Inactivation of frown lines is a procedure used to improve the appearance of “worry lines,” “frown lines,” “crow’s feet,” “forehead wrinkles” and other so-called dynamic wrinkles. To inactivate frown lines, botulinum toxin (also known as Botox and Dysport) is injected into these muscles. Botulinum toxin works by temporarily weakening these tiny facial muscles in a very precise manner. After treatment, the overlying skin remains smooth and unwrinkled while untreated facial muscles contract normally, allowing normal facial expression to be unaffected. Though inactivation of frown lines is a relatively new treatment for dynamic wrinkles, botulinum toxin injection have been safely and effectively used for over a decade for neurological and opthamological disorders. Thousands of Botox and Dysport injections are performed each year for a variety of conditions, ranging from strabismus (squint or cross eyes) to spasmodic torticollis (twisting of the neck with painful muscle spasms). Botox was first shown to be beneficial for dynamic wrinkles by neurologists and ophthalmologists treating these other conditions. Today, paralleling an exponential increase in our knowledge of the science of aging, inactivation of frown lines has emerged as an exciting new treatment for ameliorating the visible signs of aging.

Botox Questions and Answers:

How is it performed?

Inactivation of the frown lines is a simple and safe procedure. A very small amount of Botox or Dysport is injected with a very fine needle into several locations in the face. Because the needle is so fine and only a small amount of liquid is used, the pain associated with the procedure is minimal. Many people say the sensation is similar to a pinch. No sedation or local anesthetic is required and you will be able to drive and engage in your daily activities immediately after your injections. You may have slight and temporary bruising of the skin at the injection sites, but otherwise there will be no visible signs of treatment.

Are there any side effects?

Bruising is relatively common, but usually very mild. Because the medication can sometimes cause excessive weakness of the injected or nearby muscles, rarely there can be transient weakness of the eyelid, drooping of the eyelids, or asymmetry of facial expression. The risk of any side effects depends on the muscles injected at your visit. Our staff will discuss this with you at length before your injections. Because Botox is reversible, any side effects related to excessive weakness are temporary, only lasting days or weeks.

What kind of results can I expect?

If dynamic wrinkles are making you look older than you should, inactivation of the frown lines can smooth these out and give you a more youthful appearance. However, this procedure will not improve the more common “static” wrinkles that are unrelated to facial muscle contraction. If you have a combination of the two, your improvement may therefore be more limited. Because of this, a combination laser peel or the use of a filling agent with inactivation of frown lines may be more appropriate for you. Your doctor will discuss the possibilities with you and recommend the best alternatives for your particular situation.

Are there other limits to inactivation of frown lines?

Unfortunately, inactivation of frown lines is not a permanent solution to the problem of dynamic wrinkles. Because the injections only last about four to six months, you will need to have injections two to three times a year. Though early results from clinical trials suggest the duration of benefit increases with time, so that you may only require injections infrequently in the future, this will vary from person to person. In addition, inactivation of frown lines may be less effective past age 65.

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