Q&A Topic: Everything You Need to Know About Botox
Michael H. Rosenberg, MD, FACS
What exactly is Botox and how does it work?
Botox is a muscle relaxant that is used to treat migraines, overactive sweat glands, and spasms. When injected into the skin in very small amounts, it diminishes the appearance of fine lines and wrinkles that make us look tired, angry, or older, by temporarily paralyzing the muscles below. While Botox injections are the best known, two other muscle relaxants commonly used are Dysport and Xeomin. Their formulations are different, but they all work the same way.
Where do people most often get Botox injections?
The three most common areas are the vertical frown lines between your eyebrows, often called the “eleven lines” because they look like the number eleven; the lines that go across your forehead; and “crow’s feet,” the little laugh lines at the sides of your eyes.
What’s it like to get a Botox injection?
It’s an office procedure that takes about 10 to 20 minutes. We pretreat the area with a topical numbing cream and then use tiny insulin syringes to make the injections—usually a few for each problem area. You may feel a little pinch or pressure, but it’s not at all hard to tolerate, and you can resume your normal activities later that day. Though the Botox starts working immediately, it typically takes three or four days for the lines to go away. The results last about three months.
At what age do people get Botox injections?
The most common age is 40s and 50s, but my Botox patients range in age from late 20s to 80s. Thanks to Botox, fewer people are getting face-lifts: patients who used to get face-lifts in the past are seeing nice results with Botox and fillers instead.
Is there anything else I should know before getting Botox?
Although side effects are rare, if the Botox is injected in the wrong area, it is possible for the eyelids to droop a bit. There’s also “Spock brow”—where one brow is raised and the other is not. This happens if you don’t inject the Botox correctly; you get paralysis of the muscle on one side but not on the other. That’s why it’s important to do your research and go to someone who’s board-certified and skilled in doing these procedures—rather than, say, attending a Botox party. This is not a dangerous treatment, but it is a medical treatment and should be treated as such.
Finally, you should know that cosmetic Botox treatments are not covered by insurance. Typically, the patient is charged by the area, so the crow’s feet is an area, the forehead is an area, and the “elevens” is an area. One area costs somewhere between $300 and $400.
Michael Rosenberg, MD, FACS
Institute of Aesthetic Surgery & Medicine
Associate Medical Director,
Northern Westchester Hospital
Northern Westchester Hospital is a proud member of Northwell Health.
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