Botulinum toxin injections (BTX), often referred to by the product names Botox® or Myobloc®, are biological toxins (botulinum toxin) transformed into a therapeutic agent. Work with BTX began in the late 1960s to treat neurological disorders. Today, BTX is used for the treatment of forehead furrows, "crow’s feet," lines and wrinkles. BTX injections have proven to be a very popular nonsurgical cosmetic procedure; see current American Society for Aesthetic Plastic Surgery (ASAPS) statistics. Aesthetic plastic surgeons have found that the type of lines and wrinkles that respond to BTX injections are those caused by the muscles—specifically those muscles that contract during facial expressions such as frowning or squinting.
Technique: The patient is asked to contract the muscles in the area being treated so the surgeon can determine the proper location for injection. In most cases, BTX is injected directly into the muscle with a tiny needle. It takes a few days to realize the effect of BTX injections.
ASAPS Position: The American Society for Aesthetic Plastic Surgery (ASAPS) maintains that BTX injections for aesthetic purposes appear to be safe and effective. Patients who show early signs of aging, as well as those who may not be suitable candidates for more extensive aesthetic facial surgery, may be good candidates for this procedure. Certain medications (some antibiotics, anti-inflammatories, or aspirin) and even some vitamins and herbs may increase the potency of BTX and may increase bleeding and bruising at the time of injection. Therefore, patients should be candid with their surgeon about all medications and supplements. Pregnant or nursing women should postpone undergoing this procedure. It is not known whether injection of BTX has any effect on a fetus or whether it is found in breast milk.