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What Exactly Does Botox Do?

23 Aug, 2021

What Exactly Does Botox Do?

Everyone's heard something about Botox, whether it's a rumour about a celebrity's "Botox lip flip" or something your dermatologist once mentioned offhandedly. However you came across the term, you may be wondering what exactly Botox is. 

Although it's most commonly used to reduce the appearance of fine lines and wrinkles, Botox has a long list of other uses as well. Whether you're looking to get a cosmetic procedure or treatment for another condition, Botox might be right for you.

There are many factors to consider before plugging the phrase "Botox near me" into Google. If you're hoping to learn more about the injection, look no further. Read on for a comprehensive guide to Botox procedures, side effects, costs, and more.

What Is Botox?

More commonly known as "Botox," botulinum toxin (in the case of Boxtox, specifically onobotulinumtoxinA) is a protein produced by Clostridium botulinum, a type of bacterium. It works by preventing acetylcholine from being released at the neuromuscular junction.

Acetylcholine is a neurotransmitter that works primarily with the parasympathetic nervous system. That's the branch that's responsible for muscle contraction. So, you can probably guess that inhibiting acetylcholine will stop or slow muscle contraction. 

You'd be right: that's exactly how Botox works. It stops the release of acetylcholine at the site where the nerve endings meet the muscle cells. This stops the muscle from contracting, a condition called "flaccid paralysis."

Of course, the muscle paralysis is targeted, and only affects the intended areas. It's also temporary, which is why people tend to get Botox regularly rather than as a one-time treatment.

This temporary paralysis is useful for both cosmetic purposes and to alleviate symptoms of certain muscle or nerve disorders. 

Botox was first used for cosmetic purposes in the 1980s, pioneered by ophthalmologist Jean Carruthers, along with her husband, a dermatologist. They were the first to use the specific toxin onobotulinumtoxinA for these purposes.

Dysport vs Botox

However, there are other variants of botulinum toxin. If you've ever heard of Dysport, you may be wondering how it's different from Botox. It simply uses a different variation of the botulinum toxin protein, abobotulinumtoxinA.

Often, though, people tend to use "Botox" as a synonym for variants like Dysport, Xeomin, and Myobloc. They perform relatively the same function but aren't interchangeable. Each has specific dosage units and other characteristics, so you should consult with your doctor to choose the best one for your needs.

Why Is Botox Done?

Botox is used for both cosmetic and medical reasons, but most commonly as a cosmetic enhancement. To reduce fine lines and wrinkles, the toxin is most often injected into the following areas:

  • Wrinkles between eyebrows, or frown lines
  • Wrinkles surrounding the eyes, or crow's feet
  • Horizontal forehead creases
  • Lines surrounding the mouth
  • Uneven skin on the chin

The Medicines and Healthcare products Regulatory Agency (MHRA) has approved Botox for all cosmetic purposes and many medical ones. Choosing to get Botox done cosmetically is a highly personal decision, and there are many factors to consider.

What's the Best Age to Start Botox?

Patient age varies wildly when it comes to cosmetic Botox. It's become more popular, however, to use Botox as a preventative treatment. Therefore, you can begin when you notice wrinkle formation, or even before to stop them from even forming.

If you're worried about starting too early, fret not. It isn't risky to use Botox over long periods of time. In fact, many patients use it repeatedly for decades without experiencing any negative side effects.

What About Medical Applications?

The most common use of Botox is cosmetic, to reduce fine lines and wrinkles. However, these injections can also have medical applications. Botox is used to treat conditions like:

  • Lazy eye due to muscle imbalance
  • Eye twitching or uncontrollable blinking (blepharospasm)
  • Hyperhydrosis, or excessive sweating
  • Bladder dysfunction or urinary incontinence 
  • Chronic migraines 

Your ophthalmologist or another doctor may use Botox to treat the above conditions since they're caused by excessive muscle contraction in those areas. Outside of cosmetic procedures, the most common use for Botox is for chronic migraine treatment.

