What is Botox?

Botox is a brand name for Botulinum Toxin Type A which is a protein produced by the bacterium Clostridium botulinum. When given in tiny doses this can smooth and soften wrinkles caused by dynamic or overactive muscles. At the practice we use another brand of Botulinum Toxin Type A called DYSPORT. It works as a neurotoxin that blocks messages between muscles and the nerves that control them.

Proposed Treatment

Injection of a very small amount of a purified toxin produced by the bacterium clostridium botulinum, into the specific muscle causes weakness or paralysis of that muscle. This results in relaxation of the muscle and improvement of the lines or wrinkles that the muscle action has formed.

Anticipated Benefit Response usually is seen 2-10 days after injection. Typically, the muscle action (and wrinkles) will return in 3-5 months. At this point, a repeat treatment will relax the muscle and soften the lines again.

Risks and Complications

Possible side effects include: transient headache, swelling, bruising, pain during injection, twitching, itching, numbness, asymmetry (unevenness), temporary drooping of eyelids or eyebrows. These side effects are rare, but have been reported. In a very small number of individuals, the injection does not work as satisfactorily or for as long as usual. Known significant risks have been disclosed, yet the theoretical risk of unknown complications does exist.

Bruising may occur after injection. Substances that increase the risk of bruising include Vitamin E, aspirin, motrin and other non steroidal anti-inflammatory drugs. I understand that if I have taken any of the above within the last 7 days; I have increased risk of bruising. Bruising is also a significant risk with the use of blood thinning medications. I understand that if I am taking a blood thinning medication, this treatment may result in significant bruising and may not be recommended.

I understand that there may be a higher possibility of side effects if I do not follow certain instructions and will adhere to these instructions for at least 4 hrs from the time of treatment. These include:

• I will not lie down or bend forwards for extended periods of time for at least 4 hours from the time of treatment.
• I will not manipulate or massage the treated area for at least 4hours after the treatment.

Pregnancy and Neurological Disease

I understand that there are certain conditions where BOTOX treatments are not recommended. These include:

• Neurological diseases, such as myasthenia gravis or Bells Palsy
• Have Eaton-Lambert syndrome or Lou Gehrig’s disease
• Allergy to albumin
• Have an infection, skin condition or muscle weakness at the site of injection
• Pregnancy or breast feeding

None of the conditions above apply to me.

Limitations and Alternatives

Botulinum therapy is best at treating dynamic facial lines, those caused by facial muscle activity; lines present at rest may or may not improve. A treatment may be effective for variable lengths of time with subsequent treatments, may not work as well or for as long as expected, or may not work at all. Although the results are usually dramatic I have been informed that the practice of medicine is not an exact science and that no guarantees can be or have been made concerning the expected results in my case. Other alternatives which exist for the treatment of wrinkles include topical creams, chemical peels, laser treatments, surgical removal of frown muscles, forehead/brow lift, facelift, collagen or hyaluronic acid treatments.

Follow-up

I agree to follow-up in 2-4 weeks after my first treatment if asked to do so, and that I am required to have photographs taken before, during and after treatment for my medical records