Botox: The Cosmetic Use of Botulinum Toxin

Medically reviewed by Cynthia Cobb, APRN on May 17, 2017Written by Lucie Wisco

What is Botox Cosmetic?

Botox Cosmetic is an injectable wrinkle muscle relaxer. It uses botulinum toxin type A, specifically OnabotulinumtoxinA, to temporarily paralyze muscle. This reduces the appearance of facial wrinkles.

A Botox treatment is minimally invasive. It’s considered a safe, effective treatment for fine lines and wrinkles around the eyes. It can also be used on the forehead between the eyes.

Botox was originally FDA approved in 1989 for the treatment of blepharospasm and other eye muscle problems. In 2002, the FDA approved the use of Botox for a cosmetic treatment for moderate to severe frown lines between the eyebrows. It was approved by the FDA for treatment of wrinkles around the corners of the eyes (crow's feet) in 2013.

According to a 2016 clinical study, Botox is a simple, safe, and effective treatment for reduction of forehead wrinkles.

In 2016, over 4.5 million procedures were performed using Botox and similar medication to fight wrinkles. This type of procedure is the number one nonsurgical cosmetic procedure in the United States.

Read more: 5 books that will change the way you treat your skin »

Preparing for Botox Cosmetic

Botox Cosmetic involves a nonsurgical, in-office treatment. It requires minimal preparation. You should let your treatment provider know about your medical history, allergies, or medical conditions before your procedure. Your treatment provider should be a licensed physician, a physician assistant, or a nurse.

You might need to remove all your makeup and cleanse the treatment area before the procedure. You may also need to avoid blood-thinning medicine like aspirin to reduce the risk of bruising.

What areas of the body can be treated with Botox Cosmetic?

Cosmetically, the injectable can be used in the following areas:

  • the area between the eyebrows (glabellar region), to treat moderate to severe frown lines
  • around the eyes, commonly known as crow’s feet lines

Botox also received FDA approval to treat various medical problems, including:

  • overactive bladder
  • excessive underarm sweating
  • lower limb spasticity
  • chronic migraines

How does Botox Cosmetic work?

Botox Cosmetic works by temporarily blocking nerve signals and muscle contractions. This improves the appearance of wrinkles around the eyes and between the eyebrows. It can also slow the formation of new lines by preventing contraction of facial muscles.

It’s a minimally invasive procedure. It doesn’t involve incisions or general anesthesia. If you’re concerned about pain or discomfort, a topical anesthetic or ice can numb the treatment area.

During the procedure, your provider will use a thin needle to administer 3-5 injections of botulinum toxin type A. They will inject the targeted area between the eyebrows. You will usually need three injections on the side of each eye to smooth out crow’s feet.

The entire procedure takes approximately 10 minutes.

Are there any risks or side effects?

Minor bruising or discomfort may occur, but should improve within a few days. Other side effects may include:

  • swelling or drooping in the eyelid area
  • tiredness
  • headache
  • neck pain
  • double vision
  • dry eyes
  • allergic reactions, such as rash, itching, or asthma symptoms

Contact your provider immediately if any of these side effects occur.

What to expect after Botox Cosmetic

Avoid rubbing, massaging, or applying any pressure to the treated area. These actions can cause Botox Cosmetic to spread to other areas of the body. This can negatively affect your results. When being injected between the brows, do not lie down or bend over for three to four hour. Doing so may cause the Botox to slip under the orbital rim. This could possibly cause an eyelid droop.

There is little to no downtime expected after the treatment. You should be able to resume normal activities immediately in most cases.

It’s important to understand possible improvements and have realistic expectations. Noticeable results can be expected within 1-2 days post-treatment. The full effect of Botox Cosmetic typically lasts up to four months. It can also help prevent the return of fine lines through relaxing the muscles.

Additional Botox injections can be administered to maintain your results.

How much does Botox Cosmetic cost?

The average cost of a botulinum toxin treatment such as Botox Cosmetic was $376 in 2016. Costs may vary depending on the number of injections, the size of the treatment area, and the geographic location where you receive treatment.

Botox Cosmetic is an elective procedure. Health insurance does not cover the cost when used for cosmetic reasons.

Outlook

Botox Cosmetic is FDA approved for the reduction of fine wrinkles around the eyes and on the forehead. It’s relatively safe and noninvasive.

When choosing a provider, confirm that they’re licensed to administer Botox Cosmetic. Let your provider know about any allergies or medical conditions, and call them right away if you experience any side effects following your treatment. Results should last for about four months, and it’s possible to have additional injections to maintain the reduction of your wrinkles.

CMS Id: 121522