Botulinum Toxin

Botulinum toxin is also known as Botox cosmetic, Dysport, or botulinum toxin type A.

Botulinum toxin (type A) is injected into humans forcosmetic purposes. It prevents signals from the nerve cells reaching muscles, whichprevents contraction of muscle cells. The injection can soften fine lines and wrinkles caused byrepetitive facial movements (especially the lines between the eyebrows, the lines around the eyes called crow’s feet and forehead horizontal lines). Botox is cosmetically usedto balance facial asymmetry and relax tight neck bands. It is medically used toreduce perspiration and treat migraine attacks and muscle spasticity.


When should I think about getting Botox?

  • Deep lines between your eyes make you feel tired, angry, upset or worried.
  • Facial expressions createfine wrinkles on the forehead and around the eyes.
  • Eyebrow and facial asymmetry can be fixed by loosening the underlying muscles.
  • Botox can prevent migraine attacks in case that you suffer from these attacks



  • Botox injections are relatively painless and low-risk and often do not need bed rest.
  • Botox helps you cut down on angry expressions and look almost happy.
  • Botox makes subtle changes to your face and gifts you with a smiley and refreshed appearance.



  • The effect of Botox injections last three to six months.
  • Inappropriate Botox injection increases the risk ofeyelid ptosis or muscle weakening.
  • Sensitive skin may bruise at injection sites.

These are the most important advantages and disadvantages that should be considered before getting Botox. If you have a singular case in mind, please consult a cosmetic surgeon.


Are you a suitable candidate for Botox injection?

Botox injection is a suitable option for filling the line and wrinkles caused by common facial expressions. Depending on genetic backgrounds, facial lines may appear at the late 20s or early 40s. The plastic surgeon may recommend Botox injection as a preventive measure if you are prone to developing frown lines or wrinkles caused by facial movements.

Dermal fillers, fat grafts, or surgery is the best treatment for certain wrinkles or creases in the face caused by the weakening or drooping of the soft tissues, such as the nasolabial folds, which extend from the sides of the nose to the corners of the mouth(Botox is often used to reduce or improve these fine lines and wrinkles).

You are a suitable candidate for Botox if you are healthy, have positive attitude towards Botox and expect realistic results.


How Botox works in details

How is Botox performed?

Botulinum toxin type A can be injected at the same time the physician has evaluated the case. The injections take an hour and the recovery time is less than one day. If you have decided on the suitable treatment through consultation, the physician can fillthe injection needles with your desired Botox type. The physician cleans the injection site. There is no need for anesthesia prior to injection. Thin and small needles are used for Botox injections to feel less pain during injection. The number of injections to achieve the desired result depends on your conditions and expectations. Mild pain, slight bruising or swelling; rash or redness, and a small amount of bleeding are expected after Botox injections.


Botox injections to correct vertical lines between eyebrows

Neurotoxin injections start taking effects after a couple of days. A follow-up session is usually scheduled within a few weeks to several months after the first injection.

A simple procedure with the least side effects is expected in case that the injection was made by a skilled person, preferablya board certified plastic surgeon. The person in charge of injection should be aware of the structure of muscles in the face and body.


What options do I have?

BotoxCosmetic is widely recognized as the first FDA approved neurotoxin for cosmetic purpose in the United States. Other brands including Dysport and Xeominare also used for cosmetic purposes. These are similar to Botox in many aspects but differ in term of dosage, diffusion, onset of action, and duration of action.

There are different combinations of Botox, some of which are merely suitable for cosmetic use (such as botulinum toxin type A). Here is a list of medical and cosmetic cases of Botox.

  • Lines and wrinkles
  • Facial asymmetry
  • Muscle spasticity
  • Eyelid spasm (blepharospasm)
  • Hyperhidrosis or excessive sweating (seeanticholinergics)
  • Chronic migraines
  • Cervical dystonia
  • Motor disorder
  • Lazy eye (amblyopia)

The person in charge of injection or the plastic surgeon will help you choose the suitable type of Botox.


Choosing a surgeon

Choose a reliable surgeon

Choosing a surgeon or a person in charge of injection depends on the following factors.

