As we age our skin changes, the main changes seen are skin sagging, appearance of fine wrinkle lines and deepening of facial animation lines.
How quickly these changes take place depend upon various factors - smoking, exposure to ultraviolet radiation (sun), environmental pollution, skin care routine, pattern of facial expression and genes.
BOTOX® (Botulinum toxin A) injections offer a safe, quick and effective way of reducing the impact facial animation lines and in some cases completely eliminating them.
We hope that this fact sheet will provide many of the answers to the questions you may have about BOTOX® injections for facial animation lines.

Why do these animation lines appear?

The muscles that allow us to produce facial expressions are attached to the skin at various points. As we make these expressions the muscles pull on the skin causing the appearance of animation lines. The facial expressions we produce are predetermined during late childhood and are subconsciously carried out throughout adulthood. The repetitive action of these muscles on the skin causes the animation lines to deepen with time.

Which lines can be treated?

There are four sets of animation lines that can be effectively treated by botox injections, these are:

• Horizontal lines on the forehead - produced when a person raises the brow
• Vertical lines between the eyes (frown lines) - produced when a person frowns
• Horizontal lines just above the nose (crunch lines) - produced when a person squints
• Lines around the eyes (crow's feet) - produced when a person squints or smiles

What is BOTOX®?

The active ingredient in BOTOX® is a nerve toxin derived from the Clostridium Botulinum bacteria called Botulinum toxin A. There are no animal products in the injection. The injection does contain a small amount of human albumin.

How does it work?

The Botulinum toxin A works by blocking the release of an enzyme at the junction of the nerve and muscle. This means that the underlying muscle will no longer respond to signals from the brain and remain relaxed. So when BOTOX® is injected into a muscle, that muscle in effect becomes paralysed and as it can no longer move animation lines cannot be formed.

Can anyone have the treatment?

In keeping with other non-essential cosmetic treatments we would not recommend women who are pregnant or breast-feeding to have BOTOX® injections. We would not recommend treatment to people with muscle disorders or bleeding disorders. People on anticoagulants (warfarin or sinthrome) and certain antibiotics (gentamicin) should also avoid treatment. Otherwise anyone else can have the treatment

How does the treatment feel?

We use very fine needles to inject small amounts of BOTOX® into or around the muscles, this causes a slight stinging sensation at most.

How long will the treatment take?

This will depend on the number of areas requiring treatment - even if we treat all the muscles around the eye and in the forehead this would take no more than 10 minutes.

Are there any side effects?

Immediately after treatment you may get some bleeding at the injection site - this usually stops within a few minutes with the application of pressure. Afterwards some people will experience bruising and swelling at the sites injected this usually settles within a few days.
Another side effect often quoted but rarely seen is droopy eyelids (ptosis), this occurs if the injections are placed too close to the eyebrows or if toxin works its way down to the muscles of the top eyelid. This causes a temporary paralysis of the muscles of the top eyelid preventing them from being fully opened. This is not harmful but can be unsightly, however it would improve within 4 to 6 weeks.

Do I need to take any precautions after the treatment?

It is also important that you do not rub or massage the injection sites and avoid strenuous exercise for up to 4 hours after the treatment. It is also helpful if you do not lie down or fly for 4 hours after the treatment. Any of these things can move the BOTOX® around in the muscles and cause unwanted paralysis.

How effective is treatment?

In clinical trials in the USA the treatment consistently produces high satisfaction scores - with 80% - 90% of patients being satisfied with the results of the treatment. Based on these results the treatment has now got FDA approval in the USA, it is still not licensed in the UK however.
Some patients will not get as good a response on the first occasion because of an inadequate dose - subsequent doses can be adjusted to allow for this.

How soon will I see a difference?

It can take 5 to 7 days for the effects of the injection to reach a maximum, so you may not notice any improvements until that time.

How long does it last?

The blockage and therefore the paralysis of the muscles are only temporary, the nerve forms new nerve endings with the passage of time and so the muscle gradually regains its movement. By about 4 to 6 months the muscle paralysis is completely reversed and the muscle returns to normal function. The effect on the animation lines can therefore last up to 4 to 6 months, the lines will slowly become noticeable towards the end of this period.

Can I repeat the treatment?

Yes it is safe to repeat the treatment as the effects wear off. In the first year many people will have three treatments thereafter treatments will normally be only required every 6 months. We would not recommend repeating a treatment for at least 3 months.
You can use BOTOX® in conjunction with other treatments - such as N-Lite, cosmetic fillers and dermabrasion. In some cases it may even enhance the effects of these treatments.

© 2004 Laserase