BOTOX® Cosmetic

One 10-minute treatment at Hopkins Clinic, a few tiny injections, and within days there's a noticeable improvement in moderate to severe frown lines between the brows, which can last up to 4 months. Results may vary.

What is BOTOX? | Considering Botox? | FAQs | Parties | Video

Cost | FREE Consultation

There’s only one BOTOX® Cosmetic. Talk to your doctor to see if BOTOX® Cosmetic is right for you!

BOTOX® Cosmetic is a simple, non-surgical, physician-administered treatment that can temporarily smooth moderate to severe frown lines between the brows in people from 18 to 65 years of age. It is the only treatment of its type approved by the Food and Drug Administration (FDA).

Take a look at men and women who've had BOTOX® Cosmetic treatments, and see for yourself!

BOTOX® Cosmetic is a purified protein produced by the Clostridium botulinum bacterium, which reduces the activity of the muscles that cause those frown lines between the brows to form over time.

In 2005, almost 3.3 million procedures were performed with FDA-approved BOTOX® Cosmetic.

BOTOX® is a therapeutic muscle-relaxing agent that works at motor nerve endings (nerves that lead to muscles).  It is in a class of drugs called neurotoxins.

When considering neurotoxin therapy, it is important to understand how the product works, the history of its use in patients, its protein content, and possible side effects.

back to top

What is BOTOX®?

BOTOX® is a novel therapeutic agent derived from the bacterium, Clostridium Botulinum.  Also known as Botulinum Toxin Type A, the brand BOTOX® is produced in controlled laboratory conditions and given in extremely small therapeutic doses.

BOTOX® is indicated for the treatment of blepharospasm associated with dystonia in patients 12 years of age and above.  BOTOX® is being investigated for several conditions associated with overactive muscle activity. Botulinum Toxin Type A is the most studied of the seven different serotypes of botulinum toxin (A, B, C1, D, E, F, G). Each serotype has different properties and actions. No two are exactly alike.

Botulinum Toxin Type A (BOTOX®) is one the most popular aesthetic procedures performed in the United States today. It is FDA approved for the treatment of wrinkles caused by overactive muscles above the eyes, the frown lines. BOTOX® blocks the chemicals that cause facial muscles to contract, thereby relaxing them. It has proven to be extremely safe. Treatments take only a few minutes, there is no downtime and you experience minimal and very brief discomfort. Results may be seen in just a few days but it may take up to one week to start noticing the effects of the BOTOX®. These results typically last 3-4 months. It is recommended to continue injections every 3-4 months to maintain desired aesthetic results.

back to top

Frequently Asked Questions

How does BOTOX® work?

Normally your brain sends electrical messages to your muscles so that they can contract and move.  The electrical message is transmitted to the muscle by a substance called acetylcholine.  BOTOX® works to block the release of acetylcholine and, as a result, the muscle doesn't receive the message to contract.  This means that the muscle spasms stop or are greatly reduced after using BOTOX®, providing predictable and reliable relief from symptoms.

BOTOX® is not a cure.  For many patients, however, its effects have been dramatic - symptoms usually begin to dissipate within a few days and the effects can last for approximately three months. 

How is BOTOX® administered?

BOTOX® is injected into the muscle.  Your doctor will determine the muscle(s) in need of treatment.

Does the treatment hurt?

A very fine needle is used for the one to three injections that are usually given per muscle.  Some patients report minor and temporary discomfort from treatment. Ice is applied prior to the procedure which significantly relieves any injection site discomfort.

When does BOTOX® start to work?

Usually, you will see the effects of BOTOX® within three days.  The maximum benefit is reached in one to two weeks.

How long does the effect last?

Given its unique mechanism of action, BOTOX® offers sustained relief, dose after dose over the course of long-term treatment.  The relief you will feel from a single treatment of BOTOX® will normally be sustained for approximately three months.  You will notice a gradual fading of its effects.  At this point, you will return to your doctor for your next treatment.

Usually, BOTOX® treatment is required only three or four times a year.  Symptoms may vary throughout the course of the condition, and so the degree of relief and duration of effect varies from person to person.  Consult your doctor, who has special knowledge about how to achieve the best possible results with BOTOX® for your individual case.

How long can I be treated with BOTOX®?

Treatment with BOTOX® can typically be repeated indefinitely.  BOTOX® has been used for over 10 years worldwide.  Acceptable safety in long-term treatment has been well established. There are a number of factors that can impact the long-term usage of BOTOX®.  These include: Appropriate muscle selection - Identifying and injecting the affected muscle can be difficult, complicated by the changing pattern of muscle involvement and progression of the disorder.

Adequate dosing - Changes in response may require dose adjustment.
Minimizing exposure to neurotoxin complex proteins1 - Botulinum toxins contain proteins.  In certain circumstances, when foreign proteins enter the body, the natural response is to form antibodies to the protein.  When antibodies are formed, the effect may be that one is no longer able to respond to the therapy.  High doses and frequent injections of botulinum toxin have been linked to the formation of antibodies. Antibody formation with BOTOX® is rare.  The likelihood of forming antibodies is reduced by having treatment no more frequently than about every three months.  BOTOX® has only 5 ng of neurotoxin complex proteins per 100 unit vial, a relatively low amount of protein, which may help to further minimize the potential to form antibodies.

