A BOTOX® Cosmetic treatment is natural, purified protein, which in very low doses relaxes the overactive muscles that cause frown lines to form. Treatment is simple and non surgical and smoothes the deep, persistent lines between your brows that developed over time.

It generally remains only in the treated muscle and gradually disappears without breaking down or traveling throughout the body.

Expect a dramatic improvement in the appearance of your frown lines but not a radical appearance change. In clinical trials, nearly 90% of the men and women surveyed rated the improvement in their brow lines as moderate to better. Overall, you’ll look more relaxed and refreshed but not like “you’ve had work done.”

Your doctor will determine exactly where to administer several tiny injections to achieve the best results. No anesthesia is required, although he or she may choose to numb the area with a cold pack or anesthetic cream prior to injecting. The entire treatment takes approximately 10 minutes. Discomfort is minimal and brief-most patients compare the sensation to a bug bite. Most people return to work or normal activity immediately.

Within days, you’ll see a marked improvement, which may continue to improve for as long as a week and should last up to 4 months. In clinical trials with BOTOX® Cosmetic, 89% of patients rated improvement in frown lines as moderate or better. Individual results may vary.

The most common side effects, if they occur, are headache, respiratory infection, flu syndrome, temporary eyelid droop, and nausea. BOTOX® Cosmetic should not be used if there is an infection at the injection site.

Results last about 4 months, after which lines gradually disappears without breaking down or traveling through the body.

BOTOX® which has been safely used to treat a variety of conditions for more than 10 years, is now FDA-approved as BOTOX® Cosmetic for the temporary treatment of frown lines in people aged 18 to 65.

Discomfort is minimal and brief. Your physician may choose to use a local anesthetic cream or ice to minimize this. Once the injection is complete, there is usually no discomfort.

Treated Area Care

• Always use a strong sunblock, if sun exposure is unavoidable (SPF 30 or greater).

• Stay out of the sun until redness and bruising subsides (usually 48 hours).

• There are no activity restrictions for this treatment.

• Patients should avoid aspirin and non-steroidal anti-inflammatory drugs such as Motrin, Advil, St. John’s Wart or high doses of Vitamin E supplements because these substances can cause increasing bruising or bleeding at the injection site.

What to Expect

• Temporary stinging, throbbing, burning sensation, redness, swelling, bruising, and excess fullness.

• Redness and bruising usually lasts about 48 hours.

• Patients notice a clinical effect between 5 days and 2 weeks following the injection.

• Some diffusion of the toxin occurs. This can cause circular areas of paresis, a partial loss of movement, with a radius of 1.5 cm and temporary weakness of nearby muscles.

• In rare cases, there can be a drooping of the eyelid or asymmetry of facial expression.

• The risk of any side effect depends on the muscles injected.

• The effects of Botox are completely reversible; any side effects are temporary, lasting only a few weeks.

Length of Benefits

• The benefits of Botox injections usually last 3-6 months and then resolve.

Follow-Up Care

• No activity restrictions.

• Return visit every 3 months to maintain results.

• If you have increased swelling or bruising.

• If swelling and redness persist after a few days.

• If you have severe or increased pain not relieved by medication.

• If you have any side effects to medications; such as, rash, nausea, headache, vomiting.

• If you have an oral temperature over 100.4 degrees.

• If you have any yellowish or greenish drainage from the incisions or notice a foul odor.

• If you have bleeding from the incisions that is difficult to control with light pressure.

• If you have loss of feeling or motion.

• If you have any sign of abscesses, open sores.

No. The only expression you’ll lose is the unintentional frown caused by the overactive muscles between your brows. So you can frown, smile, or look surprised-without the creases and wrinkles between your brows.

If you’re between the ages of 18 and 65 and doing all you can to look your best is important to you, BOTOX® Cosmetic may be for you.

If reducing those tough lines between your brows would make you feel more approachable, BOTOX® Cosmetic may be for you.

Thousands of appearance-conscious women and men have already discovered the benefits of BOTOX® Cosmetic. Not just models and movie stars, but ordinary people-teachers, mothers, and business people from all walks of life. Your doctor can help you decide if BOTOX® Cosmetic is right for you.

Every procedure involves a certain amount of risk, and it is important that you understand the risks involved. An individual’s choice to undergo this procedure is based on the comparison of the risk to potential benefit. Although the majority of patients do not experience the following complications, you should discuss each of them with your plastic surgeon to make sure you understand the risks, potential complications, and consequences of BOTOX injections.

