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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After

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.

Before

After

WHAT BENEFITS CAN I EXPECT FROM BOTOX TREATMENT?

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.

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.