Back to my favorite injectable drug... BOTOX and it's not so long a list of side effects.
BOTOX is increasingly safe and has been around for decades, with first documented use for cosmetic purposes in 1989.
With any injectable procedure you should think about possible side effects.
#1 - Bruising
Relatively common (after all, you need a needle to get the injection completed). In my experience, the location of the injection plays an important role. Injections around the eye tend to have a higher chance of bruising, although the bruise can occur anywhere a needle is used. So how do you decrease the chances of a bruise?
- no alcohol 5 days prior to the procedure
- no NSAIDS (Ibuprofen, Advil, Aleve) 5 days prior to procedure - Tylenol is ok
- no retin-a type creams or vitamin E creams 3 days prior to procedure
- Use ice during the procedure
- Arnica cream before and after the procedure
- most importantly try not to have the injections right before an important event. Bruises can be bad sometimes!
#2 - Asymmetry | Uneven Results
Typically BOTOX is used to treat the forehead. The forehead controls our eyebrow height and architecture. When these muscles are relaxed with injections the results can sometimes be seen in the eyebrows. The undesired effect of asymmetry is not common, but does occur. Most faces have resting asymmetry (sorry I just knocked your self esteem down a notch). BOTOX when improperly placed (or even when properly placed) can result in exaggeration or new asymmetry. This is easily fixed with a second time 1 or 2 spots of injection of a few 'extra units' to even out the undesired effect.
#3 - Under treatment | Over treatment
Under treatment - not getting the desired effect of BOTOX can occur and is easily fixed with additional units. Some patients do require more units in order to get the look they want or any effect at all. You can work with your injector to better understand how many units you need.
Over treatment - Too much BOTOX can cause the "frozen appearance" or ptosis (see #5). It is always easier to add more BOTOX, you cannot take it away!
#4 - Spock Brow | Jack Nicholson Brow
When treating the forehead, injectors are extra careful to prevent eyelid drooping (which can happen, see #5). To do this injectors tend to concentrate on the central forehead (more commonly in women). This can sometimes lead to eyebrow arching, some patients request this look, others do not like it. The BOTOX works by relaxing the forehead muscle and if the outer part of your forehead is still very strong it can pick up the eyebrow into an arched shape sometimes. Thankfully this is usually easily corrected with a couple extra units of properly placed injections.
#5 - Eyelid drooping | Brow Drooping | Double vision
Thankfully rather rare, but does occur. The more aggressive your treatment is and your injector is, the higher the likelihood of ptosis or eyelid drooping. This is not a fun side-effect but can happen. This is the result of the forehead usually being too heavily treated on the outside. There are special eye drops your injector can likely provide that can help increase your recovery rate to about 2 weeks.
#6 - Headache and flu like symptoms
A very common side effect is Headache. They are usually short in duration and a results of the BOTOX itself or the needle from the injection. The good news is, BOTOX will usually help you get less headaches over the course of its 3-4 months of action. Tylenol and or a muscle relaxer can help with this short term headache. Flu symptoms are uncommon but do occur and last for up to 3 days.
Do not fret, side effects are usually short lived. Your injector can help facilitate any adverse effects you have and give you an estimated timeline.
More to come..
Dr. B
P.S. Don't jump to conclusions, injections usually take 3-7 days to start working!
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