Botox - All Clinical Facts You Need To Know

Botox® Cosmetic is the first and only FDA-approved prescription product, which temporarily improves the appearance of both moderate to severe laugh lines between the brows and moderate to severe crow's feet in adults. Unlike other invasive facial rejuvenation procedures or a facelift treatment, Botox administration takes minutes and requires zero downtime. Inject Botox into the facial muscles responsible for fine lines, unsightly wrinkles to relax the muscles. The ingredients in Botox block signal to the muscle, that is generated from the nerves and therefore reduces its ability to contract and from unsightly wrinkles.

Key Highlights

• FDA approved
• Treatment only takes minutes
• No downtime for recovery
• Smooths wrinkles in the forehead, Crow’s Feet and between the eyes

Botulinum Toxins (BT) can be differentiated into seven types from A to G. However, commercially available variants include purified exotoxin and only BT types A (BTA), and BT types B (BTB) are marketed by various brand names.

Botulinum Toxin (BTA) is marketed as follows

• Botox - Allergan, Irvine, CA, USA
• Dysport - Speywood Pharmaceuticals, Maidenhead, UK
• Xeomin - Merz Pharmaceuticals, Germany
• Prosigne - Lanzhou Biological Products Institute, China

Botulinum Toxin (BTB) is marketed as follows

• Myobloc - Elan Pharmaceuticals, San Diego, CA, USA
• Neurobloc - Elan Pharmaceuticals, County Clare, Shannon, Ireland

How long does Botox last?

Treatment usually lasts between 3-6 months. Many factors influence how long effects of Botox® lasts. As the product wears off with time, muscle action will return gradually; previously treated lines & wrinkles begin to reappear and need to be treated again. If treatments are repeated on a regular basis, the lines and wrinkles often appear less severe than before, as the muscles are now being trained to relax.

Some of these factors that may shorten or lengthen the effects include

• Age
• Condition of skin and level of sun damage
• Facial expressions and structure
• Diet
• Smoker or not
• Past/previous experience with Botox® or another wrinkle relaxers.

Is Botox® Safe?

Botox® Cosmetic is approved by FDA, and the injections are relatively safe when performed by an experienced practitioner. It has proven to be a successful and valuable therapeutic protein when dosage, variety of treated clinical conditions and frequency of treatment are considered. The best way to ensure quality treatment is receiving injections from a highly experienced provider, such as a medical trained dentist in facial aesthetics or nursing professionals.

When will I see results?

You begin to notice results within 24-48 hours, with the maximum effect visible to 30 days. Results vary between individuals.

Who should not receive Botox?

While most people aged 18 to 60 are excellent candidates for Botox and wrinkle relaxing treatments, you should not use Botox if you have the following conditions.

• Are pregnant
• Breastfeeding
• Have skin infections or other conditions in the area to be treated.
• Are allergic to any ingredients in Botulinum Toxin Brands like Botox, DYSPORT
• Have had facial surgery
• Have difficulty swallowing
• Weakness in forehead muscles

Botox Reconstitution

• Strong vacuum in vial
• Use 1.0 or 2.5 cc sterile saline per 100 U vial
• Greater dilution will result in greater diffusion
• Use (preservative free) saline (NaCl 0.9%)
• Introduce saline very slowly into Botox vial
• Try not to shake the vial!
• Make every effort to avoid foaming

(As foaming will denature protein). The standard reconstitution method for most BoNT-A's commercial products according to their package insert information is the addition of unpreserved saline. Manufacturers recommend vials should be stored before dilution at temperatures between 2°C and 8°C (OnaA and AboA) under refrigeration or between -5°C and -20°C (OnaA and Prosigne) in freezer. According to manufacturers, after being reconstituted, BoNT-A should be used as soon as possible, within the interval of 4 h (OnaA) and 8 h (AboA), when kept at 2°C and 8°C. However, these parameters are the subject of many published studies that reveal different forms of BoNT-A Storage (Botox 2010; Dysport 2009; Prosigne 2005; Xeomin 2010; BTXA 2015). Botox Reconstitution 100 Unit Vial].