What is Botox?

Botox Cosmetic is a trade name for a cosmetic injectable developed by Allergen and is otherwise known in the scientific community as onabotulinumtoxinA. It was the first and to date is one of the most widely recognized injectable neuromodulators on the market with almost 10,000,000 people receiving treatment in 2022 with an increase of patiants being treated year after year. Derived from botulinum toxin, Botox is injected into the skin superficially and temporarily relaxes the facial muscles. In doing so, it has the ability to reduce the appearance of dynamic wrinkles caused by repeated muscle movements. Unknown to most, Botox was initially created to address medical conditions like crossed eyes (strabismus) and eyelid spasms. Botox Cosmetic is now FDA-approved for treating wrinkles in the face such as crow’s feet, frown lines and forehead wrinkles as well.

Beyond these approved uses, Botox is often used off-label to address other concerns as well. Examples of these include softening lip lines, bunny lines on the nose as well as chin wrinkles to name a few. Another procedure, often referred to as the Nefertiti Lift, uses Botox to improve the contour of the jawline and reduce banding of the neck. Botox is also popularly used for achieving a nonsurgical brow lift and for enhancing the upper lip (lip flip.) It can also be used to relax the scrotum, streamline the jaw angle, reduce teeth grinding by relaxing the masseter muscles, slim the neck through injections in the trapezius muscle and even help treat acne with very superficial injections being placed into the skin.

When Botox was first approved for cosmetic use back in 2002, it was criticized for creating expressionless faces. This was due to the very high doses being used by physicians at the time, which fully paralyzed peoples facial muscles. While this stigma lingers on to some degree, with some people fearing the dreaded frozen masked face, many physicians now aim at providing subtle, natural-looking results that preserve enough muscle movement to convey patients emotions while also achieving a softening of facial wrinkles.

Beyond its cosmetic applications, Botox can lend itself in multiple medical settings as well. Examples of this include; treatment of excessive sweating (hyperhidrosis), TMJ disorders, lazy eyes, urinary incontinence, overactive bladder, chronic eyelid twitching, neck spasms, chronic migraines, vaginismus, cerebral palsy, and other forms of muscle spasms like upper limb spasticity. Research is ongoing to explore its potential for managing chronic pain, scarring, and depression.

How is Botox preformed?

A Botox procedure involves injecting small amounts of the botulinum toxin into specific muscles to have a relaxing effect on them and consequently reduce wrinkles in that area. The procedure is typically performed in a medical office or clinic, with a thin needle being used to deliver the injections. It's crucial your injector knows exactly what depth to place the Botox into as it will be one of the main deciding factors on whether or not you have a desirable result. Botox is measured in units, the number and placement of injected units depends on the area being treated and the individual's needs. Factors that will affect your results include how fast your metablism is and how strong your muscles are that are being injected.

How does Botox work?

Neuromodulators, such as Botox, work by interrupting the nerve signals between the skin and the muscles which in turn diminishes the strength of muscle contractions. After being injected, the substance quickly gets to work disrupting the nerve signals and is usually out of your body within some hours. The after effect of this, the one people pay to see, however takes some time to come into effect, usually 4-14 days.

As the treated muscle's movement becomes restricted, wrinkles created by repetitive motion gradually fade and appear less pronounced. Additionally, Botox can help stop current wrinkles from deepening and may even prevent the development of new ones.

Once the Botox has kicked in, you will usually see a smoothing out of the skin in the area where it was injected and this result will last as long it takes for your body to reconnect the muscle to those nerve endings in the skin.

How much does Botox usually cost?

The global cost of Botox varies significantly by region and provider. For example, in the United States, a Botox treatment typically ranges from $300USD to $600USD, with prices per unit averaging $10USD-$20USD. However, in countries like South Korea, the cost can be much lower, with per-unit prices averaging $4USD-$8USD and total area costs starting at $75USD. Factors like location, the number of units used, and the injector's experience can all affect the final price.

Australia

Price per unit: Expect to pay anywhere from $9AUD to $15AUD per unit of Botox.

Treatment areas: A single area, like forehead lines, could cost between $180 and $500.

South Korea:

Average cost per session: $75USD+.

Average cost per unit: $4USD-$8USD.

Mexico: Significantly cheaper than the US and Australia, with Botox injections averaging around $30USD.

Turkey: Prices can range from €330 to €500, with an average cost of €390.

Global Market: The global botox market was valued at USD 6.4 billion in 2022 and is expected to continue growing.

Popular uses of Botox

Botox is primarily known for its cosmetic ability in reducing wrinkles, but it also has several other popular applications as mentioned above in treating various medical conditions. It is used to relax facial muscles and treating wrinkles, especially those on the forehead and around the eyes. Beyond aesthetics, Botox is also used for conditions like chronic migraines, excessive sweating (hyperhidrosis), overactive bladder, and certain eye problems as well.

Cosmetic Uses:

Reducing wrinkles:

Botox is widely used to smooth out wrinkles, particularly frown lines between the eyebrows (bunny lines) crow's feet (wrinkles around the eyes) and forehead wrinkles as well.

