What is BOTOX? BOTOX Injections are a non-surgical procedure designed to paralyze the portions of overactive facial muscles that cause deep furrows, creases and fine wrinkles in the face. BOTOX is a sterile purified botulinum neurotoxin type A complex produced from a culture of the A strain of bacteria called Clostridium Botulinum. Although the Clostridium bacteria, when given orally in large amounts, it blocks the nerve signals from the brain to the muscle, causing a generalized paralysis called botulism, the BOTOX extract does not. The BOTOX extract is the purified, sterilized product from the bacteria and is a potent localized muscle, paralytic agent. The toxin binds to the nerve endings and blocks the release of a chemical that would otherwise instruct the muscle to contract. This in turn causes the muscle to relax, creating a smooth surface where the wrinkle used to be. By injecting very tiny amounts into a specific facial muscle, only the targeted impulse of that muscle will be blocked, causing a local relaxation and weakness. In this way, botulinum toxin acts as a muscle blockade to immobilize the underlying cause of the unwanted lines and prevent "wrinkly" expressions. BOTOX has been used safely for many years in the treatment of muscle disorders of the eyes and voice box. The most recent application has been in the treatment of wrinkles, creases and lines in the face. What is treatment like? With a very fine needle, BOTOX® is injected exactly into the specific muscle that is contracting and causing the lines and wrinkles on the face. No anesthesia is required although he or she may choose to numb the area with cold pack or anesthetic cream prior to injecting. Treatment is effective, safe, and takes approximately 10 minutes. The pain is a minimal "pin prick" and most patients compare the sensation to a bug bite. Immediately following treatment, you may resume regular activities. How soon will I see results and how long does it last? Typically, the effect of BOTOX® is visible within 3 days. Maximum benefits are reached between 10 to 14 days. Once the muscle relaxes and the skin softens, you will have a more relaxed and youthful appearance. The optimum appearance may be achieved with BOTOX® therapy in conjunction with laser resurfacing, and skin rejuvenation. The effects usually last 3 to 6 months. You will notice a gradual fading of its effects. The results, following several treatments, may last 6 to 8 months or more especially when combined with other procedures such as soft tissue fillers (Resylane, Radiesse, Juvederm..).

Treatment areas BOTOX injections for cosmetics are best suited for: The vertical “11” lines between the eyebrows (glabella) Forehead lines (frown lines) Wrinkles around the eyes (crows feet) Elevate the eye brows / making them symmetrical Bunny lines at the bridge of the nose Gummy smile Mouth corners Vertical Neck bands (Turkey neck) Horizontal neck lines (Venus ring) Pebbly chin, horizontal crease in chin Nasolabial folds Upper lip wrinkles Scar Management

What Are The Potential Benefits Of BOTOX? Prolonged softening of the fine lines, wrinkles, creases and furrows of the forehead, eyes and neck, create a more serene-looking, younger, pleasant appearing face with less active muscles and creases.

Risks Of Botox Injections Pain/Discomfort There is a minor degree of discomfort from the small needle that is inserted under the skin. There is a slight burning discomfort as the BOTOX is injected into the muscle. Most patients find the process less painful than an immunization. The BOTOX treatment only takes a few minutes to complete and is performed in the office. Bruising / Swelling Most patients have some swelling in the injection area for a couple of hours. It is rare to develop bruising after, but if this were to occur, it should disappear in 7-10 days and can be camouflaged with makeup immediately following treatment. Infection- Like any injection technique, an infection may rarely occur (less than 0.5% risk) and can usually be treated with an oral antibiotic. Treatment Failure Occasionally, the BOTOX may fail to completely paralyze the facial muscle or soften the wrinkle and repeat treatment within 2 weeks may be necessary Long-term Effects The duration of improvement with the BOTOX varies between patients, but generally, 3-6 months of decreased muscle activity and wrinkle improvement may be achieved. Repeat treatments can be performed but prolonged use over many years may result in a permanent weakness of muscle function Pregnancy BOTOX should not be used while pregnant as there is risk of premature delivery. If there is any chance that you may be pregnant, you should first exclude the possibility with a pregnancy blood test, or not have the BOTOX. Lactation There is no known risk of BOTOX during lactation but if you are concerned, we recommend postponing your BOTOX until you have completed breast feeding. Asvmmetry When two sides of the face are treated for the same problem, there may be some asymmetries that result between the BOTOX performed on one side and the same treatment on the other side. Functional Problems Although extremely rare, if the BOTOX treatment is too effective or there is subcutaneous migration of the substance, functional or esthetically displeasing effects may occur such as Brow Ptosis (drooping of the eye brow), Eyelid Ptosis (subtle drooping of an eyelid), Diplopia (double vision), lagopthalmous (weakness of eye closure) or a smile droop. Fortunately, these side-effects are extremely rare and temporary (as the BOTOX effect wears off in a few months). General Body Symptoms These occur very rarely (less than 0.1 %) but can include skin rash, itchiness, general malaise, headaches, drowsiness, fever or flu-like symptoms that last for several hours or several days. These symptoms are temporary and may be remedied with a plain Tylenol or ibuprofen.

Contraindications BOTOX should not be used if you have any of the following conditions: Neuromuscular disorders, Myasthenia Gravis, pregnancy, infection, cancer, or using any of the following medications: Aminoglycosides (gentamycin, streptomycin, kanamycin), D-penicillamine (used in rheumatoid arthritis), chloroquine (antimalaria).

Health Insurance Most health insurance companies exclude coverage for cosmetic surgical operations such as BOTOX injections. Please carefully review your health insurance subscribar-information pamphlet. Generally, complications arising from such surgery are covered by Health Insurance.

Other Applications For BOTOX Excessive sweating can be alleviated with injections of a highly diluted form of botulinum toxin directly into the underarm skin or skin on the palms and soles of the hand or foot. There it paralyzes the sweat glands of the skin which are responsible for excessive perspiration. A single treatment session can provide months of relief, and experts believe that injections can be repeated indefinitely once or twice a year to maintain dryness. Many other medical conditions have been treated successfully with BOTOX injection such as headache, anal fissure, back pain and many other conditions.