Botox® Cosmetic & Dysport®
About BOTOX® Cosmetic and Dysport® at Dermatology Associates of Atlanta
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All the doctors at Dermatology Associates of Atlanta offer BOTOX® Cosmetic injections that will reduce the appearance of fine lines. This has become our most popular cosmetic procedure because it is safe and patients love the results. Botox® uses the powerful medicine botulism to relax facial muscles in order to help treat the appearance of fine lines caused by expression or constant movement.
Botulism is food poisoning produced by a bacterium. BOTOX® is a medicine produced by the same bacteria. BOTOX® is not alive but is a protein that weakens and inactivates muscles. This is another example where natural products are used for medicinal purposes: fungi produce penicillin, cowpox virus protects against smallpox and foxglove plant produces the “poison” digitalis that millions of patients take daily for heart disease. Now with bio-engineering, it is common for bacteria to produce the necessary medicine for a specific disease.
In 1973, BOTOX® was used as a treatment for patients with crossed eyes. By weakening the overactive eye muscles, this medicine provided an alternative to surgery. After this “breakthrough,” BOTOX® quickly gained acceptance for other ophthalmologic disorders including nystagmus and blephospasm (involuntary spasm of the eyelids). Extensive BOTOX® research repeatedly confirmed a high success rate with minimal side effects using minuscule amounts of this new-found “medicine.”
About Dysport®
In addition to offering Botox® treatments, Dermatology Associates of Atlanta also offers Dysport®. Dysport® was approved by the FDA in June of 2009 as another botulinum-A treatment proven to reduce wrinkles and fine lines on the face. Results from Dysport® can last from 4 – 6 months and it is setting out to differentiate from their competition, BOTOX® by boasting faster results, meaning even less downtime than the already minimal downtime demanded of BOTOX®.*
Dysport® also demands a higher level of technical skill to administer, meaning those who offer it are going to be well-versed in the anatomy and muscles of the face and overall more skilled with cosmetic injections. At Dermatology Associates of Atlanta, our highly trained staff routinely performs thousands of cosmetic injections annually.
Cosmetic Injectable Treatment
BOTOX® injections were pioneered in 1988 by a Vancouver ophthalmologist and her husband, a dermatologist. The ophthalmologist noted that the wrinkles disappeared in her patients with eyelid spasms who were treated with BOTOX®. This led to further research, which confirmed the effectiveness and safety of BOTOX® for improving wrinkles due to overactive muscles.
In 1996 at the annual meeting of The American Academy of Dermatology in Washington, a presentation by dermatologist Dr. Nicholas Lowe showed that BOTOX® was useful for improving facial expression lines. Significant improvement was noted on both fine lines. No significant side effects were noted beyond the expected injection discomfort.
While BOTOX® is a potent medicine in high concentration, it is used in very small quantities with high margins of safety. After a muscle is injected, its first effects are not seen for 24 hours and the complete effect on the muscle will not be complete for two weeks. Fifty units (one half vial) or less of BOTOX® per session is generally used. To have toxic effects on a patient, over 2,000 units would have to be injected at one time. BOTOX® has no effect on the central nervous system or on the body if injected accidentally into a nerve or blood vessel. BOTOX® is also safe because complete recovery of the muscle is possible. Recovery is due to the body’s excellent ability to form new fibers that allow activation of the muscles.
Crow’s Feet
Wrinkles radiating from the corner of the eyes caused by smiling, laughing or squinting are especially distressing to some individuals. Previously, no reasonable medical or surgical solution improved this problem due to the strong underlying muscles. Even with the deepest chemical peels or laser resurfacing techniques, rapid recurrence of these lines around the eyes is inevitable. Now for best results, BOTOX® and Dysport® injections are used in conjunction with resurfacing procedures. It is the function of BOTOX® and Dysport® to prevent the recurrence of wrinkles by inhibiting the underlying muscles.
