Botox All you need to know.

What is a Botox:

Botox is a onobotulinumtoxinA, this is a prescription medication that is injected into the muscle to temporarily treat moderate to severe frown lines and crows feet. Typically 20 to 40 units depending on the individual

Botox Injections are the first and only treatment FDA-approved to temporarily make moderate to severe frown lines, crow’s feet and forehead lines look better in adults.

BOTOX^® Cosmetic works beneath the surface and temporarily reduces the underlying muscle activity that causes moderate to severe frown lines, crow’s feet and forehead lines in adults – to help them look visibly smoother.

Who is it for:

Anyone who would like predictable, subtle results, so you look like you, only with less noticeable facial lines.

Botox injections are not just for women!

The number of men choosing treatments like BOTOX^® Cosmetic has risen fast – in the past three years alone, men have received over one million botulinum toxin treatments. When surveyed, the majority of men say they want to look good and they’re bothered by the changes they see in the mirror. 80% would choose to treat their crow’s feet first, while 74% would prioritize their forehead lines, and 60% would most like to treat their frown lines.^†

Pre-Treatment Instructions:

• Avoid taking aspirin or other non-steroidal anti-inflammatory drugs such as Ibuprofen, Advil®, Motrin®, Nuprin®, Aleve®, Celebrex®, Fish oil, Ginko Biloba, St. John’s Wort and high doses of vitamin E for 7-10 days prior to procedure, as these may cause increase risk of bleeding and bruising at the treated site(s). Regular multi-vitamin and Tylenol® is permitted (If not contraindicated).
• Avoid alcoholic beverages for 24 hours prior to procedure as this can increase the risk for bleeding and bruising at the treated site(s).
• Avoid waxing, bleaching, tweezing, or the use of hair removal creams in the area(s) to be treated.
• Take Tylenol® (if not contraindicated) 1 hour prior to your appointment to help with any discomfort you may have, if you have concerns about discomfort.
• If you have any history of Herpes Simplex (cold sores) on your face, make sure you inform the doctor that you have made your appointment with, one week prior to your appointment; this will allow us adequate time to prescribe a medication to prevent an outbreak.
• Sunburn skin is difficult to treat so avoid exposure to the sun.

During Treatment:

Some patients receiving BOTOX^® Cosmetic report the injections feel like a pinch.

Post-Treatment Care:

• Do NOT lay down for 4 hours post injection.
• If choosing to lay down, elevate the head with pillows so it remains higher than the heart.
• Do NOT work out or elevate heart rate for 24 hours post treatment
• Small red welts may appear at the injection sites and last up to a few days, but typically disappear within a few hours.
• Mild pain, swelling, itching, or redness at the site of injection may occur, but should resolve within a few hours.
• Drinking alcohol or taking Ibuprofen may increase the risk of bruising.
• Botox® is used to treat headaches. However, it may trigger a headache initially. If you get a headache, we recommend Tylenol. Typically, headaches resolve in less than a day.
• Results begin to set in 3-4 days after treatment, but take a full 14 days before the complete results. During this time you may notice unevenness in the eyebrows, lingering fine lines, and other differences in your anatomy. This is caused by the muscles working against your Botox. At the 14 day mark if you notice any abnormalities or are not satisfied with the results please contact the office for a touchup appointment, as a few more units might be necessary.
• WE will not inject more units BEFORE the full 14 days has passed!
• If you believe you are having an allergic reaction, infection, or other serious medical complication, contact medical help immediately and let our office know.

What To Expect:

• You may begin to notice results within 24 to 48 hours for moderate to severe frown lines. Full results in 30 days and can last up to 4 months for moderate to severe frown lines.

• Treatment requires minimal downtime. You can return to your daily routine immediately after you leave your specialist’s office.

• BOTOX^® Cosmetic is not a permanent treatment. If you discontinue treatment the moderate to severe frown lines, crow’s feet and forehead lines will gradually return.

Now that you’ve had your BOTOX^® cosmetic (onabotulinumtoxinA) treatment, here are some reminders:

• Since there’s minimal downtime or recovery, you should be able to resume your normal activities
• You can expect to see real, noticeable results, but you’ll still look like yourself
• BOTOX^®Cosmetic starts to work within 24 to 48 hours ¹– in clinical trials, a majority of people saw significant improvement at 7 days, continuing for up to a month¹
• Long-lasting: Proven to last up to 4 months¹, with a physician-reported response of 25% (102/403) vs 2% (2/128) for placebo¹

Other important information you should know:

• Side effects associated with the injection include localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising¹
• What to avoid: BOTOX^®Cosmetic may cause loss of strength or general muscle weakness, or vision problems within hours to weeks of taking BOTOX® Cosmetic. If any of this happens, do not drive a car, operate machinery, or do other dangerous activities¹
• See additional Important Safety Information below.
• Be sure to contact your aesthetic provider with any questions or concerns.

BOTOX^® Cosmetic (onabotulinumtoxinA) Important Information

Approved Use:

BOTOX^® Cosmetic is a prescription medicine that is injected into muscles and used to improve the look of moderate to severe frown lines between the eyebrows (glabellar lines) in people 18 to 65 year of age for a short period of time (temporary).

Important Safety Information:

BOTOX^® Cosmetic may cause serious side effects that can be life threatening. Call your doctor or get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX^® Cosmetic:

• Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months
• Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice (dysphonia), trouble saying words clearly (dysarthria), loss of bladder control, trouble breathing, trouble swallowing. If this happens, do not drive a car, operate machinery, or do other dangerous activities

The dose of BOTOX^® Cosmetic is not the same as, or comparable to, another botulinum toxin product.

There has not been a confirmed serious case of spread of toxin effect when BOTOX® Cosmetic has been used at the recommended dose to treat frown lines.

Serious and/or immediate allergic reactions have been reported.

They include itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint. Tell your doctor or get medical help right away if you are wheezing or have asthma symptoms, or if you become dizzy or faint.

• Do not take BOTOX^®Cosmetic if you: are allergic to any of the ingredients in BOTOX® Cosmetic (see Medication Guide for ingredients): Had an allergic reaction to any other botulinum toxin product such as Myobloc^® (rimabotulinumtoxinB), Dysport^® (abobotulinumtoxinA), or Xeomin^® (incobotulinumtoxinA); have a skin infection at the planned injection site.
• Tell your doctor about all your muscle or nerve conditions, such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects including severe dysphagia (difficulty swallowing) and respiratory compromise (difficulty breathing) from typical doses of BOTOX^®
• Tell your doctor about all your medical conditions, including: plans to have surgery; had surgery on your face; weakness of forehead muscles, such as trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX^®Cosmetic can harm your unborn baby); are breast-feeding or plan to breast-feed (it is not know if BOTOX^® Cosmetic passes into breast milk).
• Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal products. Using BOTOX^®Cosmetic with certain other medicines may cause serious side effects.
• Do not start any new medicines until you have told your doctor that you have received BOTOX^®Cosmetic in the past.
• Especially tell your doctor if you:have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin, such as Myobloc^®, Dysport^®, or Xeomin^® in the past (be sure your doctor knows exactly which product you received); have recently received an antibiotic by injection; taken muscle relaxants; take an allergy or cold medicine; or take a sleep medicine.

Other side effects of BOTOX^® Cosmetic include:

Dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes.

For more information refer to the Medication Guide or talk with your doctor.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

1. BOTOX^®Cosmetic Prescribing Information, November 2012.