Botox Injections, Dysport (Reloxin)
(botulinum toxin A)

The transient lines of facial expression become more permanently etched as wrinkles as we get older. More than just a giveaway of our age, these wrinkles and the frowning and squinting that causes them can create the appearance of worry, stress, or anger where there is none. For these reasons, individuals often seek treatment for them.

One of the most effective techniques for reducing muscle-generated wrinkles such as the "frown lines" above the nose and the "crow's feet" around the eyes, is to eliminate the activity that causes them. This is where a medicine called botulinum toxin A ("BOTOX® Cosmetic" or "Botox" for short) excels.

Botox Cosmetic
Botox is actually one of several potent poisons (neurotoxins, specifically) produced by a bacterium called Clostridium botulinum. BOTOX® Cosmetic works by paralyzing the muscles into which it's injected, rather than acting as a filler like collagen. The paralyzed muscles can no longer create the scowling or squinting facial expressions that crease the skin to form wrinkles, and thus over time those wrinkles fade. And while Botox has lately received a lot of good publicity for its use in facial plastic surgery, it's hardly a newcomer to medicine. It has been used safely and extensively by doctors for nearly twenty years in the treatment of a variety of muscular diseases in addition to using it for the treatment of wrinkles.

See the video below for more information on how Botox Cosmetic might be right for you:


Not all facial wrinkles will benefit from Botox injections, and determining whether yours could benefit from Botox or rather require different approaches is important to determine. Your skin type, skin thickness, and degree of wrinkling all play a role in determining whether Botox will be effective for you. In addition, certain specific medical conditions can exclude some patients as candidates for Botox. A careful history and physical exam of the face will be done to determine whether or not you would qualify. Rare patients may have antibodies to botulinum toxin in which case Botox will be ineffective. In such patients a Botox alternative called Myobloc® (botulinum toxin B) may be appropriate, but we have found that its duration of effect is significantly shorter.

Dysport (a.k.a., Reloxin)
Botox Cosmetic (from the makers of Juvederm) is now facing more serious competition, however. Just approved by the FDA in April 2009 is another botulinum toxin type-A, sold under the name Dysport® (pronounced "DISS-port" not "DICE-port" or "DYE-sport" and previously known as Reloxin). We are keeping an eye on this product to see whether Dysport (Reloxin) will offer our patients any specific advantages over Botox, when it finally starts shipping this summer (2009). In all likelihood, Botox and Dysport should produce the same results, so perhaps the competition will make its cost even more affordable.

If, after discussing your treatment options in detail with Dr. Pearson, you and he feel that you can expect reasonable improvement from BOTOX® Cosmetic treatments or Dysport injections, routine photographs are obtained for documentation and an appointment will be scheduled for the injection.

What to expect after Botox or Dysport (Reloxin)

Two of the most attractive aspects of Botox treatments is that they are relatively inexpensive and also require no "down time" for the patient. The procedure only takes a few minutes to perform, and requires no bandages, dressings, or ointments afterward. And because Botox injections are done in the office and require local anesthesia at most, patients can resume their normal activities immediately.

After cleaning the overlying skin with an antiseptic, the medicine is injected into the selected muscles of the face using a very fine needle to deposit tiny amounts at several points. By carefully choosing the muscles to treat with Botox, Dr. Pearson's goal is to weaken only the wrinkle-producing muscles while still allowing for natural facial animation. Again, the aim is not to give the patient an unnatural, expressionless look.

Post-procedure, the only patient restriction is to avoid strenuous physical activity for the first twenty-four hours after the injection. Patients should also note that the paralysis from BOTOX® Cosmetic is not immediate—it typically takes from two to five days for the injection to take full effect. The specific potential risks of Botox injections will be thoroughly discussed with you before your first treatment.

If botulinum toxin A is such a potent poison, how can Botox be used so safely?

Despite its label as a "toxin", it is exceedingly safe for cosmetic use. The toxic effects of BOTOX® Cosmetic are directly related to its dose. The total dose used to treat the frown lines of the forehead, for example, is typically a hundred to two hundred times less than a poisonous dose. The dose used for crow's feet around the eyes is often even smaller. Moreover, the Botox is supplied from the manufacturer in vials whose total packaged dose is still many, many times less than these poisonous amounts so that even in a case of someone incorrectly mixing the concentration for injection there simply isn't enough BOTOX® Cosmetic present in the whole vial.

As a side note, you should know that currently, the only FDA-approved botulinum toxin A's are Botox Cosmetic from Allergan and Dysport (Reloxin) from Medicis. Patients have been seriously injured (some have ended up on ventilators) by unscrupulous practitioners offering illegal forms of botulinum toxin. Needless to say, at Pearson Facial Plastic Surgery, we only offer genuine Botox Cosmetic or Dysport. Beware of offices advertising "Botox" at a deeply discounted cost...it may not be the real thing.

Does Dr. Pearson personally administer the injections?

Absolutely! While it's unfortunately true that other practices have their nurse or aesthetician perform the injections, Dr. Pearson believes that patients deserve to have a physician perform the procedure. Key to the safety and effectiveness of Botox is that the person giving the injections is intimately familiar with the neuromuscular anatomy of the face, the dose characteristics of Botox, the recognition and management of potential complications, etc. And after all, you're paying for what is essentially a luxury service. We think that deserves direct care by the doctor.

Is the effect of Botox permanent?

Once the BOTOX® Cosmetic has taken full effect that effect typically lasts between three and six months before the affected muscles begin to function again. At that time, most patients will schedule time on one of our monthly "Botox days" to be re-injected. Ideally, patients should be re-injected with BOTOX® Cosmetic before full muscle recovery has occurred. In this way faded wrinkles do not have the chance to be recreated.

For more information about Botox treatment and cosmetic facial plastic surgery here in Orange Park and the greater Jacksonville, Florida area, please check our Frequently Asked Questions page or call to schedule an appointment.

To schedule a private consultation with Dr. David Pearson,
please call 904-215-7377 or e-mail us.

"When beauty fires the blood, how love exalts the mind!"
—John Dryden (1631-1700)
 
Why Choose Dr. Pearson?   • More than 13 years in practice   • Mayo Clinic trained & former Mayo staff   • Board-certified in Facial Plastic Surgery   • Our Results!