All About BOTOX® Cosmetic and Dysport
BOTOX® Cosmetic blocks impulses from the nerve to the tiny facial muscles that are related to expression lines. BOTOX® Cosmetic relaxes the muscles so they do not contract. After treatment, the overlying skin remains smooth and unwrinkled while the untreated facial muscles contract in a normal fashion, allowing normal facial expression to be unaffected.
BOTOX® Cosmetic and Dysport injections have been used safely and effectively for over ten years to treat many opthalmological and neurological disorders. Each year thousands of patients receive BOTOX® Cosmetic and Dysport treatments for a variety of conditions and it is quickly becoming a popular treatment for reversing the visible signs of aging.
Cosmetic denervation with BOTOX® and Dysport is a simple and safe procedure. Using a tiny micro needle, a very small amount of BOTOX® Cosmetic or Dysport is injected, very precisely, into several locations on the face. Because the needle is so fine and only a small amount of liquid is used, the pain associated with the injections in minimal. Most patients compare the sensation to a bug bite. No sedation or local anesthetic is required, and you can resume normal activities immediately. You can even drive yourself home or back to the office. Some patients experience a slight temporary bruising at the injection site. This can be covered with make-up.
Temporary bruising is the most common side effect. In some cases, the toxin can migrate and cause a temporary weakness of nearby muscles. In rare cases, there can be a drooping of an eyelid or asymmetry of facial expression. The risk of any side effect depends on the muscles injected. Your doctor will discuss this with you at length before your treatment. Because the effects of BOTOX® Cosmetic and Dysport are completely reversible, any side effects are temporary, lasting only a few weeks.
If dynamic wrinkles make you look older than you are, cosmetic denervation can smooth these out and give you a more youthful and pleasant appearance. However, this procedure cannot improve wrinkles due to aging and sun-damaged skin since they are unrelated to facial muscle contractions. BOTOX® Cosmetic and Dysport injections will not improve sagging skin or replace the need for a facelift or brow lift.
Unfortunately, BOTOX® Cosmetic and Dysport injections are a temporary solution for the treatment of dynamic wrinkles. the effects of the injections last from three to six months. You will need to have injections about two to three times a year. The early clinical studies indicate that the duration of treatment benefits is increased over time so that you should require injections less frequently in the future. Also, the duration of effect varies from patient to patient and may be less effective for those over 65 years of age.
Yes, BOTOX® Cosmetic and Dysport have been used for over ten years on thousands of patients to treat blepharospasm associated with dystonia.
If you would like to learn more about your cosmetic options, or find out if BOTOX® Cosmetic and Dysport treatments might work well for you, please call our office and schedule a consultation with the doctor.
BOTOX® Cosmetic is indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in patients 18 to 65 years of age.
IMPORTANT SAFETY INFORMATION INCLUDING BOXED WARNING
Postmarketing reports indicate that the effects of BOTOX® Cosmetic and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, blurred vision, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening, and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity, but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have underlying conditions that would predispose them to these symptoms. In unapproved uses, including spasticity in children and adults, and in approved indications, cases of spread of effect have occurred at doses comparable to those used to treat cervical dystonia and at lower doses.
BOTOX® Cosmetic is contraindicated in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation.
The recommended dosage and frequency of administration for BOTOX® Cosmetic should not be exceeded. Risks resulting from administration at higher dosages are not known.
The potency Units of BOTOX® Cosmetic are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, Units of biological activity of BOTOX® Cosmetic cannot be compared to or converted into Units of any other botulinum toxin products assessed with any other specific assay method.
The recommended dosage and frequency of administration for BOTOX® Cosmetic should not be exceeded. Risks resulting from administration at higher dosages are not known.
The potency Units of BOTOX® Cosmetic are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, Units of biological activity of BOTOX® Cosmetic cannot be compared to or converted into Units of any other botulinum toxin products assessed with any other specific assay method.
Please refer to Boxed Warning for Distant Spread of Toxin Effect. No definitive, serious adverse event reports of distant spread of toxin effect associated with dermatologic use of BOTOX® Cosmetic at the labeled dose of 20 Units (for glabellar lines) have been reported.
Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, urticaria, soft-tissue edema, and dyspnea. If such reactions occur, further injection of BOTOX® Cosmetic should be discontinued and appropriate medical therapy immediately instituted. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent and, consequently, the causal agent cannot be reliably determined.
Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junctional disorders (eg, myasthenia gravis or Lambert-Eaton syndrome) should be monitored particularly closely when given botulinum toxin. Patients with neuromuscular disorders may be at increased risk of clinically significant effects including severe dysphagia and respiratory compromise from typical doses of BOTOX® Cosmetic.
Caution should be used when BOTOX® Cosmetic treatment is used in patients who have an inflammatory skin problem at the injection site, marked facial asymmetry, ptosis, excessive dermatochalasis, deep dermal scarring, thick sebaceous skin, or the inability to substantially lessen glabellar lines by physically spreading them apart.
Patients should be counseled that if loss of strength, muscle weakness, or impaired vision occur, they should avoid driving a car or engaging in other potentially hazardous activities.
Administration of BOTOX ® Cosmetic is not recommended during pregnancy. There are no adequate and well-controlled studies of BOTOX® Cosmetic in pregnant women.
It is not known whether BOTOX® Cosmetic is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when BOTOX® Cosmetic is administered to a nursing woman.
General
The most serious adverse events reported after treatment with botulinum toxin include spontaneous reports of death, sometimes associated with anaphylaxis, dysphagia, pneumonia, and/or other significant debility. There have also been reports of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors including pre-existing cardiovascular disease. The most frequently reported adverse events following injection of BOTOX® Cosmetic include blepharoptosis and nausea.
Overdosage
Excessive doses of BOTOX® Cosmetic may be expected to produce neuromuscular weakness with a variety of symptoms. Respiratory support may be required where excessive doses cause paralysis of respiratory muscles. In the event of overdose, the patient should be medically monitored for symptoms of excessive muscle weakness or muscle paralysis. In the event of suspected or actual overdosage, please contact your local or state health department to process a request for antitoxin through the Centers for Disease Control and Prevention (CDC). If you do not receive a response within 30 minutes, please contact the CDC directly at 1-770-488-7100.
