Botox is approved by the FDA for the treatment of wrinkles in the glabellar area of the face (between the eyebrows). Botox is also used in an “off label” fashion to treat wrinkles in other areas of the face as well. Off label refers to use of a medication outside of the purpose that it has been approved for by the FDA. For example, erythromycin is approved as an antibiotic, but it is often used in the intensive care setting to help stimulate intestine function in critically ill patients.
Some of the off label uses of Botox include injection the frontalis muscle in the forehead to improve the appearance of horizontal forehead wrinkles and injection into the lateral portion of the muscles that surround the eyes to improve the wrinkles commonly known as crow’s-feet. Small doses of Botox can also be injected into the muscle that surrounds the mouth to improve the appearance of wrinkles extending from the lips. More advanced Botox injection techniques can be used to paralyze the muscles that pull down the lateral edges of the eyebrows leading to a more elevated, arched appearance of the brow. Another advanced technique involves injecting the muscles that act to pull down the corners of the mouth leading to a more youthful, less tired appearance.
The amount of Botox injected for cosmetic purposes is very small and is measured in units. You can think of a unit in similar terms to milligrams for an antibiotic. Each different area of the face that is treated requires a different number of injections and total number of units injected. Each injection that is performed is carefully positioned to maximize the efficacy of the injection. The muscle paralyzing effects of Botox will typically only diffuse about 1.5 cm from the point of injection. For this reason several injections are required to achieve the desired result for each area of the face. The glabellar area typically requires 5 injection sites, the forehead can require 4 – 8 injection sites and the crow’s-feet usually require 3 – 5 injections per side. The number of units that are required to treat each area is a function of the size of the muscle being injected. For women, the glabellar and forehead areas average 20 units each and the forehead averages 12 units.
If you have any questions or would like to see if Botox is right for you visit my website www.signatureplasticsurgery.com or call 281-616-8800 to schedule a free consultation.
Next time I will discuss what to expect from the actual treatment including discomfort, time for the onset of effect, length of effect and possible side effects.
Until then, for more information about Botox you can go to www.botoxcosmetic.com where you can get information directly from Allergan – the manufacturer of Botox.