment done about two weeks prior to ensure maximum effect.

Is One Brand Or Product Better Than B-Tox?

The brands available for use in the US are Botox (Allergan), Xeomin (Merz), and Dysport (Galderma). All three are FDA approved. Some people respond better to one company’s B-tox compared to another. Some people report that one of the toxins lasts longer than another. If you have a personal preference of B-tox product or are interested in trying a different formula, let us know.

Is It Possible To Get B-Tox The Day Before Or The Same Day As A Big Event?

Most people feel comfortable getting B-tox the day before or the same day as an event. There isn’t any true down time after treatment, but we counsel patients to  avoid vigorous exercise or activities that would cause your blood pressure to become elevated. There is always a slight chance to have a bruise from B-tox at the injection site. Results are not generally immediate from B-tox injection. If you want the effects to be maximized for your event, we recommend you try to have the injections performed 10-14 days before your event.

What Is The Typical Recovery Time For B-Tox?

Patients typically return to normal activities after treatment. We often have patients come from treatment on a lunch break and return to work immediately after. We do counsel patients to avoid activities that would cause your blood pressure to become elevated for 48 hours after treatment. If you happen to bruise at your B-tox injection site, most usually resolve in a few days. Concealer can be used to cover a bruise if it develops after B-tox. Patients generally see their full results by two weeks post injection and results generally last 3-4 months, but some patients find they develop a regular schedule of when to repeat injections.

Does It Hurt To Get B-Tox?

The injections from B-tox can be uncomfortable, but overall patients do not complain of pain during or after treatment. Most people do not find the injections too difficult to handle without pretreatment. A topical local anesthetic can be used to decrease the discomfort from the needle sticks. Some patients choose to use ice on the areas prior to injections to help lessen the pain from the injections.

How Does B-Tox Get Rid Of Wrinkles?

Botulinum toxins block the communication to the specific treated areas. This stops one’s muscles from contracting and the skin on top of the muscles stops becoming crinkled by the repeated motions. The cessation of this repetitive movement of your skin will allow the creases in your skin to relax and the appearance begins to smooth.

Can I Get B-Tox Done The Same Day As Another Injectable Procedure?

Yes, you can have B-tox the same day as other injectables. Many patients will have b-tox and hyaluronic acid fillers injections in a single session. Fillers do not need to be repeated as frequently as b-tox, so you may also stagger visits. B-tox may also be done in conjunction with other procedures for the face or body. We will discuss if this makes sense to do during or perhaps at a follow up appointment after a procedure.

What Happens If I’m Not Happy With The Results?

The effects of most B-toxins usually last 3 months and are not reversible. So, if too much B-tox was used, it may take a minimum of 3 months for the effects to wane. With the first treatment we will discuss your options and may choose to undertreat to see how you react and touch up at a second appointment to avoid over treating. Remember, full results can take up to two weeks. Some people do not respond to BOTOX Cosmetic and need a different type of B-tox to treat their wrinkles.

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