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The development of lines and furrows on the face is associated with the aging of our skin, the long-term effects of gravity and sun-damage, and both our normal and hyperactive repetitive use of these particular muscles for facial expression. Creases begin to appear wherever the skin is repeatedly folded by the action of the particular facial muscles. Any fine lines on our face may produce the appearance of aging, but the prominent lines associated with our facial muscle movements can also appear to portray the emotions we feel. Repeated conscious and unconscious use of certain muscles, especially in the forehead, between the brows, and around the eyes, may produce deep lines or furrows, which persist despite our voluntary relaxation of these muscles. The presence of these persistent lines, or habitual negative expressions, may portray to others the negative appearances of worry, anger, anxiety, disgust or sadness, despite our feeling positive. BOTOX injections are used to reduce or eliminate the facial lines and furrows, due to repeated facial muscle action, by reversiblyweakening or paralyzing only the selected muscles associated with certain facial lines. Except for the softening of these facial creases, your resting facial appearance will remain unchanged. During the time the BOTOX is effective, usually three to four months in duration, expressions involving the active use of these muscles will be weakened or impossible. Subsequently, full facial expressions will gradually return. BOTOX injection treatments may be repeated at this time to restore the desired aesthetic effects. The sites best treated with BOTOX injections are: ¨ Forehead creases. ¨ Brow and nasal furrows.¨ Eye squint creases (Crow's feet). ¨ Negative upper facial and brow expressions. = What is BOTOX (Botulinum toxin type A)? = BOTOX is a sterile, purified protein produced from bacteria (Clostridium botulinum) in the laboratory which, when injected into muscle, weakens or paralyzes the muscle for a typical period of several months. BOTOX has been safely and effectively used for the cosmetic treatment of facial lines and furrows in thousands of patients in the United States and Canada. BOTOX is now specifically FDA-approved for cosmetic facial muscle treatment. BOTOX has long been approved for facial muscle spasm disorder treatments involving the identical facial muscles and similar treatment technique as that required for your aesthetic needs. = = = How does BOTOX work? = Injected BOTOX protein binds to the nerve endings supplying the specific facial muscle beneath the injection site and prevents the nerve impulse from traveling to the muscle, thereby weakening or paralyzing the muscle. Without muscle movement acting upon the facial skin, previous skin creasing is reduced or eliminated and new skin creasing is avoided. BOTOX does not affect the major nerves supplying sensation to the face, only the nerves carrying impulses for movement of the specifically targeted facial muscles. BOTOX typically takes 3 to 4 days to begin taking effect and the reasonable paralyzing effect typically lasts 3 to 4 months, in most persons, before full muscle movement returns. Repeated treatments may be performed at the time muscle movement returns to prevent the renewal or deepening of facial lines. A few individuals may have effects of shorter or longer duration, but regardless of the duration of effect, all persons will regain eventual full facial movement. = Which facial lines respond to BOTOX treatments? = Significant improvement of the forehead creases, brow and nasal furrows, and crow's feet eye creases may be expected with individual area or combined area BOTOXtreatments. BOTOXtreatments provide additional and complimentary aesthetic benefits when combined with another facial rejuvenation procedure such as a facelift, browlift, eyelid surgery or facial laser skin resurfacing. Facial lines due to muscle movements on areas of the mid-upper eyelids, mid-lower eyelids or around the mouth are not available for BOTOXtreatment, since markedly undesirable difficulties with eye opening and closing, speaking and eating would likely result. Extremely deep, longstanding creases may not improve with BOTOX if permanent skin creasing has occurred. In these cases, skin fillers, in the form of collagen injections or other substances, available in an office setting, may be necessary to fully correct current persistent creases and abate new crease formation.

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