Botox Basics

Some basic information for anyone considering cosmetic botox or just curious to learn more. First, Botox is a brand name for botulinum toxin A. The name is often used to describe a whole class of neuromodulators / neurotoxins but there are multiple products on the market that work in a similar manner. I will use “botox” generically here to include other products like Dysport, etc.

With botox, the effect occurs at a specific location where it is injected in the muscle. Here the botulinum toxin attaches to nerve endings. Once attached it inhibits the release of the neurotransmitter responsible for triggering muscle contractions. It reduces the strength of the muscle, thereby minimizing the appearance of wrinkles as muscles remain relaxed. The effects will generally last for 3-6 months but varies based on area injected, amount injected and muscle strength.

One of the most common uses for botox is to treat lines in the upper third of the face. These lines are formed due to repetitive muscle movement. One location is the glabella, where botox is used to treat the “11s” (the lines made when you frown). Botox can also be used to treat horizontal forehead lines, “crow’s feet” and "bunny lines." We also use it to provide an eyebrow lift, to help with dimpling of the chin, and to treat masseters for TMJ pain and also to slim the face. There is a long list of areas that can be treated, both on and off label.

It's important to understand that botox works to treat dynamic wrinkles, not static wrinkles. Dynamic wrinkles only appear when you make facial expressions, for example when you furrow your brow, frown, or smile, so you don't see them when your face is still. For deeply etched in static lines, soft tissue fillers may need to be considered as well.