Botox comes as a crystalline substance from the manufacturer, which then has to be reconstituted with saline or another liquid. Practitioners add varying amounts of liquid when reconstituting it. Although there is no right or wrong amount of liquid to add, most physicians add about 2 mL-3 ml (about a half a teaspoon) of liquid to each vial. Some add quite a bit more, which can lead patients to think they are getting more Botox when, in reality, they are getting the same or less amount of Botox than samples reconstituted in a stronger way. It is the total dose of medication, not the volume of liquid that leads to the desired effect.
The injectable facial and cosmetic filler is injected into the affected area of the skin to help restore the smoother appearance as well as fill in the wrinkles on the face. Botox blocks signals from the nerves to the muscles. The injected muscles can no longer contract, which causes the wrinkles to relax and soften. It is most often used on forehead lines, crow’s feet (lines around the eye) and frown lines. Wrinkles caused by sun damage and gravity will not respond to Botox.
The effects are may be first noticed in 72 hours but it may take up to 7 days to maximize the effect. You may be asked to return after the first treatment so that your provider can assess your response. The first set of Botox injections may only give a partial response. The effects from Botox will last three to six months. As muscle action gradually returns, the lines and wrinkles begin to reappear and need to be treated again. The lines and wrinkles often appear less severe with time because the muscles are shrinking.
Getting Botox takes only a few minutes and no anesthesia is required. Botox is injected with a fine needle into specific muscles with only minor discomfort. It generally takes three to seven days to take full effect and it is best to avoid alcohol at least one week prior to treatment. Aspirin and anti-inflammatory medications should be stopped two weeks before treatment as well in order to reduce bruising.
After the injections, the patient will usually lay upright or semi upright on the exam table for about two to five minutes to make sure he or she feels good after the procedure, and then the patient should avoid lying down for two to four hours. If bruising is a concern, it will be important for the patient to avoid taking aspirin or related products, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), if possible after the procedure to keep bruising to a minimum.
There are many physicians who encourage their patients to either work the area several times during the next several days or, alternatively, to not use the affected muscles during the next several days. Many practitioners do not tell the patients to do anything in particular other than to avoid strenuous activity for several hours afterward because of an increased risk of bruising.