Botox® and Dysport®

About your treatment

BOTOX® (botulinum toxin type A) has been used for decades in children and adults to improve medical conditions involving muscle spasms. BOTOX® Cosmetic is approved by the U.S. Food and Drug Administration (FDA) for the cosmetic treatment of glabellar frown lines (the wrinkles between the eyebrows) and wrinkles around the eyes (“crow’s feet”). It has also been widely used off-label to treat other areas, including forehead wrinkles, upper lip wrinkles, the chin, the neck and the nose (“bunny lines”).

Injecting tiny amounts of BOTOX® or DYSPORT® into small muscles of the face and neck causes those muscles to weaken. This improves the appearance of the wrinkles above them, prevents frowning, and gives the skin a softer, smoother appearance.

Treatment results

Results of BOTOX®, DYSPORT® and XEOMIN® treatment are usually dramatic, with high rates of patient satisfaction. Some remaining muscle movement is necessary and natural. The goal is not to look “frozen” but to look rested and relaxed.

Visible results typically develop over 3 to 10 days. The treated muscles weaken gradually, with the greatest effect about 2 to 4 weeks after treatment. Results typically last 3 to 5 months and vary from patient to patient.

Treatment is not permanent. Over time, as the material is slowly absorbed, fine lines and wrinkles will return. Treatment may be repeated to maintain results if you wish. With continued treatment, patients often find that their results last longer. After multiple treatments, most patients come in only twice a year to maintain their improvement.

Most patients are very pleased with their results. However, as with any cosmetic procedure, there is no guarantee that you will be completely satisfied, that fine lines or wrinkles will disappear completely, or that you will not need additional treatments to achieve the results you want. Sometimes the first correction is just what you wanted but seems to fade sooner than expected; other times the correction is less than you had hoped for. In either case, additional treatments may be needed.

The cost of treatment is based on the amount of product injected. Over time, your face and eyelids may continue to change because of aging, weight loss or gain, sun exposure or other reasons not related to your injections. There is some evidence that continued treatment may help prevent fine lines and wrinkles from forming or deepening, but BOTOX® and DYSPORT® do not stop the aging process.

Risks and possible complications

Complications and side effects are generally mild and temporary. Most people have slightly swollen, pinkish bumps at the injection sites, which usually last a few hours or less. Other possible side effects include bruising, numbness, irritation or tenderness at an injection site, and headache.

Rarely, a nearby muscle may be weakened after an injection. This may cause double vision or difficulty raising the eyelid or eyebrow. This complication can last several weeks or longer and occurs in less than 3% of treatments. If it happens, eye drops can be prescribed to minimize the effect. In a very small number of people, the injection is not as effective as expected.

Because everyone’s facial muscles are slightly different, some muscles may be more affected than others, causing an uneven appearance. In most cases this can be corrected with additional treatment, but in rare instances it can last for several weeks or months. Several treatment sessions may be needed to achieve the results you want.

Uncommon reactions that have been reported include headache, flu-like symptoms with mild fever, respiratory problems such as sinusitis and bronchitis, dizziness, nausea, infection, nerve damage and allergic reaction.

Before your treatment

• Come to the office with a clean face, free of makeup and moisturizer in the area to be treated.
• To reduce the chance of bruising, stop non-essential blood-thinning medications and supplements for 10 to 14 days before treatment if possible. These include aspirin, ibuprofen, Advil, Motrin, Midol, Aleve, Excedrin, Alka-Seltzer, vitamin E, green tea, garlic, ginkgo biloba, ginseng and St. John’s wort.
• Important: if you have been prescribed aspirin or another blood-thinning medication such as Plavix or Coumadin for medical reasons, do not stop taking it. Bruising does not affect the success of treatment.
• Injections are generally very well tolerated with minimal discomfort. A topical numbing cream is optional and usually not needed. If you would like to apply one at home, ask your physician for a prescription.
• If you are pregnant, breastfeeding or trying to become pregnant, please tell your physician. You are not a candidate for treatment at this time.
• If you cannot keep your appointment, please call 501-817-3923 to cancel or reschedule. Patients will be charged for any missed appointment that is not canceled at least 24 hours in advance.

After your treatment

• Do not lie flat for at least four hours after your treatment. After four hours, you may resume your normal activities.
• Do not touch, massage or otherwise press on the injection sites.
• To minimize redness and bruising, avoid anything that makes your face or body flush for 24 hours, such as direct sunlight, exercise, alcohol, hot showers or spicy foods. If bruising occurs, it will go away in several days.
• You may apply cool water compresses to the treated areas if they are uncomfortable or red.
• If you get a headache, you may take Tylenol. Do not take aspirin or ibuprofen, as they may increase the risk of bruising.
• You may gently wash your face the evening of your treatment, but wait until the next day to resume your normal facial care, including makeup.
• To help the treatment take effect, frequently use (contract) the muscles in the treated area for two to three hours after treatment.
• Because every patient’s facial anatomy is different, results can be uneven. Sometimes the correction is less than expected or fades sooner than expected, and additional treatment may be needed. Please call our office for a follow-up visit if you have any of these concerns.
• If you develop a droopy eyebrow or eyelid, do not be alarmed. This uncommon side effect is not serious. Call our office — eye drops can be prescribed to help. This problem generally resolves in several weeks to several months.

Cost and payment policy

Because BOTOX® and DYSPORT® treatments are considered cosmetic, you are responsible for the cost of treatment, including any additional treatments. Full payment is due at the time of service, and credit cannot be extended. Please discuss the estimated cost before your procedure. Your final cost may be more or less than the estimate depending on the amount of product used. If you have any questions, please make sure they are answered to your satisfaction.

We are pleased that you have chosen Pinnacle Dermatology for your skin care, and we appreciate your confidence in us. If you have any questions or concerns about your treatment, please call 501-817-3923.