Michael C. Neuenschwander, MD

Botulinum Toxin (Botox) Information Sheet

What is Botox?
Botulinum toxin is one of the most powerful toxins known.  There are several types, and it is prepared from the bacterium Clostridium botulinum.  It causes muscle paralysis by blocking release of a chemical in the muscle.  In high enough doses, around 2500-3000 U, it can be lethal for humans.  Fortunately, in otolaryngology we use very small fractions, usually 10-75 U.

What is it used for?
It is used to treat dynamic wrinkles caused by muscle overexpression.  These include crow's feet, frown lines, forehead lines, and deep nasolabial folds.  Unsightly, deep wrinkles are often interpreted by others as anger, anxiety, fatigue, or fear.  Today, it is a popular treatment for these signs of aging.  In addition, it is used to treat a variety of other neurologic-muscle disorders.  It causes a paralysis of the small muscles injected in a process known as chemical denervation.  It has been used safely since 1978 in thousands of patients without any known long term effects.

Is the paralysis permanent?
Clinically, the muscle paralysis is temporary, typically lasting 2 months to 6 months, rarely longer.  There are no known clinically permanent sequelae of Botox.

How is it injected?
Botox is injected with a micro needle that places small amounts of toxin directly into the muscle.  Several injection sites are usually used, depending on the type and degree of wrinkling.  The needle is very small and feels like a tiny pinprick.  There should be minimal discomfort.  No sedation or anesthetic is required.  Rarely, patients may experience temporary bruising, which can be covered with make-up.

When does it start to take effect?
The effects of Botox are not immediate.  Usually, it starts to take affect around 3 to 7 days and should reach their maximum in about 2 weeks.

Am I an appropriate candidate for Botox?
Everyone is different!  Remember, Botox works by temporarily paralyzing the small muscles in the face that cause dynamic wrinkles such as when we squint our eyes, frown, or wrinkle our forehead.  Botox prevents you from making those wrinkles.  It does not improve wrinkles from sun damage or sagging skin related to aging.  It does not replace a facelift or browlift. 

For these reasons, we comprehensively treat conditions such as wrinkles and other aesthetic concerns with a variety of methods.  Other treatments for facial wrinkles include Retin A and other skin preparations, chemical peel, laser resurfacing, collagen or fat injection, and ultimately surgery.  Some conditions may be treated with one or more of these methods and may even need to be repeated.  Please consult your facial plastic surgeon for a comprehensive review of a treatment plan that would work best for you.  In today's age, there are many ways to treat similar conditions, some more invasive or permanent than others.  Please do not hesitate to ask questions.  We are here to help you feel better about your appearance.


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Atlanta, GA 30327
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Fayetteville, GA 30214
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