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What is Botox?
Botox is a brand name for botulinum toxin type A. It is a very powerful neurotoxin (nerve poison) produced by a bacterium Clostridium botulinum, which is found in soil. This bacterium can cause food poisoning, which results in muscle paralysis. The ability of botulinum toxin to cause muscle paralysis has been cleverly used to paralyze overactive facial muscles and to temporarily reduce facial wrinkles that are caused by muscle activity (so called dynamic wrinkles). Botox is injected into the muscles and into the skin with very fine needles.
What is Botox used for?
In our practice we use it for cosmetic purposes to reduce wrinkles on face, and to decrease excessive armpit and palm sweating. However, it is also used to prevent migraine headaches, to treat muscle spasms, an overactive bladder and bladder spasms.
What are side effects and adverse reactions of Botox?
Thus far none of our patients have ever experienced any side effects or adverse reactions from Botox used for cosmetic purposes, and we have been using it for many years. However, U.S. FDA has mandated inclusion of this “black box” warning with every bottle:
“WARNING: DISTANT SPREAD OF TOXIN EFFECT
The effects of BOTOX and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults, particularly in those patients who have an underlying condition that would predispose them to these symptoms.”
You should call your doctor or get medical help right away if you have any of these problems any time (hours to weeks) after injection of Botox:
- Problems swallowing, speaking, or breathing,
due to weakening of associated muscles can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months
- Spread of toxin effects.
The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, trouble swallowing. If this happens, do not drive a car, operate machinery, or do other dangerous activities
- Serious and/or immediate allergic reactions have been reported.
They include: itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint. Tell your doctor or get medical help right away if you are wheezing or have asthma symptoms, or if you become dizzy or faint.
- You should not receive Botox injections if you:
are allergic to any of the ingredients in Botox such as albumin; had an allergic reaction to any other botulinum toxin product such as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); have a skin infection at the planned injection site.
- Tell your doctor about all your muscle or nerve conditions,
such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), myasthenia gravis, or Lambert-Eaton syndrome, as you may be at an increased risk of serious side effects including difficulty swallowing and difficulty breathing from typical doses of Botox.
- Tell your doctor about all your medical conditions, including:
plans to have surgery; had surgery on your face; weakness of forehead muscles, such as trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if Botox can harm your unborn baby); are breast-feeding or plan to breast-feed (it is not known if Botox passes into breast milk).
- Tell your doctor about all the medicines you take,
including prescription and nonprescription medicines, vitamins, and herbal products. Using Botox with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received Botox in the past. Especially tell your doctor if you: have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin, such as Myobloc®, Dysport®, or Xeomin® in the past (be sure your doctor knows exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; take a sleep medicine; take aspirin-like products or blood thinners.
Other side effects of Botox include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes. Since this drug is made from human plasma (part of the blood) and may have viruses that may cause disease. This drug is screened, tested, and treated to lower the chance that it carries an infection.
Note: None of our patients have ever had any side effects or adverse reactions after Botox injections for cosmetic purposes.
Where can Botox be used for cosmetic purposes?
For temporary reduction of wrinkles on forehead between eyes (glabellar wrinkles).
- The average number of Botox units we inject is 25-30. Duration of the effect is 3-4 months.
For temporary reduction of wrinkles on the sides of the eyes (“crow’s feet” or lateral canthal wrinkles).
- The average number of Botox units we inject is 24 (12 units to each side). Duration of the effect is 3-4 months.
For temporary reduction of forehead wrinkles
- (Not yet approved in the US). The average number of Botox units we inject is 24. Duration of the effect is 3-4 months.
For temporary appearance of fuller upper lip.
- (Not yet approved in the US). The average number of Botox units we inject is 4-6. Duration of the effect is 3-4 months.
Where can Botox be used to reduce excessive sweating?
We use it in armpits and palms. The average number of Botox units we inject is 50 per each armpit or palm. Duration of the effect is up to 6-7 months.