The muscles around the eyes and forehead are attached to the underside of the skin. Every time you frown or squint, these muscles contract and pull your skin into a wrinkle. Over time, these wrinkles become deeper, and are eventually permanently etched into your skin. Botulinum ( also known as "Botox" ® is a product  that temporarily relaxes the muscles it is injected into.  When the muscles on your forehead and around your eyes are relaxed, your skin can smooth out. Botox is an excellent way to prevent frown and squint lines from becoming permanent wrinkles for patients who do not already have lines etched into the skin.

The Technique

Relatively painless injections (3-12 depending on areas treated) are administered in the consulting room with an acupuncture-size needle. Local anesthesia is not used because it is more uncomfortable than the Botox injections themselves.

Immediate After-Effects and Instructions

Some tiny spots of blood may appear at the injection sites (typically between and over the eyebrows). This goes away with a few minutes of pressure. Occasionally there may be some slight bruising at the injection sites. Patients may resume their normal activities, exercise, and diet within fifteen minutes.

Beneficial Effects

A relaxing effect is noted by the end of the first week and continues for between three and six months. There is no change in sensation and no numbness. Many patients report a decrease in tension-type headaches and brow aches. The full effect provides a diminution of the deeper muscle wrinkles and softening of dynamic lines that occur during facial expressions in only the areas treated. Facial expression is maintained except for the vertical furrowing between the eyebrows. Actresses, performers, and TV personalities in whom we have used Botox describe no problems in their ability to show facial expressions.

Side Effects

The vast majority of patients have no side effects at all. About one in twenty patients may get a mild headache after the treatment. Rarely there may be a temporary eyelid weakness (ptosis) resulting from the injection, although this is totally reversible over time. Occasionally there will be a minor asymmetry evident after the treatment, but again this reverses in time.