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Frequently Asked Questions about Botox®

What is Botox?

A favorite among physicians and clients, Botox is a non-invasive prescription medicine that temporarily relieves prominent wrinkles and irregular movements caused by muscle contraction. It is available in a powder form of 100 units per vial, which requires fresh reconstitution and preparation for each treatment. The active ingredient botulinum toxin A is a highly potent neurotoxin that acts on the neurotransmitter acetylcholine. By blocking the transmission of cholinergic reaction, it prevents the muscle from contracting and leads to relaxation. The skin covering the muscles follows suit and expands, creating a smooth complexion without any lines or wrinkled imperfections. While Botox is commonly known for reducing the appearance of wrinkles, it also has the ability to relax other muscles of the body that spasm, such as in the upper or lower limbs.

Ideal candidate

This treatment is best for patients aged 65 and below who are aiming to correct deep-set wrinkles on their foreheads, lines between the eyebrows, or at the corner of the eyes. These wrinkles appear due to the continuous muscle activity, such as squinting and frowning, which leads to the formation of the lines and folds on the face.

It is also suitable for irregular muscle contractions and twitching, such as muscle spasticity in the limbs, chronic migraines, and cervical dystonia. For pediatric patients aged 2 and above who are suffering from cerebral palsy, this treatment can ease any lower limb spasticity and lessen any overactive reflexes.

However, it is not suitable for people who are susceptible to muscle deformity disorders such as ALS, myasthenia gravis, or Lambert Eaton Syndrome. Clients who exhibit allergic reactions to botulinum toxin should avoid this treatment.

Treatment areas

• Crow's feet – Botox temporarily relaxes the orbicularis oculi, the muscles that frame the side of the eye, and reduces the visible wrinkles developed through constant muscle activity.
• Frown lines – Known as glabellar lines, these are deep, furrowed lines caused by extensive frowning and movement of the procerus and corrugator muscles. Correct using Botox to reduce signs of aging and stress across this area.
• Other medical conditions, such as muscle spasms, chronic migraines, cerebral palsy, and cervical dystonia, can be treated by reducing their irregular muscle activity. Apply intramuscular injections into the targeted muscle with the appropriate dosage. Certain areas, such as upper limb muscle spasticity, may require higher dosage.
• Pediatric patients who are aged 2 and above who suffer from lower limb spasticity due to cerebral palsy may also receive treatment with Botox to lessen the effects of overactive reflexes.
• Under the arms – excessive sweating under the arms are easily corrected using Botox.

How does Botox work?

This FDA-approved injectable is made of onabotulinumtoxin A. Using an innovative purification process, it is sourced from the bacteria Clostridium botulinum. Albumin, the water-soluble human protein, aids in the delivery of the neurotoxin to the muscle cells. It acts by inhibiting the release of the neurotransmitter acetylcholine, which leads to the blockage of the cholinergic reaction. The muscle cells do not receive any signal to contract, and remain relaxed.

As a result, the skin’s surface expands and becomes firmer and smoother. The expansion removes any visible folds, thin lines, and wrinkles that are prominent, and develops a smooth surface. With the correct dosage and administration, the face can maintain its natural expression without locking into a frozen look. Through the same mode of action, this treatment works to soothe contracting muscles that cause irritating and painful muscle spasms.

Treatment details

The treatment should be carried only by certified physicians and dermatologists. To have a more comfortable procedure, apply a local anesthetic according to the patient's pain tolerance. For preparation, reconstitute the powder using preservative-free 0.9% sterile saline, USP, according to the dosage outlined in the product pamphlet.

Each area of treatment requires a different concentration, dose, and injection point. For more information, refer to the product monograph for specific instructions based on each targeted areas.

The treatment can achieve the maximum benefits within a quick session.

How long do the effects last?

Each session of Botox application may last up to 4 months. The effect is as immediate as 24 to 48 hours after the session is carried out. Depending on the area of treatment, amount of medication prescribed, and the individual's biological condition, maintenance sessions can be carried out in every 12 weeks.

Safety information

Although Botox is widely used and is FDA-approved, it may cause serious side effects if it is not handled correctly. Inaccurate administration may cause tense muscle reactions, such as: Difficulties in swallowing, speaking, or breathing;
Spread of the toxin to other areas, causing muscle weakness;
Vision impairment;
And loss of bladder control.

Common reactions that may occur due to the injection may include pain, redness, bruising, and swelling.

Recovery time

Each treatment has minimal downtime, in which the client can return to their normal routine immediately after leaving the office. Results are noticeable within 24 to 48 hours. As this is a technique-sensitive treatment, the physician must be well-trained in administering botulinum toxin-based injections.

Treatment cost

On average, a treatment may cost your patient around $575. Botox may also be priced per unit, as can cost up to $20 per unit.