Botox® is a potent local neuromuscular inhibitor, successfully used in the treatment of motion disorders and/or the involuntary contraction of the muscles.  Expression lines are caused by contractions of the facial muscles, which have a constant natural tension that with the usual expressions of anger, laughter, emotion and worry, permanently mark the skin of the face in adjacent zones. These lines are known as hyperkinetic lines, which, with time, become more noticeable and pronounced. The application of small doses of Botox on the facial muscles blocks nerve impulses, resulting in a reduction in muscle activity. In this way a prolonged and completely reversible effect is obtained without the use of fillers or surgery.

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