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Botox
can decrease the strength of the underlying upper facial muscles. By
relaxing these muscles, your frown lines, squint lines, nasal crunch
lines, and horizontal forehead wrinkles become less deep.

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INTRODUCTION
The first step in deciding whether you might be a candidate
for Botox is an examination by Dr. Trimas. He will assess both your
facial movements and your wrinkles. Botox is different from other
types of therapy, so it is natural for you to want to know more
about it. This pamphlet provides answers to the questions that
patients most often ask. The decision to start treatment with Botox
is an important one. If, after reading this pamphlet, you don’t
understand something or need additional information, be sure to ask
Dr. Trimas.
WHAT BENEFITS
CAN I EXPECT FROM BOTOX TREATMENT?

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Botox can decrease the strength of the underlying upper
facial muscles. By relaxing these muscles, your frown lines, squint
lines, nasal crunch lines, and horizontal forehead wrinkles become
less deep. Your muscle strength and action will be minimized. Botox
works on the muscles underneath the skin and therefore, any creases
found in the skin will not be changes. There are other methods that
can be used to improve those creases, such a collagen injections
and/or laser resurfacing.
WHAT IS BOTOX?
Botox is a substance produced by a bacterium called
“Clostridium Botulinum”. It has been purified under very strict and
controlled conditions.
IS BOTOX RELATED
TO BOTULISM?
This is a very important question. The active ingredient in
Botox is the same one that, in much larger amounts, can cause
Botulism. Knowing what Botulism is and how different it is from the
way Botox works, will remove any fear you may have. Botulism
poisoning, although rare, can occur if a person eats food that is
contaminated with the Clostridium Botulinum bacteria. This bacteria
makes large amounts of toxin that circulate throughout the body.
This can lead to respiratory paralysis and is sometimes fatal.
Through experimentation, it has been concluded that the estimated
death dose is about 3, 000 units. However, because only extremely
small units of Botox are used (under 20 units), it can be safely
injected into specific muscles of the upper face to relieve the
increased muscle strength. Other areas and functions are unaffected.
Any drug would be harmful if given in large enough doses to affect
the entire body. The most notable is ASA, or aspirin, which can lead
to death if taken in large quantities. Given in the appropriate way
and in the right amount, they are valuable allies in fighting
disease and suffering. Clinical studies spanning fifteen years have
shown Botox to be safe and effective.
IS BOTOX FDA
APPROVED?
Yes. Botox is approved by the Food and Drug Administration.

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HOW DO I KNOW
THAT MY DOCTOR WON’T GIVE ME TOO MUCH BOTOX?
The production of Botox is carefully controlled at every stage
to ensure it is safe for medical use. Dr. Trimas has been trained to
administer it safely and to manage any problems that might occur.
ARE THERE ANY
PATIENTS WHO SHOULD NOT RECEIVE BOTOX?
Botox should not be given to pregnant women, nursing mothers,
or people who have myasthenia gravis or muscle disease.
WHAT DOES BOTOX
LOOK LIKE?
Botox comes in glass vials containing small amounts of
crystals. A special solution containing water and a small amount of
saline is added before it is ready for injection by Dr. Trimas. A
freshly made solution is injected into the specific muscles with a
disposable syringe and a fine needle. Dr. Trimas will discuss with
you, prior to the injection, where the injection will be placed.
It is important that patients receive their injection
promptly, as each freshly made solution of Botox becomes inactive
after two hours.
Each vial of solution contains 100 units. As each patient
requires 20 units, a vial will last for five patients before
becoming inactive. Therefore, the scheduling of your appointment
time is precise to ensure effective treatment. Please be on time!!
DOES THE
INJECTION HURT?
When injected, Botox does not cause irritation or inflammation.
Occasionally, patients have complained that the fluid felt like a
mild sting.
ARE THERE ANY
SIDE EFFECTS?
Because of the tiny doses that are used for upper facial
wrinkling, no side effects have been reported. When massive amounts
of Botox are used for other muscle conditions, transient mild
symptoms may be noted.
DOES BOTOX
INTERACT WITH OTHER DRUGS?
It is always important to let your doctor know if you are
taking other drugs and specifically aminoglycoside antibiotics.
These types of antibiotics may increase the effect of Botox.
HOW LONG DOES IT
TAKE BOTOX TO WORK?
The effects are usually first noticed in 72 hours and it may take
up to 10 days to maximize the effect. You will be asked to return
after the first injection so that Dr. Trimas can assess your
response.
HOW LONG DO THE
EFFECTS OF BOTOX LAST?
A recent study in the medical literature showed that Botox
lasted from four to eleven months for upper facial wrinkling. In Dr.
Trimas’s experience, it lasts five to six months. Most patients are
re-injected in six months.
DOES IT MEAN
THAT I WILL NEED MORE INJECTIONS?
Yes. Injections twice years are often common to maintain a
benefit over a long period of time. The treatment can be repeated
for as long as is required.
ARE THERE ANY
DISADVANTAGES?
The only disadvantage is the need for repeated injections.
However, our patients have found that injections every six months
are beneficial and do not adversely affect their time schedules.
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