Where does the name Botox come from, and what is it?
Botox is the trade name for the original medication developed from botulinum toxin, the active neurotoxin found to produce temporary muscle relaxation. The FDA has two other companies that make drugs with similar effects – namely, Dysport and Xeomin.
What Can Botox / Dysport / Xeomin do For Me?
There are lists of areas that cosmetic botulinum toxin has been used to treat, including crows feet (periocular wrinkles), vertical or 11 lines (glabellar) frown, Horizontal (frontalis) frown, Bunny Lines (nose wrinkles), Upper Lip, angle of the mouth, jaw line (platysma), venus rings (horizontal neck rhytids), Turkey neck (vertical platysmal bands), amongst others. Many of these are off-label, meaning the FDA has not provided specific indication for those areas.
Beyond the cosmetic results seen with botulinum toxin injection, other uses include, reducing excessive sweating (hyperhidrosis), painful teeth clenching (bruxism), migraine headaches, neck muscle spasm (cervical dystonia), blepharospasms, etc.
What CAN’T Botox / Dysport / Xeomin Do For Me?
Botulinum toxin injection may improve the appearance of fine lines and wrinkles, especially those only present with motion. For deeper wrinkles or those present even while the facial muscles are at rest, recommendations in addition to botulinum toxin injection may be of benefit. Also, because of how these medications work, they are not to be injected in people with certain neuromuscular disorders, taking certain medications or those that are pregnant or breast feeding.
How Is Botox / Dysport / Xeomin Administered?
The medication is injected directly to the areas of concern during a simple office procedure that takes a few minutes. The needle used is one of the smallest made and there is no pain after the injections are complete. Patients often will have a raised area at the injection site that quickly disappears. Patients are cautioned against laying down, doing strenuous activity/exercise, or wearing tight hats immediately following injection.
How Does Botox/Dysport/Xeomin Work?
At a basic level, the botulinum toxin works by blocking the release of chemicals that normally act between the nerves and muscles which cause the muscle to contract. The time period between injection into the muscle and decreased muscle function is between 24 hours and five days. With this block in place the muscle does not contract and as a result of non-use it tends to become weak and small. Think keeping your arm in a cast for a few weeks, then noticing how small the arm looks once the cast is removed. This effect is reversible, however, as with time new chemicals act from the nerve to the muscle to allow it to contract again. This is why the effects of cosmetic botulinum toxin are not permanent and require repeated injection for continued effect.
How Long Will It Last?
As explained above, the effects of Botox / Dysport / Xeomin are limited in their duration and last on average around 14 weeks, with the full effects seen by the first 4 weeks. There is some evidence that the muscle remains relatively less bulky even beyond this time.
It has also been reported that patients may become resistant or develop decreased effectiveness to the drugs over time. In those cases, switching to one of the other muscle relaxing agents usually resolves the issue.
Is Botox / Dysport / Xeomine Safe?
Botox has been FDA approved for treatment of glabellar lines since May 2002, with recent new approval for the treatment of the periocular or “crow’s feet” area in September 2013 Beyond this, the same medication has been used for non-cosmetic reasons since the late 70’s. The American Society of Plastic Surgeons has reported Botulinum Toxin injection has become one of the most performed non-surgical cosmetic procedures in the world at 6.3 million procedures in 2013 alone. This is up 3 percent from the previous year. With millions of patients being injected each year, the safety and effectiveness of Botox / Dysport / Xeomin is unquestioned.
Having established its safety, it is important to also know that there can be side effects to injection with botulinum toxin. The most common being mild bruising, swelling, temporary headache, asymetries, or ptosis.
How Much Does Botox / Dysport / Xeomin Cost?
Cost is usually discussed in terms of “units” of the medication injected to treat specifically areas. Because specific areas require different amounts of the botulinum toxin costs can range significantly.