BOTOX is the trade name for botulinum toxin. Botulinum toxin is a protein produced by the Clostridium botulinum bacterium. In its pure form, it is a type of food poisoning that causes muscle weakness by preventing muscles from contracting. In its extremely diluted form, it has many medical applications. BOTOX has been used by ophthalmologists for years for the treatment of involuntary eyelid spasms, a condition known as benign essential blepharospasm.

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Patient with benign essential blepharospasm, before and after eyelid surgery and treatment with BOTOX.

In recent years, BOTOX has been used for cosmetic purposes as well. Facial wrinkles form as a result of repetitive muscular contractions. When you raise or furrow your eyebrows, squint your eyes, or simply laugh or smile, the muscles around your forehead, eyebrows, and eyelids contract and wrinkle the skin. When you are young, the wrinkles are only visible when the muscles are actively contracting. As you age, and after years of these repetitive muscular contractions, the forehead, eyelids and eyebrows develop deeper and deeper wrinkles that are visible all of the time. Since BOTOX acts by preventing muscular contractions, it can be injected into the forehead, the area between the eyebrows (glabellar area), and the outer eyelids (“crow’s feet”) to soften the existing wrinkle lines. As an even greater benefit, with repeated BOTOX injections, these wrinkles are then less likely to form as you get older.

The injections are given in the office. They are typically placed in 10-15 areas of need around the forehead and eyes. They begin to work in 7-10 days. Thereafter, the muscles injected will be weakened, decreasing the ability for the wrinkles to show, and over the long term, for the wrinkles to form. The effects of the injections last 3-6 months, and if desired, can be repeated when they diminish. The active effect of BOTOX on your everyday facial movements and expressions is usually entirely unnoticeable to others.

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