Botox for Migraines

If you're considering using Botox as a migraine treatment, there are a few things to consider. First, the treatment should only be used to treat extremely frequent migraines, i.e., 15 or more days a month. Each treatment involves 31 injections or the equivalent of 155 units. 

The injections are placed throughout the face, back of the neck, and upper back. The effects last approximately three months. One of the major benefits of Botox for migraines is that it doesn't come with side effects like weight gain or nausea that oral medications tend to cause.

What to Expect

Before getting Botox, you should have an in-depth discussion with your provider regarding your medical history. Inform them if you've had any form of Botox within the past four months, and tell them about any medications you're on. If you take blood thinners, you may need to take a break in the days leading up to your appointment to reduce bleeding.

You'll also want to avoid drinking alcohol for about a week before your procedure. It's also smart to stop taking anti-inflammatories about two weeks before to minimise bruising.

Anaesthesia is not needed, but you may want to ask your doctor for numbing cream or ice to ease discomfort. 

Your provider will dilute the Botulinum toxin powder in saline, and then inject it into the intended site. Typically, for cosmetic treatments, 40 to 60 units of Botox are used per area. 10 units of Botox is equivalent to about 1mL of the diluted solution.

The needle will be thin, meaning any discomfort will be mitigated. This also allows for precision and control over the injections. The number of injections you'll need depends on what area is being treated and the extent of the issue.

Your doctor will then dispose of any sharps used in a proper disposal container.

In the days after the appointment, you'll want to avoid rubbing the affected area to prevent the toxin from migrating elsewhere. There's no downtime or bed rest, and you can return to your regular routine immediately after treatment. However, you will want to avoid exercise for about 24 hours after your appointment.

How Long Do Injections Last?

Although everyone's different, you can start seeing results as early as four to five days after injection. They'll then last three to six months, but patients may choose to seek treatment more or less frequently.

Some sources say results can even last up to a year. Again, when to seek repeated treatment is truly up to the patient's discretion.

Associated Risks

The risks associated with Botox are quite low. While side effects do happen, they're extremely uncommon. They'll affect only 1 to 5% of cases, and even then, they're temporary.

When side effects do occur, they'll include droopiness of the eyelid, bruising around the injection site, and slight headaches. Luckily, these will usually go away within one to two weeks post-treatment.

However, there are other risks to be aware of. If you experience any of the following, it could be a sign that the toxin has spread to unwanted areas of the body. Call your doctor if you experience:

  • Blurred vision
  • Muscle weakness
  • Urinary incontinence 
  • Difficulty swallowing
  • Breathing problems

If you're allergic to cow's milk, you should avoid Botox entirely. Doctors also recommend against the treatment for individuals that are pregnant or breastfeeding. You should also avoid Botox if you have an infection at or around the injection site.

Paying for Botox

Pricing for Botox is dependent on a number of factors, including region, provider, specific treatment, and more. Doctors may charge based on the number of units of Botox used, while others may charge based on the area of skin covered. One unit typically costs £11 to £18, and each area typically costs £291 to £365. 

Pricing for treatment for medical conditions is entirely different. These treatments, especially for migraines, are often paid for by the NHS. When used for cosmetic purposes, Botox is rarely covered by the NHS.

If your doctor deems your Botox treatment medically necessary, the NHS will likely cover it. However, this rarely, if ever, applies to cosmetic procedures.

Choosing a Provider

If you think Botox sounds right for you, the first step is to consult with your dermatologist. Often, they'll offer the service within their office. However, if you'd like to seek treatment outside your regular provider, there are a number of paths you can take. 

You can consult the official websites for the drugs based on Botulinum toxin. Another option is to explore academic settings, where doctors will often have done research surrounding Botox. 

Look for a board-certified provider with good reviews that performs the procedure often. Finally, verify your provider sources their supplies from a trusted medical supplier. Check out the telltale signs of a verified supplier here.