Frequently Asked Questions - Botox

What can be done for "frown lines" and "crow's feet"?

We use our facial muscles for smiling, frowning and other expressions and, over time, prominent lines may be formed in the outer layers of skin. Botox® can be injected into these overactive muscles to cause temporary paralysis and smooth these problem areas. Botox® works best for dynamic wrinkles or those wrinkles that are caused by expression or muscle contraction.

What is Botox®?

"BOTOX® treatments", or "BOTOX® injection treatments" are a therapeutic muscle-relaxing agent that works at motor nerve endings (nerves that lead to muscles). BOTOX® Cosmetic is a drug used for the temporary improvement in the appearance of moderate to severe glabellar lines (frown lines). These frown lines come from muscles called corrugator and/or procerus muscles. The BOTOX® injection treatment is the name used for the process of injecting the Botox® product into the patient.

BOTOX® injection treatments were approved by the U.S. Food and Drug Administration (FDA) for cosmetic use in April 2002. (It has been approved for the treatment of several medical conditions since 1989.) BOTOX® is a trade name for botulinum toxin A. BOTOX® is related to botulism.

BOTOX® injection treatments are successfully used to treat blepharospasm and strabismus, and BOTOX® treatments are also proven useful in treating cervical dystonia -- these are all conditions that in some way involve spasms, involuntary muscle contractions. Within a few hours to a couple of days after the botulinum toxin is injected into the affected muscle(s), the spasms or contractions are reduced or eliminated altogether. The effects of BOTOX® treatments are not permanent, reportedly lasting anywhere from three to eight months. By injecting the toxin directly into a certain muscle or muscle group, the risk of the BOTOX® injection treatments spreading to other areas of the body is greatly diminished.

When BOTOX® -- botulinum toxin A -- is injected into the muscles surrounding the eyes, for instance, those muscles can not "scrunch up" for a period of time. They are paralyzed. So the wrinkles in that area, often referred to as "crow's-feet," temporarily go away.

How Long Does It take Botox® to Begin Working?

It takes approximately 5 days for the medicine to reach full effect causing the muscle to relax. The creases should then begin to smooth out in 1 to 2 weeks. For people with very deep creases it may take longer for the skin to “iron” out.

How long does Botox® last?

Botox® usually lasts 3 to 5 months when used to correct dynamic wrinkles of the face. For first time patients the effects may be on the short end (approximately 3 to 4 months) and for repeat patients the effect may be longer (approximately 5 to 6 months).

Do I need to follow up with Dr. Zemmel after my Botox® treatment?

Dr. Zemmel will see you in the office 2 weeks after injection. He wants to make sure you forehead and brow are symmetric and your results is optimal. Small touch ups are included with your original fee.

Is treatment with BOTOX® Cosmetic painful?

Discomfort is usually minimal and brief. Prior to injecting, your physician may choose to numb the area with a cold pack or anesthetic cream. The entire procedure takes approximately 10 minutes. Many people are in and out of the physician’s office without downtime following BOTOX® Cosmetic treatment.

Who should not use BOTOX® Cosmetic?

BOTOX® Cosmetic should not be used in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any ingredient in the formulation. Patients with neuromuscular disorders such as ALS, myasthenia gravis or Lambert-Eaton syndrome may be at increased risk of serious side effects.

Will I experience any side effects?

The most common side effects following injection include temporary eyelid droop and nausea. Localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising may be associated with the injection. Patients with certain neuromuscular disorders such as ALS, myasthenia gravis, or Lambert-Eaton syndrome may be at increased risk of serious side effects. Dr. Zemmel will go over these with you in detail during your consultation.

Will my facial expressions continue to look natural?

Although the results are visible, a treatment with BOTOX® Cosmetic will not radically change your facial appearance or make you look as if you "had work done." The muscle activity that causes frown lines between the brows is simply reduced, so you can still frown or look surprised without the wrinkles and creases between your brows.
What will happen to the frown lines between my brows if I choose not to continue treatments?

If you do not continue treatments, the moderate to severe frown lines between your brows will gradually look like they did before treatment.

Is BOTOX® Cosmetic affordable?

When considering your facial aesthetic options, BOTOX® Cosmetic is quite affordable. According to an American Society for Aesthetic Plastic Surgery survey, BOTOX® Cosmetic is one of the low-entry-cost facial aesthetic procedures in the United States. Like other appearance-related investments, such as hair coloring and cuts, teeth whitening, and chemical peels, the cost must be weighed relative to your expectations. Consult your doctor for further information.

Do treatment results differ?

To get the best results, it's important to go to a doctor who is experienced in administering BOTOX® Cosmetic. Dr. Zemmel has performed hundreds of successful Botox® treatments. His results are natural, pleasing, and long lasting.