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All You Need to Know About Botox®

Botox® Injections

Botox® also known as Botulinum Toxin was approved by the FDA for cosmetic use in April 12, 2002. Formal trials were conducted and it was proven to be a success in temporarily improving the appearance of moderate to severe frown lines.

The Botulinum Toxin (Botox®)  drug was an invention of Dr. Alastair Carruthers, an ophthalmologist who used Botox® to treat muscle spasms in the eyes. He accidentally discovered that the injection caused wrinkles around the eyes to disappear. Subsequently, the procedure of targeting wrinkles by using Botox® gained popularity as a cosmetic treatment and is now a multi-billion-dollar industry.

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What is Botox® Made From?

Botox® can be used to treat medical muscular conditions and remove wrinkles by paralyzing the muscles for a temporary period. It is made using a neurotoxin named botulinum toxin which is derived from the bacterium Clostridium botulinum.

Botox®, among other things is also used in treatments such as excessive sweating, muscle disorders, migraines, and certain bowel or bladder disorders.

What is in Botox®?

Clostridium botulinum (Botox®) is usually found naturally and it is in the form of a non-toxic and largely inactive organism. The bacterium is derived from soil, forests or lakes. It can also be extracted from the intestinal tracts of fish and mammals or the gills of shellfish such as crabs. These naturally occurring forms of the clostridium botulinum bacteria are usually harmless.

During a certain point in time, the bacteria begin producing botulinum toxin which is a neurotoxin. The neurotoxins affect the nervous system by disrupting the process that allows the neurons in the brain to communicate effectively. This results in relaxing or paralyzing certain muscles or blocking certain nerves. The effects last about three to twelve months, depending on dosage and what area you are treating.

How Does Botox® Work?

Botulinum toxin (Botox®) is widely and successfully used in the aesthetic industry. Botox® can be injected into specific problem areas in very small concentrations. These concentrated injections prevent the nerve cells from sending signals to the muscles which in turn relaxes them for a period of time.

To allow the muscles to contract, the nerves must release acetylcholine, a chemical messenger at the connection where nerve endings meet the muscle cells. The neurotransmitter acetylcholine then attaches itself to the muscle cell receptors and contracts or shortens them.

By injecting the botulinum toxin (Botox®), the release of acetylcholine is prevented and the muscle cells do not contract. Botox® reduces the abnormal muscle contractions and makes them less stiff thereby reducing the movement of muscles in the face which resulting in the reduction and prevention of wrinkles.

Who Qualifies for Botox® Treatment?

The FDA in the United States recommends that only patients between the ages of 18 and 65 should be administered cosmetic Botox® injections. As with every other medical treatment, the patient’s complete medical history must be reviewed before proceeding further.

Those who are allergic to any of the ingredients in the drug should not use it. This includes people who are allergic to any of the botulinum toxin brands such as Botox®, Myobloc®, Xeomin® and Dysport®. Anyone who has experienced a side effect from using these products should also avoid using them.

Patients suffering from a skin infection or any other type of condition in the area that is to be treated should certainly avoid Botox®. The injections cannot be administered to those with ALS, Lambert-Eaton syndrome, myasthenia gravis or any other type of illness that affects the nerves and muscles.

Patients who have trouble breathing, suffer from asthma or have trouble swallowing are also advised against seeking Botox® treatment. Those who experience excessive bleeding or are planning to undergo invasive surgery any time soon are also not candidates.

It is important to ask patients if they have ever had facial surgery and why. Drooping eyelids are a warning sign relative to Botox® patients.

Even though it is not expected of the drug to travel throughout the body and affect the fetus or breast milk it is still not recommended for pregnant or breastfeeding woman to undergo Botox® treatments.  There have been no clinical studies conducted on expectant mothers for ethical reasons so there is no proof to support this.

Common Misconceptions About Botox®

Botox® injections are not painful although like all injections, the needles can hurt but those used for Botox® administration are very small so the pain is almost negligible. The medical professional can numb the area using a topical anesthetic cream or an ice pack. This is done 10 to 20 minutes before injections are administered so there is little to no pain felt. Once the anesthetic wears off, there is some discomfort but it is usually bearable.

There are some misconceptions that getting Botox® treatments done will make the wrinkles look worse. The injections prevent the lines from deepening and it is only when you stop getting treatments that aging of the skin will resume its natural course. Typically, in the past, Botox® was usually popular with women, however according to published statistics, men are also being encouraged to choose this treatment to improve their appearance and look much younger.

How is Botox® Administered?

Only trained medical professional can administer Botox® injections even if the purpose for the treatment is purely cosmetic. Botox® is injected directly into the muscle and each treatments is administered after a period of at least 3 months. More than one area can be treated at a time depending on the patient.

Patients who are getting treated for conditions related to the eye muscles might need to use ointment, eye drops or special contacts to protect their eye. Those who are being treated for excessive sweating in the underarms must shave their armpits at least 24 hours prior to being injected. Also, they should avoid using antiperspirants or consuming warm beverages or spicy food.

Common Side Effects of Botox®

After receiving Botox® injections patients may experience trouble swallowing for a few weeks following the treatment. The muscles near the injected area may also get weaker and in some cases, there is bleeding, bruising, redness, pain and swelling at the site of injection.

It is usual to get headaches, neck pains, stiff muscles and joint pain after Botox®. Some patients may experience nausea and symptoms of a cold. These reactions are also completely normal.

Botox® is a completely safe, medically and FDA approved cosmetic treatment. The International Association of Physicians in Aesthetic Medicine (IAPAM) states that Botox® injections should only be performed by a properly trained Botox® administrator who has all the necessary certifications, information on the side-effects and interactions of the treatment. For more information on how to become Botox certified, visit IAPAM’s Botox training courses and certifications!


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For more information, visit the the IAPAM’s Aesthetic Medicine Symposium with Botox Training website! 

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