What is botox?

Botox is an injectable cosmetic therapy that temporarily reduces or eliminates facial lines, wrinkles and creases. Doctors also use Botox for some medical conditions, including nerve spasms and chronic migraine headaches.

Botox is the brand name for botulinum toxin, which works by blocking chemical signals from nerves. Your doctor precisely delivers a small amount of diluted solution to targeted muscles — those you use often for repetitive activity, such as squinting or frowning. The Botox causes these muscles to relax. As they relax, wrinkles start to smooth out — an effect that typically lasts for a few months.  

Botox injections are a quick, relatively painless way to give your face a younger, more rested appearance. Repeated use may also prevent lines from getting worse over time.

Board-certified plastic surgeons at The Ohio State University Wexner Medical Center in Columbus are skilled in performing all types of cosmetic procedures, including Botox injections. If you’re considering Botox, your doctor will evaluate your condition and goals in a personal consultation. Your plastic surgeon can help you decide whether Botox or other cosmetic procedures, nonsurgical skin rejuvenation and skin care treatments may be right for you. 

Why Botox therapy is done

As the years go by, your facial skin begins to “remember” repeated expressions, such as a smile, squint or frown. This repetitive muscle activity can leave permanent furrows, laugh lines or frown lines on your face. You may develop lines across your forehead, crow’s feet around your eyes and vertical lines between your eyes. Botox can also reduce marionette lines — the folds that extend from your nose to the corners of your mouth — and ring-like lines on your neck.

If you’re not happy with these changes in your face and neck, Botox could be an option. Doctors inject small amounts of Botox formula with minimal discomfort to temporarily diminish the look of lines on your face. Botox requires periodic touch-ups within three or more months after initial injections. The frequency of repeat treatments depends on the nature and area of lines treated, the amount of Botox injected and other variables. 

Botox is not a treatment for sagging skin and wrinkles caused by aging, gravity and loss of skin elasticity, but it can address problems like these: 

  • Forehead lines
  • Lines around and between the eyes
  • Lip lines and wrinkles 
  • Lines extending from nose to corners of mouth
  • Lines and folds around the neck
  • Botox for migraine headaches

Ohio State plastic surgeons offer specialized care for individuals who suffer from chronic migraine headaches. Migraines are severe headaches that typically have other symptoms, such as sensitivity to light and sound. Doctors inject Botox into specific pathways in the head and neck known to be involved in migraine pain, and Botox blocks the release of neurotransmitter chemicals before they can reach nerve endings and cause pain.

Learn more about Nerve Decompression Surgery for Migraines at Ohio State

Botox isn’t recommended for cluster headaches or other types of headaches, but you can ask your doctor about Botox for migraine headaches if: 

  • You have a doctor’s diagnosis of migraine 
  • You have a history of migraine headaches 
  • You get migraines 15 days or more each month 

Your doctor will advise you on your personal risk factors based on your treatment and condition.

Potential complications of Botox for migraines include: 

  • Bruising  
  • Dry mouth  
  • Fatigue
  • Neck stiffness
  • Redness and swelling
  • Muscle weakness
  • Drooping or uneven brows
  • Seek immediate medical attention if you have blurred vision and difficulty speaking, breathing or swallowing

How to prepare for Botox

Preparing for Botox injections may include the following steps as directed by your doctor:

  • Medical evaluation 
  • Assessment of skin health and condition 
  • Examination of areas to be treated  
  • Guidance about medications to take or avoid 
  • Instructions about eating and drinking before your procedure 

What to expect

Your plastic surgeon will schedule your Botox injection treatment at one of Ohio State’s easily accessible outpatient clinics in Columbus or surrounding areas. Your face and any other areas to be treated will be cleansed and prepared before treatment.

The surgeon will use fine microneedles to inject the formula into predetermined areas. You may feel a mild stinging or pinching sensation. Your doctor can apply a topical numbing cream if you’re having more sensitive areas of skin treated.

The doctor will make injections into each of the areas you’ve targeted for treatment. In most instances, Botox injections can be completed within 15 minutes or less. There is no downtime, so you can plan to return to normal routines after your treatment. Your doctor will offer specific post-treatment guidelines, such as: 

  • Avoid strenuous physical activity for the next day
  • Avoid any abrasive facial treatments or rubbing your face across treated areas
  • Stay in an upright position for the first three to four hours after your treatment

You may have some mild swelling or bruising in the areas treated. This should begin to go away within a two or three days

Results of Botox therapy

After a day, you’ll start to see fewer lines and wrinkles. Your skin will continue to improve over the next week. Results vary, but you’ll most likely require another treatment after three to six months to keep facial lines and wrinkles at bay.

If you have Botox injections to prevent migraine headaches, It’s not unusual to require two treatments before effects are noticeable. Depending on your condition, you may find the number of migraines reduced by half. Effects should continue to improve with treatments, with ideal results within six months, including fewer and less-severe migraine attacks. For long-term migraine relief, plan to schedule regular visits to an Ohio State outpatient clinic every few months or so to improve and maintain your results.

Risks of Botox injections

Risks of Botox therapy vary with each person, condition and areas treated. Our experienced plastic surgeons take steps to protect your health and safety during any medical procedure. Your doctor will carefully evaluate your health, condition, medical history and goals to determine whether it’s a safe option for you.

To be considered for Botox injections, you should meet these and other criteria determined by your doctor:

  • In good health
  • Not pregnant
  • Not breastfeeding
  • Healthy facial muscles
  • Free of certain allergies and health conditions

Potential risks of Botox injections include:

  • Allergic reaction
  • Bruising
  • Infection
  • Inflammation
  • Persistent pain
  • Crooked or uneven results
  • Dry eyes
  • Drooping eyelids
  • Excessive tearing in eyes

During your office visits, your doctor will tell you what to expect and any warning signs. Certain symptoms can be delayed and may develop later. These and other unusual changes or warning signs should be reported to your doctor right away, including:

  • Weak muscles
  • Vision problems
  • Difficulty breathing, swallowing or talking
  • Feeling faint or nauseous 
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