Botox Overview

Botox is one of the most versatile medical tools in existence. It can be used to treat a host of health problems, including migraines, bladder and bowel disorders, TMJ, and excessive sweating. Perhaps one of the most popular ways botox is used is to eliminate the appearance of fine lines and wrinkles on the face and neck. About seven million people in the U.S. have had botox injections to treat a variety of underlying health conditions and premature aging.

Primarily, Botox works by paralyzing the underlying facial muscles, preventing wrinkling and sagging of the skin. Botox stands for botulinum toxin, the same toxin that causes the deadly “lockjaw” disease. But what medical and scientific magic makes this toxin go from fatal, to beneficial?

Botox is the isolated form of the bacterium Clostridium botulinum. The botulinum bacteria paralyzes the facial muscles and the throat before it moves to the rest of the body. Most people contract botulism through contaminated foods. The last botulism outbreak in the U.S. happened in California in May of 2017, where ten people were hospitalized, and one person died from eating contaminated nacho cheese sold at a gas station.

There are several botulinum strains in existence, but only two of the strains are used to treat medical disorders and the signs of aging. The strains are called serotypes A, B, C1, C2, D, E, F, and G. Only serotypes A and serotypes B are safe to use in clinical applications.

Botox does not eliminate wrinkles or make them disappear permanently. But it does either remove or at least soften their appearance for some time. Once the serum is injected into the muscle, the toxin binds to the nerve terminal and eliminates the release of a neurotransmitter called acetylcholine. When acetylcholine is removed, all muscle activity at the injection site stops.

This targeted paralysis stops the underlying muscle from spasming and reduces the appearance of wrinkles in the skin above the injected muscle. In other words, Botox does not get rid of the wrinkles. It smooths the lines by paralyzing the muscles beneath them for a time. Also, Botox stops specific pain and inflammatory signals from being released too. This mechanism is why the toxin is also useful for treating the pain associated with chronic migraine headaches.

Typically, Botox injections last between three and six months. After that, wrinkles and fine lines will reappear, and a patient will need another injection. However, as time goes on, wrinkles and fine lines will be less apparent because each injection of Botox will shrink the underlying muscle. Subsequent doses of Botox are gradually increased over time.

Once a doctor injects Botox, it is not reversible, although the effects will wear off in about 120 days. A patient will first notice the effects of Botox within two days, and the results will become most notable within five to ten days after injection.

Some of the most common Botox side effects include swelling and bruising at the injection site. Patients may also experience a mild headache or muscle weakness. It is advised that patients discontinue the use of anticoagulants for two weeks before injection to minimize bruising at the injection site. Using topical anesthetics or icing the area before the injection can reduce pain at the site.

What makes Botox so unique in medical history is that it was the first ever microbial injection used to treat a variety of health conditions and diseases. Injecting otherwise deadly bacteria into the body is a relatively new invention. Scientists and the medical community continue to find new ways to use Botox, making it an incredibly versatile treatment method.

The bacteria used in botox is called Clostridium botulinum, and it was first discovered in Belgium when there was an outbreak of botulism, or “lockjaw,” which is a deadly disease which paralyzes the respiratory muscles. People can contract a fatal botulism infection by eating contaminated food or having an open wound or sore that becomes infected with the botulism spores. The botulism bacteria is often found in poorly processed canned foods or honey. Infants under one year of age should never eat honey because the spores can become lodged in the intestine, where they release the deadly toxin.

After the Belgium botulism outbreak, scientists in California tried to isolate the toxin in crystalline form. Eventually, Dr. Edward Schantz was successful. However, it wasn’t until the 1970s that scientists were able to find a beneficial way to use the isolated botulism toxin. During the 1970s, scientists used the isolated toxins on monkeys, and they noticed that the injected toxin reduced the appearance of wrinkles between the eyebrows and around the nose. Botulism was first used to treat the condition strabismus, or crossed eyes, and it was successful.

After the isolated botulism toxin was officially approved for medical use, the company Allergan licensed the treatment of strabismus and branded the compound with the name “Botox.” Soon after, the FDA approved Botox for a variety of health conditions and cosmetic procedures, including:

• Strabismus
• Blepharospasm
• Glabellar lines
• Cervical dystonia
• Excessive sweating (axillary hyperhidrosis)
• Migraines
• Upper lip spasticity
• Bladder incontinence
• Lateral canthal lines (crow’s feet)

Much of the cosmetic uses for Botox are used “off label,” meaning that a physician will use their clinical expertise and judgment to use Botox for treating the symptoms of premature aging. Botox is incredibly effective for treating the appearance of wrinkles that appear when the muscle contracts.

Wrinkles and fine lines around the mouth, cheeks, and eyes that appear when someone smiles, squints, or frowns are significantly reduced in appearance after treatment with Botox. Permanent creases and wrinkles will develop as a person ages. Botox cannot reduce the appearance of these types of wrinkles, but injections can help “soften” them and make them less apparent.

Getting Botox injections can shave off several years of aging on the face and neck, and give a patient a refreshed and rejuvenated look. If you’re interested in seeing how well, a Botox treatment can work for you, please contact the office of renowned facial plastic and reconstructive surgeon Doctor Binder today.