Botox (Botulinum toxin type A) has been used for over 15 years in the cosmetic surgery industry as a popular treatment for facial wrinkles. Indeed, it has become the most popular procedure, in the world, with 3 million Americans treated last year, alone. It derives from the bacteria Clostridium botulinum, which can be harmful when present in high doses and is the toxin that causes food poisoning. However, small dilute quantities can be injected safely under the skin to act as a muscle relaxant.

How does it work?

Botox is used to treat lines and creases by injecting small amounts into the facial muscles. Normally, chemicals released by nerve cells in the face cause the muscles to tighten, leading to frown lines. Botox blocks these chemical signals causing a slight weakening of the muscle contraction and a smoothing of the skin's appearance. Contrary to popular belief, skillfully applied Botox does not paralyze the facial muscles completely, just relaxes and reduces their response.

What can Botox do for me?

Botox treatment can reduce the appearance of frown lines, forehead wrinkles and crows feet around the eyes. It can also be used to treat creases around the mouth. When performed properly it should have a gentle relaxing effect while still allowing natural expressions like smiling and frowning. Botox treatment will not reduce lines caused by sun damage and may not be fully effective on very deep creases.

Is it safe?

A course of Botox injections is a well established and recognized treatment that is considered to be safe when carried out by a qualified practitioner. There are, however, some groups of people who should not use Botox. These include pregnant and breastfeeding women and anyone suffering from a disease that affects the nerves or muscles. Certain medicines can react with Botox and you should consult your doctor if you are taking antibiotics or drugs to control heartbeat irregularities, Alzheimer's disease or myasthenia gravis (a chronic autoimmune disorder). If you are known to be allergic to any of the ingredients in Botox or if the area to be treated is infected, you should not have the treatment.

What happens during treatment?

First the surgeon will discuss your medical history and assess which areas of your face to treat. A series of small injections will then be directed straight into the facial muscles using a fine needle. You will not need an anesthetic as the injections cause very little pain. The whole procedure should be completed within a matter of minutes.

How quickly will I recover?

As soon as the procedure is completed, you will be able to return to normal activities. Some patients report a slight headache but this should soon pass. Sometimes you will be advised not to lie down for 3 or 4 hours after the procedure as this can encourage the Botox to spread to other areas of the face. You should not rub the treated area for the same reason. Botox usually takes 3 to 7 days to take full effect, after which time visible improvement in facial lines should be noticeable. Your normal facial expressions should still be present. The beneficial effects of Botox usually last for 3 to 6 months.

Are there any side effects?

Side effects of Botox treatment are usually mild. Some patients experience a slight headache for the first 24 hours after injections to the forehead area, especially after their first treatment. Mild bruising of the injected area can also occur. In very rare cases, excess Botox can cause droopy eyelids, a condition known as ptosis. This is unlikely to occur when the treatment is carried out by an experienced cosmetic surgeon and will gradually correct itself as the Botox wears off. If you do experience drooping eyelids, you should tell your consultant. Although very unlikely, a small percentage of patients may suffer an extreme adverse reaction to Botox. You should seek medical help immediately if you experience difficulty in swallowing and breathing or develop a rash.

What are the advantages of using Botox?

Since its initial introduction, Botox treatment has quickly gained in popularity and is consistently one of the most requested cosmetic procedures. It is a relatively safe treatment for most people with few documented reports of serious complications. The treatment is very simple and quick and almost painless. Because no general anesthetic is required, recovery time is rapid with little or no side effects. The results of the procedure are fully reversible over time as the muscle weakening effect of the Botox eventually wears off.

Individual Botox treatments are relatively cheap and, as the effects last for 3 or 4 months, do not have to be repeated too often. Some patients find that after several sessions, the time between treatments can be increased to about 6 months.

Where should I go to get Botox treatment? Once you have decided to have Botox treatment it is important to choose the right cosmetic surgeon to perform the procedure. Botox has a proven track record for safety and good results but only when carried out by a reputable practitioner. Choose a fully qualified surgeon who has already carried out many Botox procedures. Look for a clinic where the surgeon is willing to carry out an initial consultation so that you have the chance to ask any questions and thoroughly discuss the implications of the treatment. A good cosmetic surgeon should always be happy to give you lots of information and may be able to show you photographs of past clients and the results of their treatment. It's also a good idea to ask around your friends for personal recommendations.

What else is Botox used for?

Although Botox is most well known as a cosmetic procedure for the reduction of facial lines, it is also used in the treatment of several medical conditions. Botox can be used to reduce muscle spasms and twitching of the neck or eyelids. It has also proved successful in the treatment of excessively sweaty armpits by blocking the chemical transmitters that cause the sweating. Depending on the reasons for treatment, sometimes the cost of Botox injections can be covered by medical insurance.