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Bascom Palmer Eye Institute

Botulinum Toxin (Botox®)

What about botulinum toxin (Botox®) treatments?

Botulinum toxin, commonly known as Botox®, is a protein used to reduce or soften the deep lines around the eyes or forehead. The procedure is performed easily and safely with a few injections of very low doses of botulinum toxin that relax the muscles that cause the deep lines to form. Botulinum toxin type A, is a protein produced by the Clostridium botulinum bacterium.

How does botulinum toxin (Botox®) work?

Normally, the brain sends electrochemical messages to the body’s muscles to make them move. These messages are transmitted from a nerve to the muscle by a substance called acetylcholine. Botulinum toxin works by blocking acetylcholine to the facial muscles responsible for the development of dynamic lines. Following a Botox® injection, the muscles gradually become relaxed allowing the overlying skin to appear smooth and unwrinkled.

Why should I go to an ophthalmologist for botulinum toxin (Botox®) treatments?

No one knows eyelid and eye anatomy better than an ophthalmologist. Ophthalmologists have a unique understanding of the eyelids, brows and orbit, which most other physicians using botulinum toxin do not have. Knowledge of the orbital muscles is key to good results when using botulinum toxin around the eyes.

Ophthalmologists and ocuplastic subspecialists have been using botulinum toxin for blepharospasm (involuntary spasms of the eyelids), strabismus (crossed eyes), and hemi-facial spasm since 1989. Following treatments, ophthalmologists noted that forehead and eyebrow lines were lessening in appearance in those patients receiving botulinum toxin. This led to further research, which confirmed the effectiveness and safety of the botulinum toxin vaccine for use in improving wrinkles due to overactive muscles of the face. In Spring 2002, the Food and Drug Administration approved the use of botulinum toxin “to temporarily improve the appearance of moderate to severe frown lines between the eyebrows.”

What can I expect during a botulinum toxin (Botox®) treatment?

Your ophthalmologist will determine exactly where to administer the tiny injections in order to achieve the best results. No sedation or anesthesia is required, and there is no special recovery period necessary. The entire procedure takes approximately ten minutes. Discomfort is minimal and brief, mild bruising may occur at injection sites, but they may be easily covered with makeup. The result of the injection usually becomes apparent within 2 to 4 days. The effect of a Botox® injection generally lasts four to six months.