Lip flip:

In some cases, Botox can be used to make the lips appear fuller by slightly lifting the corners of the mouth.

Neck lines:

Botox can be used to minimize the appearance of bands, fine lines, and wrinkles on the neck.

Gummy smile correction:

Botox injections can sometimes help to correct "gummy smiles," where the upper lip rests too high above the teeth and too much gum becomes exposed when a person smiles. Where the Botox is placed in this treatment can also have a softening of the nasolabial folds as well.

Jawline contouring/ V-line jaw:

Botox can be used to reduce the size of the masseter muscles, which can help to contour and slim the jawline.

Another use for Botox is having it injected in small doses superficially to shrink pores and enhance the appearance of the skin, this is known as microtox or mesotox. Furthermore, Botox can be used in smaller amounts to slightly ease the deeper wrinkles but keep full range of expressions and even allow some wrinkles to remain. As it's quite popular with men it's often referred to as brotox or sometimes babytox depending on who is getting the procedure.

Medical Uses:

Chronic Migraines: Botox is approved by the FDA for the prevention of chronic migraines.

Excessive Sweating: (Hyperhidrosis): Botox injections can help to reduce excessive sweating, especially in areas like the underarms, palms, and soles of the feet.

Overactive Bladder: Botox can help to reduce the frequency and severity of urinary incontinence symptoms in people with overactive bladder.

Eye Problems: Botox is used to treat conditions like strabismus (crossed eyes) and blepharospasm (eyelid twitching).

Neck Spasms: (Cervical Dystonia) Botox can help to relax muscles in the neck, relieving spasms.

Other medical conditions: Botox is also being researched and used for other conditions, such as TMJ pain, depression, and even to help with scar appearance after surgery.

How to prepare for a Botox treatment?

To prepare for a Botox procedure, focus on minimizing bruising and ensuring the best possible results. This includes avoiding alcohol, blood-thinning medications, and certain topical products that may have contraindicators in them while being treated with Botox. Staying hydrated and having a clean face also contributes to a smooth experience. It's also important to be aware that it's not recommended to rub your face or the treated area for 24 hours after getting Botox nor engaging in physical exercise for some hours after treatment.

What are the risks and possible side effects of using Botox?

Botox injections, while generally safe and effective, have potential risks and side effects which are important to be aware of. Common side effects include pain, swelling, bruising, headache, and flu-like symptoms. Less common, but more concerning, side effects can include drooping eyelids, crooked smiles, or even difficulty swallowing, speaking, or breathing. In rare cases, the toxin can spread beyond the injection site, causing botulism-like symptoms. This very rarely happens with a skilled and reputable injector.

Common Side Effects:

Pain, swelling, redness, or bruising at the injection site: These are common and usually go away soon on their own.

Headache or flu-like symptoms: These can occur for the first 24 hours after treatment.

Temporary drooping eyelids (ptosis): This can be a common side effect, but usually resolves on its own.

Crooked eyebrows, smile, or drooling: These can result from improper injection technique.

Eye irritation or redness: Some individuals may experience these, particularly with injections near the eyes.

Dry eyes or excessive tear production: These can be related to injections near the eyes.

Facial asymmetry: This can occur if the injection is not performed correctly.

Serious Side Effects:

Spread of toxin effects (botulism):

In rare cases, the toxin can spread beyond the injection site, leading to muscle weakness, breathing difficulties, trouble swallowing or speaking, and other botulism-like symptoms.

Vision problems: These can include double or blurred vision, or drooping eyelids.

Difficulty swallowing, speaking, or breathing: These can be signs of systemic botulism and require immediate medical attention.

Allergic reactions: While rare, allergic reactions can occur and may cause skin rashes, itching, hives, or swelling.

Minimizing Risks: Choose a qualified and experienced practitioner: Ensure they are licensed and experienced in performing Botox injections.

Follow aftercare instructions: Avoid rubbing or massaging the treated areas and follow any other recommendations from your practitioner.

Be aware of potential warning signs: If you experience any unusual symptoms, especially breathing problems, swallowing difficulties, or muscle weakness, seek medical attention immediately.

How long is recovery from Botox and how long does the effect last?

Botox recovery is typically minimal and fast. Swelling and redness at the injection site, if present, usually subside within 24-48 hours. The effects of Botox start to become noticeable within a few days, and full results are usually visible within 10-14 days. The effects of Botox typically last for 3-4 months, after which the muscles regain their original movement and you may want to go back for another treatment. Most Botox uses opt to have a schedule for their Botox usage like you would with colored hair appointments. The frequency of which really depends on the individual. Some people may want to see their provider immediately once the effects of Botox wears off while others might want to allow some time in between appointments to fully allow their facial muscles to have their full movement restored.

Please note however that results vary significantly from person to person. If you have a fast metabolism or are very expressive with your face, Botox may only last around 2 months for you and in some rarer cases even less than this.