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Botox® is a U.S. F.D.A.-approved, purified nerve-blocking agent used to treat overactive facial and eyelid muscles. Clostridium bacteria naturally synthesize a protein called Botulinum toxin. Botox® is the medicine derived from Botulinum toxin type A. There are no bacteria in Botox®, only the delicate Botulinum toxin. Botox® is a protein that is gradually degraded by the body over a period of several months. Botox® protein is so delicate, that it is shipped in a freeze-dried state.
Botulinum toxin was first used as a modern medicine in the late 1970's and early 1980's. It was approved by the U.S. F.D.A. in the mid-1980's for treatment of abnormal eye muscle disorders and eyelid spasms. Ophthalmologists and ophthalmic plastic surgeons have been successfully treating 'crossed-eyes' and blepharospasm with Botox® injections for almost 20 years.
Botox® works by inhibiting nerve transmission to muscles near the injection sites. By weakening specific facial muscles the overlying facial skin is smoother and wrinkling of the skin is diminished. With prolonged muscle inactivity those wrinkles which have occurred due to repetitive muscle contraction gradually fade.
Botox® works well on the frown lines between the eyebrows. Treating this area, called the glabella, may improve or eliminate an unwanted 'angry look'. Injecting the area lateral or to the outside of the eyes may improve "crow's feet" or "laugh lines". The deep, horizontal wrinkles of the forehead is another commonly treated area. Recently, small amounts of Botox® have been used around the mouth to help eliminate some of the wrinkling near the lips. Lower facial injections are otherwise avoided to prevent weakness which may cause drooling.
A very small (acupuncture-size or diabetic-size) needle is used to give relatively painless injections in the desired treatment areas. Some patients who are needle-shy may pretreat the skin with a topical anesthetic cream applied one hour before the injections. The entire procedure takes less than 10 minutes.
A few small spots of blood may appear at the injection sites, typically in the forehead and glabellar areas. A few minutes of firm pressure usually limits swelling and bruising in the injected areas. Most normal activities may be resumed within 15 minutes of treatment.
The effects of Botox® usually start 4-10 days after the injection peaking around 2-3 weeks. Botox® tends to begin wearing off around 3 months but may provide adequate muscle weakness for up to 6 months.
Muscle relaxation is usually noted within one week of treatment and continues for 3-6 months. There is no facial numbness. There may be a decrease in tension-type headaches and brow aches. Ultimately, regular and periodic Botox® injections result in a diminution of the deep muscle wrinkles and softening of the dynamic facial skin tension lines that occur during facial expressions in the treated areas. Facial expression is preserved as Botox® injections are limited to the glabella, forehead, and crow's feet.
Complications are rare. Rarely, patients may experience drooping of the eyelid. This is not permanent and will improve as the Botox® wears off. Brow drooping or asymmetry can occur. Dry eye symptoms may worsen for those patients that experience decreased blinking. Inadequate effect occasionally occurs. This may require repeat injections or dose and injection site modification. Systemic side-effects are extremely rare.
The cost of a Botox treatment depends on the amount of toxin used and the injection pattern required. Average treatment costs range from $350 to $700. Treatment fees include the costly Botox® medicine and Dr. Klapper's injection fee.
Dr. Klapper has extensive experience with Botox®. Dr. Klapper has been performing functional and cosmetic Botox injections for more than 10 years, long before the recent explosion in popularity of Botox for cosmetic applications. While administering Botox® is not technically difficult, surgeon experience with Botox® is critical to limit the risk of unwanted effects with this powerful and amazing medication. Visit BotoxCosmetic.com for more information.
Stephen R. Klapper, M.D., F.A.C.S. is a board certified Ophthalmologist and has completed extensive fellowship training in Ophthalmic Plastic and Reconstructive Surgery. In addition to his clinical practice Dr. Klapper has published numerous scientific articles in peer reviewed journals and presented several papers at regional, national, and international meetings on topics related to the field of eyelid and facial plastic surgery. Dr. Klapper's practice is limited to adult and pediatric cosmetic and reconstructive eyelid and facial surgery, tear duct surgery, orbital disease, thyroid eye disease and the anophthalmic patient. Dr. Klapper also has extensive experience performing facial Botox® injections and Restylane® lip and facial fold injections.
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Contact our office to discuss your eyelid problem with Dr. Klapper or a member of his staff. (317) 818-1000
