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1 With over 4 million procedures performed in 2006, BOTOX Cosmetic is the most popular minimally-invasive cosmetic procedure performed. Used to treat facial lines and wrinkles such as forehead lines, frown lines, crow's feet, and lines around the neck, BOTOX Cosmetic is the registered product name for Botulinum toxin, Type A. Botulinum toxin is produced by a bacterium known as "clostridium botulinum", and is normally responsible for causing the bacterial infection known as botulism. However, in small doses, botulinum toxin can be used safely to reduce the appearance of facial lines and wrinkles. In addition, botulinum toxin has been shown to be an effective method for treating other conditions, such as migraines, excessive sweating, and muscle spasms, among others. With little downtime and almost immediate results, BOTOX Cosmetic can help you restore a smoother, more youthful appearance to the face.

2 BOTOX Cosmetic Introduction With over 4 million procedures performed in 2006, BOTOX Cosmetic is the most popular minimally-invasive cosmetic procedure performed. Used to treat facial lines and wrinkles such as forehead lines, frown lines, crow's feet, and lines around the neck, BOTOX Cosmetic is the registered product name for Botulinum toxin, Type A. Botulinum toxin is produced by a bacterium known as "clostridium botulinum", and is normally responsible for causing the bacterial infection known as botulism. However, in small doses, botulinum toxin can be used safely to reduce the appearance of facial lines and wrinkles. In addition, botulinum toxin has been shown to be an effective method for treating other conditions, such as migraines, excessive sweating, and muscle spasms, among others. With little downtime and almost immediate results, BOTOX Cosmetic can help you restore a smoother, more youthful appearance to the face. Doctor's Personal Note: Botox and Fillers Relaxing the wrinkles and furrows caused by muscle contraction helps prevent extended wrinkles. When used together with the various filler products like Juvederm or Restylane, you will usually require less filler over time to get the same results. Too, using both seems to add longevity to both, so I will generally suggest to my patients that if they want both Botox and a filler, it's best to get the procedures fairly close together or even at the same time Procedure Preparation Prior to your procedure, the treatment area will be thoroughly cleansed. As the procedure is typically not very painful, an anesthetic is not usually administered. However, if you are especially sensitive to pain, your physician may administer a topical anesthetic to help you stay comfortable and relaxed during your procedure. Doctor's Personal Note: Before & After Tips It's a good idea to skip cocktails or wine the day of your Botox injections. Take a day off the gym or running. Stopping unprescribed anti-inflammatories such as ibuprofen or aspirin helps prevent bruising, as does refraining from Vitamin E.

3 Muscle Contraction Before performing the injections, the physician will ask you to contract your facial muscles in the desired treatment area in order to determine the precise injection sites. The entire procedure typically takes approximately ten to fifteen minutes, but may vary depending on the number of desired treatment areas. Doctor's Personal Note: Botox for Brow Elevation When you come in, take a minute to really relax your face before we get started. Sometimes a touch of Botox for brow elevation makes a nice difference and if you're relaxing your facial muscles I can see if that's a need you have - or an effect you want. By relaxing the muscles that push the brow "down", the ones that lift it can do a better job. BOTOX Cosmetic Injections Using an ultra fine needle, the physician will inject small amounts of BOTOX Cosmetic into the facial muscles along the treatment areas. If an anesthetic has not been administered, you may feel a slight stinging or burning sensation during the procedure. In addition to factors such as age, sun exposure, and heredity, one of the primary causes of facial lines and wrinkles is repetitive muscle contraction. Nerves release neurotransmitters, which are chemicals that send signals, or impulses to other nerves, muscles, or the brain. Nerve impulses are what trigger muscles to contract, or move. When injected into facial muscles, the toxin in BOTOX Cosmetic injections blocks the transmission of these nerve impulses, which temporarily paralyzes muscles and prevents them from contracting.

4 How BOTOX Cosmetic Works Under normal conditions, a neurotransmitter known as acetylcholine is released by the nerve cell. Acetylcholine vesicles must be able to bind to the nerve membrane, in order to release the acetylcholine and transmit a signal to the muscle. Once released, acetylcholine triggers the muscle to contract. As you know, this repeated muscle contraction causes facial lines and wrinkles to form. Once BOTOX Cosmetic is injected into the treatment area, the toxin enters the nerve and cleaves a special protein along the nerve membrane that is necessary for acetylcholine to bind properly. As a result, acetylcholine cannot bind to the nerve membrane and is not released. Without the release of the neurotransmitter, acetylcholine, facial muscles are unable to contract and are temporarily paralyzed, giving the face a smooth, less wrinkled appearance. Doctor's Personal Note: Message Breaker Botox is easy to understand if you simply look at it as a break or minimization in the two way communication between signals. If a frown muscle doesn't receive the message to contract, then it stays relaxed. BOTOX Cosmetic Recovery You will typically be able to resume normal activities immediately following the procedure. You may notice some redness, minor swelling or bruising, or numbness around the injection sites. If you receive injections in the forehead region, you may also experience a headache following treatment. However, these and other symptoms are generally minor and should resolve within a few days following the procedure.

5 BOTOX Cosmetic Results You will most likely begin to notice the results within a few days following the procedure. As the muscles in the treatment area are unable to contract, the appearance of facial lines and wrinkles will decrease. The results from a single procedure last approximately three to four months after which you can receive subsequent injections to maintain the desired results. Although the results are temporary, BOTOX Cosmetic can safely and effectively help to restore the smooth, more youthful appearance you desire. Doctor's Personal Note: Platinum Plus Provider Being a Platinum Plus Provider, I have plenty of practice with the wide variety of used for Botox. It's one of the most popular procedures I perform for my patients because everyone appreciates the results. It's also a core part of many procedure combinations because the effects are so profound. We physicians refer to Botox as the "biggest bang for your buck" when it comes to cost versus effect.

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