Botox injections have quickly risen to the top of the chart of most commonly performed cosmetic procedures. There were nearly three million Botox treatments performed last year. This FDA approved wrinkle treatment can provide predictable dramatic results with minimal risks and no down time. A recent survey by The American Society for Aesthetic Plastic Surgery reported that 97% of patients treated with Botox were satisfied with their results.

Prospective patients frequently express concerns about intentionally injecting botulism toxin into their bodies. This substance has been used for over fifteen years for a variety of muscular conditions and has a very favorable safety profile. Patients with certain neurologic disorders can be at higher risk for side effects and this needs to be discussed with your doctor.

Botox received FDA approval in 2002 for treating wrinkles caused by muscle activity between the eyebrows. Other common “off-label” wrinkle treatments are done in the forehead and for crow’s feet, and occasionally around the mouth and neck. More innovative uses for Botox, based on a thorough understanding of the anatomy of the facial muscles of animation, now include facial shaping. The most straightforward example of this involves injecting a small amount of Botox just beneath the outer half of the eyebrow. This weakens the muscle that pulls down on the eyebrow (the orbicularis oris muscle) and allows the muscle that elevates the eyebrow (the frontalis muscle) to act unopposed. The aesthetic result is an elevation of the eyebrow that can relieve that tired look and frequently rivals the results of a formal operation to elevate the brow.

The results of your Botox treatments are very much dependent on the level of expertise of your doctor. Many patients are being treated by physicians (and sometimes even non-physicians) with only a casual understanding of the complex anatomy and interactions of the muscles of facial animation. Errant injections can leave a patient with significant facial distortion for several months. Plastic surgeons who routinely perform procedures such as facelifts and browlifts visualize these complex structures during surgeries and are well versed in the anatomy of facial animation. Pursuing your treatment with a physician certified by The American Board of Plastic Surgery is the best way to ensure a positive experience.

Dr. Thomas Leach, M.D. is a diplomate of the American Board of Plastic Surgery and a member of The American Society of Plastic Surgery. Dr. Leach can be reached at The Princeton Center for Plastic Surgery – 609-921-7161.

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