Since its discovery over 30 years ago, the drug onabotulinum toxin A, more commonly known by the brand name Botox, has been used to therapeutically treat over 20 known medical conditions, including muscle spasms, chronic migraines, crossed eyes, urinary incontinence and more. In fact, its properties as a wrinkle-relaxer were only noticed later, merely as a positive side effect of therapy.
Eventually, the drug manufacturer Allergan created Botox Cosmetic, approved by the FDA in 2002, and designed specifically as an aesthetic treatment to soften fine lines and wrinkles. Both Botox and Botox Cosmetic contain onabotulinum toxin A as the primary ingredient.
Onabotulinum toxin A, the main ingredient in Botox, works by blocking signals from the nerves to the muscles. With the signal blocked, the injected muscle can no longer contract. If injected on the face, wrinkles will relax and soften. It is most often used on forehead lines, crow’s feet and frown lines.
While Botox can relax wrinkles, it cannot fill them in. Often Botox is used hand-in-hand with plumping fillers, such as Juvederm, Restylane, Perlane, Radiesse, or Sculptra. These fillers are perfectly suited for deeper wrinkles and folds, such as the marionette lines around the mouth.
Contrary to some opinions, it is nearly impossible to contract botulism from Botox injections. First, the concentration of the toxin is tremendously diluted. Second, the amount injected into the muscle is miniscule, just enough to relax that targeted muscle.
The artistry of Botox injections continues to evolve. Now, patients can enjoy a subtle “brow lift” with precisely-placed injections, reduce wrinkling above the so-called “smoker’s lip,” and smooth skin on the chin. Botox subtly softens the tendons in the neck that become more prominent with age. When injected in the underarms, Botox stops perspiration, eliminating the need for deodorants.
Because onabotulinum toxin A is a naturally-occurring substance, the manufacturer, Allergan, for the original therapeutic Botox, could not patent the drug itself, only the manufacturing process around it. In 2009, the patent expired, and a competing drug manufacturer introduced Dysport, abobotulinum toxin A. A third neurotoxin called Xeomin is the latest to hit the U.S. market, so now patients have three different brands to choose from. I use Botox Cosmetic, Dysport, and Xeomin interchangeably, depending on my patient’s preferences.
Regardless of which brand of wrinkle relaxer you choose, know that treatment typically takes less than 20 minutes and results will be visible within a week, lasting between two and four months. There is no downtime, except of the slight chance of a bruise. Botox Cosmetic, Dysport and Xeomin are some of the simplest, quickest, and most effective ways to noticeably improve your appearance through cosmetic medicine.