BOTOX® is a surgical injection of botulinum toxin, given to

• temporarily reduce or eliminate frown lines, forehead creases, crows feet near the eyes and thick bands in the neck
• to relieve migraine headaches, excessive sweating, and muscle spasms in the neck and eyes

by blocking the nerve impulses and temporarily paralyzing the muscles that cause wrinkles while giving the skin a smoother, more refreshed appearance. 

BOTOX® treatment is done when the following conditions exist

• worry lines, frown lines, laugh lines and other dynamic wrinkles
• forehead creases
• crows feet near the eyes
• thick bands in the neck
• migraine headaches
• excessive sweating
• muscle spasms in the neck and eyes

• Candidates who are not pregnant or nursing
• Candidates without any neuromuscular diseases
• Candidates who do not drink, smoke, or use recreational drugs
• Candidates who are physically healthy, psychologically healthy and have realistic expectations from the procedure
• Candidates who wish to enhance their appearance
• Candidates who seek improvement rather than perfection

• Temporarily weak or heavy feeling eyelid
• Droopy eyelid
• Blurred vision
• Double vision
• Inability to close the eye
• Sagging mouth
• Brow droop
• Excessive tearing
• Long-term weakness

• During the initial consultation, a thorough discussion on the expectations of the patient as well as the complete medical history of the patient is understood
• Photographs are taken for further comparison after procedure.
• A careful history and physical exam of the face will be done to determine the skin type, skin thickness and degree of wrinkling and whether the treatment is the right decision.
• The doctor discusses and advises on options of anaesthesia, type of facilities, various techniques and cost with the patient.
• The doctor provides guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications

No sedation or anaesthetic is required for the treatment.

• The doctor applies ice to the area to be treated for a few minutes before the procedure.
• The patient is seated upright after which the injection is targeted into the muscle to be treated either by
• Asking the patient to contract the muscle in the area. For e.g., if the patient is receiving injections for wrinkles between the eyes, he will be asked to frown or
• Using an electromyelogram that helps the doctor to locate the area of greatest contraction in the muscles and determine the right location, the right amount of toxin is used
• The patient is asked to gently press a gauze pad against the injection site and/or hold to it for a few minutes.
• The patient receives an average of three injections per muscle and the process is repeated depending upon the number of sites to be treated.

The whole process takes about ten minutes to half an hour, depending on the number of areas being treated.

It is an outpatient procedure and the patient can drive back by himself, the same day.

• There may be mild swelling which subsides in 4- 24 hours.
• Some patients experience a slight temporary bruising at the injection site which can be covered with make-up.
• The patient is asked to hold an ice pack to the treated area for a few minutes after the treatment to minimize bruising and discomfort resulting from the injections as well as to keep the BOTOX® within the injected areas.
• BOTOX® usually takes two to seven days to have its full effect.
• Once the botulinum toxin has taken effect, it will take three to six months for the affected muscles to begin functioning again

• As soon as the series of injections is completed, the patient can go back to regular activities
• Patients should avoid strenuous physical activity for the first 24 hours after the injection
• The patient must refrain from bending or lying down for approximately four hours after the injections until the toxin has had time to attach to the nerve-muscle connection.
• The patient must not rub the area in order to prevent the toxin from spreading to adjacent muscles.
• The patient may be asked to return after two weeks for evaluation of the treatment results
• The patient must request an immediate follow up if
• he feels that the BOTOX® treatment has not worked sufficiently
• he notices unevenness of eyebrows or other areas
• if the eyebrow is drooping

BOTOX®
Botulinum toxin type A - not live bacteria. It is a genetically engineered protein that weakens or inactivates muscles.