Botulinum Toxin Injections—Cosmetic
(Botulinum Toxin Type A; Botulinum Toxin Type B; Botox Injections)
Pronounced: baut-U-lie-num tock-sin in-jek-shuns
by Shara Aaron, MS, RD
Botulinum toxin is made from a type of bacteria. It is toxic to the nerves. Another name for it is bacterial neurotoxin. An injection puts this toxin into muscle. There, it blocks the chemical signal from the nerves to muscles. This will decrease the muscle contraction (tightening).
There are several types and brands of this toxin. Examples include Botox, Dysport, and Reloxin, which are formulations of botulinum toxin type A. Myobloc is another brand, but it is a formulation of botulinum toxin type B. These products are used for cosmetic and medical reasons.
This injection process is often called botox injection, although any brand of the botulinum toxin may be used.
Reasons for Procedure TOP
This is most commonly used as a treatment to smooth wrinkles on the face and neck. It is FDA-approved for the treatment of frown lines between the brows and the treatment of wrinkles at the outer corner of the eyes (crow's feet).
Possible Complications TOP
Complications are rare. When they occur, they are temporary and mild. Side effects are related to the site of injection. For example, if injections take place near the eyes, there may be complications with eyelids or the brow line.
Temporary issues may include:
The following are less common reactions. They are generally mild and do not last long.
Other complications that may occur include:
The toxin can also interact with medicines, such as antibiotics. Tell your doctor about all of the medicines that you are taking.
You should not have botox if you:
What to Expect TOP
Most often, none is given. Some patients may prefer to have the area numbed for comfort. In this case, a topical anesthetic may be used.
Description of the Procedure
A thin needle will be used. The doctor will inject the toxin through the skin into the targeted muscle. You will often need several injections in a small area.
After Procedure TOP
There is very little recovery needed, but remember to:
How Long Will It Take? TOP
The length will depend on the number of sites involved. It is often less than 20 minutes.
Will It Hurt? TOP
You may have some minimal discomfort.
Post-procedure Care TOP
Normal activities may be resumed after the procedure. For the best recovery, follow your doctor's instructions.
The toxin temporarily weakens targeted muscles. The treatment lasts up to four months. With repeated use, the effects may last longer.
Call Your Doctor TOP
After arriving home, contact your doctor if any of the following occurs:
In case of an emergency, call for medical help right away.
American Society for Dermatologic Surgery
American Society of Plastic Surgeons
Canadian Dermatology Association
Allergan Physician Production Information. Botox cosmetic (botulinum toxin type A). Published April 2008.
Baran R, Maibach H. Textbook of Cosmetic Dermatology . 3rd ed. New York, NY: Taylor and Francis; 2004.
Conn HF, Rakel R. Conn’s Current Therapy. 54th ed. Philadelphia, PA: WB Saunders Company; 2002.
Habif T. Clinical Dermatology . 4th ed. St. Louis, MO: Mosby; 2004.
Ondo WG, Gollomp S, Galvez-Jimenez N. A pilot study of botulinum toxin A for headache in cervical dystonia. Headache . 2005;45(8):1073-1077.
Ward A, Roberts G, Warner J, et al. Cost-effectiveness of botulinum toxin type A in the treatment of post-stroke spasticity. J Rehabil Med . 2005;37(4):252-257.
11/4/2009 DynaMed Systematic Literature Surveillance http://www.dynamicmedical.com/what.php : FDA gives update on botulinum toxin safety warnings. US Food and Drug Administration website. Available at: http://www.fda.gov... . Updated August 3, 2009. Accessed November 4, 2009.
10/1/2013 DynaMed Systematic Literature Surveillance http://www.dynamicmedical.com/what.php : US Food & Drug Administration. FDA approves Botox Cosmetic to improve the appearance of crow's feet lines. US Food & Drug Administration website. Available at: http://www.fda.gov... . Published September 11, 2013. Accessed October 1, 2013.
Last reviewed September 2013 by Michael Woods, MD
Last Updated: 9/30/2013