For the last several years Botox has been the most popular physician-administered cosmetic procedure in the US. More than 3 million treatments with Botox are administered per year.

A number of factors account for the popularity of Botox. First of all Botox causes a consistent beneficial improvement in appearance that is noticeable, yet subtle, and natural. Botox has been used in millions of patients and found to be safe. Finally, Botox does not require time off of work or out of the public eye to recover.

Botox is a pure protein that is isolated from a microorganism. Many of the most important drugs we use today such as antibiotics were first isolated from microorganisms.

Botox has been used in humans for more than 35 years but did not gain approval from the FDA for cosmetic indications until 2002. Botox was purified in the 1940’s. The FDA approved testing it on human subjects in the 1970’s. In 1989 it was approved for clinical use in patients with spasm of the eyelid face or neck muscles, as wells as treatment for some forms of double vision. Most of the initial work leading to FDA approval was done by ophthalmologist. In 2002 the FDA approved Botox for use in wrinkles between the eyebrows. Botox is also approved for treatment of excess sweating termed hyperhidrosis.

Unlike fillers, Botox doesn’t fill in facial lines. Botox relaxes the muscles underneath the skin that cause undesirable wrinkles in the forehead and the area around the eyes.

In order for a muscle to contract it requires a nerve signal. Botox blocks this signal at the junction between a nerve and a muscle.

No. Botox works only on wrinkles that are made worse or change with contraction of muscles of facial expression. Classical examples are the wrinkles between the eyebrows that become deeper with frowning. Other areas where Botox is commonly used to reduce wrinkles include the forehead, and the crow’s feet. Examples of wrinkles that do not respond to Botox include wrinkles caused by sagging skin in the upper eyelids or neck.

Botox should not be used in the presence of an infection at the injection site and in individuals known to be allergic to Botox. Botox should be used with caution in patients with a few rare neurological conditions including: amyotrophic lateral sclerosis, myasthenia gravis, and LambertEaton syndrome.

According to a recent survey working mothers between the ages of 40-55 who want to look less stressed are the most common users of Botox. Those with annual income of less than $150,000 per year account for 2/3rds of Botox users. Botox is one of the least expensive facial plastic procedures.

Even though many health-related professionals such as nurses or even general practitioners administer Botox injections, the safest option for you as a patient is to have your Botox injections by a Botox certified physician. Dr. Lin Yang is a Botox Certified physician.

In most cases nothing. Some over the counter medications such as aspirin, Motrin, vitamin E, Ginkgo and glucosamine increase the chance that you will get a bruise at the injection site. If you are taking these medications because your doctor has recommended you do so then continue to take the medication. If it is safe for you to stop for two weeks prior to injection this will reduce your chance of bruising.

Most of the patients report little or no pain. Dr. Lin Yang uses the smallest needle possible. Some of our patients also request numbing cream be used.

One of the great things about Botox injections is that it requires little or no recovery. Immediately after getting injections you will have some small bumps where the injections were given. These bumps are typically gone in an hour. Rarely a patient will get a small bruise. When it occurs, a bruise takes about two weeks to resolve.

About 3 days before you notice anything and the result becomes stronger for about two weeks.

The first time you get injections they last about 3-4 months. If you get them on a regular basis the frequency at which you need to get injections actually decreases. Patients typically require injections 3-4 times the first year, 2-3 times the second year, and twice yearly thereafter.

For cosmetic purposes this varies between about 25 and 100 units depending on the number of areas treated and the size of your facial muscles. For instance, treating the wrinkle between your brows requires about 30 units of Botox. If the crows feet, and forehead are also treated it will require 2-3 times more units of Botox. Men often have larger facial muscles and require slightly higher doses.

Less than one vial (100 units) of Botox is typically used to treat wrinkles. One vial of Botox cannot cause botulism.

All medications can cause an allergic reaction. Transient systemic side effects such as dry mouth and flu-like syndrome are also very rare. Bruising occurs in less than 15% of patients and is typically mild and resolves. Problems with the eyelids or mouth are the major concerns. Drooping of the corner of the mouth or problems with speech can occur if injections are given in the area around the mouth. Drooping of the eyebrow or eyelid can occur when injections are given around the eyes. The risk of complications like a drooping eyelid for forehead can be minimized by having an experienced physician perform the injections. When these side effects occur they resolve when the Botox wears off.

No. Botox is broken down by the body.

No. Botox should be administered only by experienced medical professionals with special training in cosmetic procedures. Dr. Lin Yang is a board certified surgeon with Botox injection training.