Candidates. Botox is used to treat expression lines (anger, laughter, worry, etc.) and not on the damage caused by the sun, flaccidity or aging. The most frequently treated areas are the lines on the forehead or between the eyebrows, periorbital lines (lines around the eyes or "crow's feet"), peribuccal lines (surrounding the cheek) and some wrinkles on the neck. Botox relaxes the facial muscles so that the lines in the treated areas disappear. In some patients this treatment may be used 2 weeks prior to facial rejuvenation surgery, notably improving the surgeon's access to hard to reach areas. Exposure to sunlight is not recommended prior to this treatment, and it is contraindicated during pregnancy and lactation.
Surgery. This is a non-surgical procedure, simple, safe, and completely painless, that does not require sedation or local anesthesia. A small amount of botox is applied in the different treatment areas to relax the muscles. This treatment does not block muscular activity entirely: due to its localized effect, the nerves and muscles are not affected. The skin in the treated area is left smooth and wrinkle-free, while the facial muscles that were not treated contract normally, without affecting facial expression and permitting a rapid return to daily activities.
Postoperative care. In some cases temporary ecchymosis or bruising may occur; analgesics are prescribed to the very few patients that experience pain. Since this is a temporary treatment, reapplication is usually indicated in six months; nonetheless studies and experience have indicated that the duration of the benefits increases with time, allowing the patient to move to smaller doses and less frequent applications.
Before and after photos showing application of botox on periorbital lines.
Application points are marked in the before photo, after photo is one month following treatment
NOTE. Botox has no significant contraindications or side effects. It has been approved in the United States since 1989 by the FDA (U.S. Food and Drug Administration) and in Mexico by the Department of Health since 1993. Doctors who apply it must be board certified plastic surgeons with a license and training certified by the Department of Health.