Botox™ treatments for wrinkle lines and facial expression have become the most common cosmetic procedures in the United States. The reasons for this popularity include good results, minimal side effects, short recovery time and affordable price. These treatments work for several areas of facial wrinkling. These types of facial wrinkles are the result of squeezing of the muscles surrounding the area of treatment. They become more prominent with smiling, frowning, squinting, or during facial expression. Some examples include glabellar folds, Crow’s feet lines, forehead wrinkles, and lipstick lines. Glabellar folds are age and expression related wrinkles that form in the area between the eyebrows. "Crow's feet" lines form in the corner of the eyes toward the temple. Peri-oral lipstick lines and the wrinkles at the corners of the mouth can be improved with Botox™. After years of raising the eyebrows, horizontal wrinkles form across the forehead. Botox™ is used to decrease these types of wrinkles by decreasing the muscle's ability to squeeze. The medication does not work on the fine wrinkles created by sun damage, these are addressed with alternative treatments. Botox™ can be used in conjunction with tissue fillers and chemical peels to keep the wrinkles away. In 1996, Dr. Foster authored the first article published in an Medical Journal detailing the cosmetic benefits of Botox™ (Foster JA, Barnhorst D, Papay F, Oh PM, Wulc AE: The use of botulinum A toxin to ameliorate facial kinetic frown lines. Ophthalmology 103:618-622, 1996.)
As experience with Botox™ has increased, an additional treatment option for facial appearance has become apparent. By adjusting the interplay of the elevating and depressing muscles of the face, the position of the eyebrows and the corners of the mouth may be modified with cosmetic Botox™ treatment. Dr Foster coined the term "Botox™ Browlift" in a scientific article published in 1999. (Huang W, Rogachefsky AS, Foster JA. Browlift with botlinum toxin. Dermatol Surgery 26: 55-60, 1999.)
Botox™ treatments are given as a small injection into the area where alteration of the muscle contraction is desired. There can be stinging discomfort at the time of injection, and occasionally bruising at the injection site. Very rarely, the treatment may spread to areas beyond the desired field of treatment resulting in droopy eyelids, brows, or mouth and watery or dry eyes. Botox™ should not be considered by those under the age of 18, pregnant or nursing, receiving intravenous antibiotics, allergic to albumin, or affected by a neuromuscular disorder such as myasthenia gravis.