Botulinum Toxin (BOTOX®) was developed for medical use and then approved by the FDA for the treatment of uncontrollable eyelid spasms in 1992. Since this time, BOTOX® has been used successfully to treat excess sweating, migraine headaches and muscle spasms and constrictions. It was found to have excellent applications in cosmetic facial rejuvenation and we have been using BOTOX® Cosmetic for these purposes for many years.


Throughout history, people have looked for ways to achieve a younger, more vibrant look by improving their facial appearance. A procedure utilizing BOTOX® Cosmetic (Botulinum Toxin) is used for the treatment of facial lines and wrinkles. BOTOX® has been safely used for certain medical conditions for more than a decade. This procedure, sometimes referred to as cosmetic denervation, has been considered a safe and effective way of treating aging skin. It is used to eliminate or reduce worry and frown lines, "crows feet", laugh lines, and other wrinkles sometimes called dynamic wrinkles. It can also be used to "lift"          such as the eyebrows and corners of the mouth and to relax muscles of the face for a more youthful appearance. 


A sedative or local anesthetic is not used because the pain associated with the procedure is minimal. A small amount of discomfort is felt when the needle is inserted and the liquid injected. This sensation lasts approximately 5 seconds. BOTOX® Cosmetic is injected into various locations on the face. The needle is extremely small and only a tiny amount of liquid is injected at one time. We use ice packs on the eye and face to provide anesthesia and decrease the chance of bruising.

Because no sedatives or anesthetics are used, patients can return to normal activities immediately after the procedure. The physician may recommend that the patient not lie flat for three hours following treatment. It is possible to experience a mild headache. If this should occur the physician may recommend Acetaminophens. Some facial exercises may be recommended. The treatment takes 3 to 8 days to take effect. The benefits will last from 3-6 months. A touchup may be necessary 1-2 weeks after the initial treatment. It usually takes 2 or 3 injections each year to maintain the desired youthful appearance.


There are no serious side effects associated with this treatment. There may be a small amount of bruising around the treated areas; however, this is temporary. On rare occasions, the needle may puncture a blood vessel which can result in a black and blue bruise around the treated area which disappears in a few days. Another side effect that rarely occurs is a slight drooping of the eyebrow or upper eyelid, usually correcting itself in 2 to 3 weeks.


The best candidates for the procedure are those between the ages of 30 and 65. In many cases, wrinkles in people over 65 are not caused by muscle pull but rather sun damage; however, each person is different and must be evaluated by the physician.

This procedure will smooth wrinkles that are caused by frown and worry lines, "crow's feet" and laugh lines; however it is not designed to take the place of the standard facelift or other facial surgical procedures. It is often used in conjunction with other procedures, such as facial fillers, to achieve the most longevity and natural appeariing results.

Dr. Eviatar is a physician trainer for Allergan and a member of their National Education Faculty.  He lectures and trains other physicians on the "best practices" for injecting BOTOX®.  If you are interested in learning more about the BOTOX® Cosmetic Treatments, please contact our office and we will be happy to answer your questions.