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Bleeding– It is possible, though unusual, to have a bleeding episode from a BOTOX injection. Bruising in soft tissues may occur. Serious bleeding around the eyeball during deeper BOTOX injections for crossed eyes (strabismus) has occurred. Should you develop post-injection bleeding, it may require emergency treatment or surgery. Do not take any aspirin or anti-inflammatory medications for seven days before and after BOTOX injections, as this may contribute to a greater risk of a bleeding problem.

Damage to deeper structures– Deeper structures such as nerves, blood vessels, and the eyeball may be damaged during the course of injection. Injury to deeper structures may be temporary or permanent.

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Corneal exposure problems– Some patients experience difficulties closing their eyelids after BOTOX injections and problems may occur in the cornea due to dryness. Should this rare complication occur, additional treatments, protective eye drops, contact lenses, or surgery may be necessary.

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Dry eye problems– Individuals who normally have dry eyes may be advised to use special caution in considering BOTOX injections around the eyelid region.

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Migration of Botox– BOTOX may migrate from its original injection site to other areas and produce temporary paralysis of other muscle groups or other unintended effects.

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Drooping Eyelid (Ptosis)- Muscles that raise the eyelid may be affected by BOTOX, should this material migrate downward from other injection areas. Eyedrops can be given to improve this problem.

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Double-Vision–Double-vision may be produced if the BOTOX material migrates into the region of muscles that control movements of the eyeball.

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Eyelid Ectropion– Abnormal looseness of the lower eyelid can occur following BOTOX injection.

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Other Eye Disorders– Functional and irritative disorders of eye structures may rarely occur following BOTOX injections.

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Asymmetry-The human face and eyelid region is normally asymmetrical with respect to structural anatomy and function. There can be a variation from one side to the other in terms of the response to BOTOX injection.

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Life – Altering Headaches / Pain– Discomfort associated with BOTOX injections is usually short duration. However, rarely permanent severe headaches may occur after BOTOX injection.

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Skin disorders– Skin rash and swelling may rarely occur following BOTOX injection.

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Unsatisfactory result-There is the possibility of a poor or inadequate response from BOTOX injection. Additional BOTOX injections may be necessary. Surgical procedures or treatments may be needed to improve skin wrinkles including those caused by muscle activity. Any and all additional injections are the financial responsibility of the patient.

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Allergic reactions-As with all biologic products, allergic and systemic anaphylactic reactions may occur. Allergic reactions may require additional treatment.

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Antibodies to BOTOX- Presence of antibodies to BOTOX may reduce the effectiveness of this material in subsequent injections. The health significance of antibodies to BOTOX is unknown.

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Infection– Infection is extremely rare after BOTOX injection. Should an infection occur, additional treatment including antibiotics may be necessary.

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Long-term effects– Subsequent alterations in face and eyelid appearance may occur as the result of aging, weight loss of gain, sun exposure, or other circumstances not related to BOTOX injections. BOTOX injection does not arrest the aging process or produce permanent tightening of the eyelid region. Future surgery or other treatments may be necessary.

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Pregnancy and nursing mothers– Animal reproduction studies have not been performed to determine if BOTOX could produce fetal harm. It is not known if BOTOX can be excreted in human milk.

Blindness– Blindness is extremely rare after BOTOX injections. However, it can be caused by internal bleeding around the eyeball or needle stick injury. The occurrence of this is very rare.

Drug Interactions– The effect of BOTOX may be potentiated by aminoglycoside antibiotics or other drugs known to interfere with neuromuscular transmission.

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Unknown risks-The long term effect of BOTOX on tissue is unknown

Most health insurance companies exclude coverage for cosmetic surgical procedures and treatments or any complications that might occur from the same.

When considering your facial aesthetic options, you’ll find that BOTOX® Cosmetic is quite affordable. Like other appearance-related investments, such as hair coloring and cuts, teeth whitening, and chemical peels, the cost must be weighed relative to your expectations. Consult Dr. Rieger for more information.

The cost of BOTOX injection may involve several charges Additional costs of medical treatment would be your responsibility should complications develop from BOTOX injections. Rarely more Botox may be necessary to accomplish the desired result. Additional injections are the financial responsibility of the patient.