  • Education, field of work and degree
  • Experience in Botox injections
  • Being comfortable with the surgeon


Your first consultation session

It is recommended that be honest and realistic prior to Botox injection to get the best results. Your concerns and goals help you determine whether Botox injection is useful for you. The surgeon gets access to additional medical records after consultation. It is important to mention recent or prolonged intake of nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin, ibuprofen (advil or naproxen),and anticoagulants.


Your treatment plan

The surgeon examinesyou after getting your full medical history to choose the best treatment that meet your expectations. The surgeon or the injector describes the following parameters in details.

  • How injections are performed
  • A reasonable expectation of Botox
  • Advantages and disadvantages of alternative treatment options including fillers, fat grafts, surgery, skin regeneration or chemical lifts (peels).
  • Possible Botox side effects

You will be satisfied after physician assessment and consultation. The surgeon encourages you to ask questions about the procedure and responds honestly. Before and after images might be taken for documentation.


What to Ask a Cosmetic Surgeon

It is important to be involved in the treatment process. Use the following list of questions for your first consultation session.

  • Do I need to be a good candidate for Botox injection?
  • Should Iexpect reasonable and realistic results?
  • Do you have before and after images from previous surgeries?
  • Do you recommend an anesthetic cream?
  • How much does treatment cost?
  • What should I do to get the best results?
  • How many days or hours the recovery time may take? When can I resume my normal activities?
  • What are the risks and side effects of this procedure?
  • How side effects are treated?
  • What options do I have in case that the results were not consistent with our goals?


Preparation for injection

How do I prepare myself for Botox injections?

You should report a full medical history and all your recent medications to the plastic surgeon although Botox injections are not usually high-risk procedures and do not require severe surgical screening. Preoperative and postoperative hydration is important for effective healing regardless of the type of treatment. The physician or the injector may ask you to quit smoking at least 6 weeks before the injection.


Report the following cases to the plastic surgeon.

  • Previous Botox injections
  • Current intake of anticoagulants and NSAID including aspirin, ibuprofen (advil or naproxen).
  • Current intake of sleeping pills, anti-allergic drugs or muscle relaxers.

Some medications may cause complications, bleeding or excessive bruising. If necessary, stop taking your medications prior to surgery to prevent any complication.


Recovery and post-operative care

You can resume your normal activities immediately after injection but avoid intensive activities by the end of the day. Redness and swelling at the injection site might disappearimmediately after the injection. Possible bruising usually disappears within one to two weeks.


Tips to get the best results

  • Avoid massaging or hand touching the injection site. This may inadvertently spreads the Botox to unwanted areas.
  • Avoid lying down or stomach sleeping immediately after the injection because it can cause complications.
  • Avoid intensive or endurance activities by the end of the day.
  • Contact the physician before taking any medicine or pain killer.


How long does Botox last?

The effect of Botox lasts at least 3 to 6 months depending on age, habits and skin types.


Keep contact with your cosmetic surgeon

The physician may schedulefollow-up sessions for re-assessment, modification, or additional treatments within a few weeks or months. It is preferred to schedule an early follow-up session if you have any questions or concerns. Since the effect of Botox is not permanent, it is recommended to keep contact with your plastic surgeon and schedule future injections.


The costs

The cost of Botox injections varies depending on many factors includingthe number and site of injections. The costs may be determined based on the concentration of injectable Botox or treatment sites.


Choose your surgeon based on their competence, field of work and career experience and not their salary.

Find the documents, field of work and credentials of the members of the American Society of Plastic Surgeons (ASPS) to realize their worldwide reputation whomconsider the highest standards for plastic cosmetic surgery.


Limitations and Risks

Given that no surgery is risk-free,FDA-approvedBotox injections by a specialistare relatively less risky. The most common side effects of Botox injections are listed here.

  • Temporary muscle weakness
  • Redness, itching and swelling at the injection site
  • Rare cases of dry mouth, headache, dizziness, nausea, and fever

Immediately contact your surgeon in case of more severe symptoms including acne or respiratory problems.

The risks can be minimalized if you carefully consider guidelines and recommendations of board-certified plastic surgeons.