Botox: Myths vs. Facts

| July 1, 2012

Botox causes many patients confusion over what it is, how it works and what it is used for in cosmetic applications. Many still don’t really know what it is used for and are totally incorrect in their assumptions. I hope that this answers many questions for most.

Botox is a paralyzing toxin that has been in use for over 40 years. It is marketed under the names Botox, Dysport, and Xeomin. This toxin is not a filler and it does not “fill in” wrinkles or lines. Many patients mistakenly believe that botox does this.

Botox “works” by paralyzing the muscle and because the muscle is no longer working, the skin overlying the muscle will not move. Since wrinkles develop from the skin repeatedly folding with the action of these muscles, the use of botox means no more folding of the skin since there is no movement. If this repeated folding of the skin goes on unchecked, the skin is eventually “creased” and the wrinkle is now permanent.

Once a crease is permanent Botox can only help to a degree. The deeper the crease, the more ineffective Botox becomes. This is where “fillers” come in to play. This is one reason we urge patients to begin Botox early to prevent the creasing from occurring. This is the single most effective action that patients have at their disposal to delay wrinkle formation.

A common request I hear is, “Please don’t dilute it, give me full strength!” This is another common misconception. Botox comes in a vial that contains 100 units and it is a dry powder that can be seen on the bottom of the vial. This powder is unusable until it is diluted by the doctor. So every vial must be diluted before it can be injected. This is where the amount of dilution is crucial. If the amount used to dilute is 4cc, then every 1 cc will contain 25 units. The use of units as a measure of effectiveness is valuable, but every patient is different. 20 units may be too much for one patient, but too little for another. Each patient will have varying degrees of muscle strength or action based on family inheritance or their individual genetic make-up. So asking for the use of specific units can be misleading.

The knowledge of your doctor about your face and the way your muscles will respond is very important. I prefer to have my patients return in two weeks so I can “learn” how they have responded to the injections and the location of my injections. This is the art of botoxing.

Category: Blog

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