BOTOX® and Dysport® FAQs
What should be expected after BOTOX® or Dysport® therapy?
BOTOX® and Dysport® are remarkably safe therapeutic agents for wrinkles. Complications have been minor and only transient. Bruising may occur where injected and a brief pain or headache may follow. Bruising may be greater in patients who are taking aspirin or any blood-thinning medicines. These products should be avoided if possible prior to the injection; however, ice helps prevent bruising. Muscle weakness is first noted at 24 hours; it is not immediate.
How long does BOTOX® last and how often is re-injection needed?
Patients normally notice improvement between 7 to 10 days after treatment. After this period, the muscle becomes more relaxed. Most patients notice that the results from their initial facial injection tend to last around three or more months. In order to keep the muscle relaxed and fine lines smooth, we recommend getting a re-injection of Botox® or Dysport® about every three months.
Who should not use BOTOX®?
- Although there have been no reports of birth defects with this medicine, no pregnant patients will be treated. It is also our policy not to inject BOTOX® in nursing mothers.
- Patients with a history of neuromuscular disease (multiple sclerosis and myasthenia gravis) or other types of diseases involving neurotransmission should avoid this medicine.
- Patients taking the following medicines should not receive BOTOX®: aminoglycoside antibiotics (Streptomycin, Tobmamycin and Garamycin injections), penicillamine and calcium channel blockers (Calan, Cardizem, Dilactor, Norvasc, Procardia, Verelan).
What unexpected benefits have come from the use of BOTOX®?
Tension headaches have disappeared for some patients. These headaches occurred in patients who were recruiting forehead and brow muscles during periods of stress and tension. When these muscles were relaxed, the headaches faded.
How exactly does BOTOX® work?
BOTOX® inhibits the release of acetylcholine at the joining site of the nerve to the muscle so that the muscle never gets the message to contract. Remember, muscles only have the ability to contract. An opposing muscle contracts to produce movement in the opposite direction.
Does the body make antibodies to the BOTOX® cosmetic protein?
Yes, especially if enough toxin is injected often enough. The crucial amount is about 100 units (less than the usual cosmetic dosage) and booster injections placed within one month of the initial injections. Antibodies have been more of a problem for neurological disorders where larger amounts of BOTOX® is required. When significant amounts of antibodies are formed, the therapeutic effects of Botox® Cosmetic are greatly reduced.
Have there been any reported cases of allergic reactions or hives to BOTOX®?
There have been no reported cases of a true allergic reaction in nearly 20,000 treatments. People who are known to be allergic to Botulism toxin or albumin should avoid BOTOX®.
What happens if a female patient becomes pregnant shortly before or after treatment?
A number of neurological and ophthalmologic patients have delivered normal children after receiving their injections. For safety reasons no pregnant or nursing females will be treated.
How painful are the injections?
The smallest needles are used and the medicine itself does not sting as much as the usual local anesthetic. Most patients feel it less than collagen. Pain can be minimized by the use of ice cooling the skin just prior to injections. Some patients find that two Tylenol tablets before the injections reduce the discomfort.
After receiving my injections, how can I help BOTOX® be more effective and avoid side effects?
First, do not massage the area of the injection. Second, do not lie down for a nap; keep upright. Third, use the muscle; intentionally making the muscle contract helps localize the protein to the selected muscle for ablation.
When injecting muscles at one site will this affect remote muscles?
BOTOX® spreads along muscle fibers and does not spread to distant areas by way of the blood stream.
Can BOTOX® cosmetic be used to weaken not totally paralyze a muscle?
Yes, in fact this is done so that the face will not be left expressionless. It can also be used to balance a weak muscle on the opposite side. By injecting medicine into the subcutaneous tissue not the muscle, and by using a smaller dosage, a relaxation of the muscles is more likely occur.
What accounts for the fact that no treatments may be necessary in some patients after repeated injection sessions?
What happens is that the patient is broken of the bad frowning habits and may not relearn them for some time in the future.
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