Is BOTOX® a new treatment?

No.  BOTOX® has been used for over 10 years in thousands of patients worldwide.  The American Academy of Neurology, American Academy of Ophthalmology, and National Institutes of Health have recognized BOTOX® (Botulinum Toxin Type A) as a valuable treatment. 

Is BOTOX® right for me?

Ask your doctor if BOTOX® is the right treatment for you.  BOTOX® should not be used during pregnancy, if you are nursing, or if you are taking certain medications.  Only your physician can determine the best course of therapy.
The effects of BOTOX® may be increased with the use of certain antibiotics or other drugs that interfere with neuromuscular transmission.  Ensure that your doctor is aware of any current medications you are taking.  If you have any questions regarding the use of BOTOX® treatment, please consult your doctor.

What side effects may be experienced when using BOTOX®?

All medications have some side effects.  With BOTOX®, side effects are usually transient and mild to moderate in nature.  Some people notice temporary weakness of muscles or discomfort at the injection site.  Based on a recent study of BOTOX® in the treatment of blepharospasm, drooping of the eyelid occurred in 20.8% of patients.  Other side effects may include eye irritation/dry eye/tearing/light sensitivity (10%), and superficial punctate keratitis.

For more information go to www.botox.com

back to top

Considering BOTOX® Cosmetic?

• Be sure that a qualified doctor performs the procedure.

• Make sure that the doctor is trained and qualified in cosmetic skin surgery of the face.

• Ask questions and be informed about the benefits and risks involved in the procedure.

• Avoid alcohol and remain upright for several hours following the procedure.

• Choose a medical setting using sterile techniques. Necessary equipment should be available to respond to any potential problems.

Source: The American Society for Dermatologic Surgery

Botulinum Toxin Type A (BOTOX® Cosmetic) is a protein complex produced by the bacterium Clostridium botulinum, which contains the same toxin that causes food poisoning. When used in a medical setting as an injectable form of sterile, purified botulinum toxin, small doses block the release of a chemical called acetylcholine by nerve cells that signal muscle contraction. By selectively interfering with the underlying muscles' ability to contract, existing frown lines are smoothed out and, in most cases, are nearly invisible in a week.

BOTOX® injections are the fastest-growing cosmetic procedure in the industry, according to the American Society for Aesthetic Plastic Surgery (ASAPS). In 2001, more than 1.6 million people received injections, an increase of 46 percent over the previous year. More popular than breast enhancement surgery and a potential blockbuster, BOTOX® is regarded by some as the ultimate fountain of youth.

BOTOX® was first approved in 1989 to treat two eye muscle disorders--uncontrollable blinking (blepharospasm) and misaligned eyes (strabismus). In 2000, the toxin was approved to treat a neurological movement disorder that causes severe neck and shoulder contractions, known as cervical dystonia. As an unusual side effect of the eye disorder treatment, doctors observed that BOTOX® softened the vertical frown (glabellar) lines between the eyebrows that tend to make people look tired, angry or displeased. But until this improvement was actually demonstrated in clinical studies, Allergan Inc., of Irvine, Calif., was prohibited from making this claim for the product.

By April 2002, the FDA was satisfied by its review of studies indicating that BOTOX® reduced the severity of frown lines for up to 120 days. The agency then granted approval to use the drug for this condition.

The FDA regulates products, but not how they are used. Approved products are sometimes used by a licensed practitioner for uses other than those stated in the product label. BOTOX® Cosmetic, for example, is currently being used by physicians to treat facial wrinkles other than those specified by the FDA. Consumers should be aware, however, that this "off-label" use has not been independently reviewed by the agency, and the safety and effectiveness of BOTOX® injections into other regions of the face and neck, alone or in combination with the frown-lines region, have not been clinically evaluated.

Ella L. Toombs, M.D., a dermatologic medical officer in the FDA's Office of Cosmetics and Colors, says, "Careful deliberation, investigation and evaluation is undertaken by the agency before any prescription product is approved." Drugs such as BOTOX®, which are not indicated for serious or life-threatening conditions, "are subject to a greater level of scrutiny because of the benefit-to-risk ratio." Toombs says this means that the FDA may allow someone to incur a greater risk from products that treat medical conditions, rather than from those that are approved for cosmetic purposes.

back to top

BOTOX® 'Parties'

The recent rise in the popularity of BOTOX® has much to do with the manner in which it is frequently marketed. Some practitioners buy the toxin in bulk and arrange get-togethers for people receiving their treatments. As in business, volume discounts can be found in medicine.

Plastic surgery events known as BOTOX® parties--also seminars, evenings and socials--are a key element of BOTOX® marketing in much of the United States. The gatherings are thought to be a convenient means of providing BOTOX® treatments more economically, and may help reduce the anxiety that normally goes along with getting an injection. Doctors are finding that treating people in groups allows them to make the procedure more affordable to their patients.

Here's how a "party" typically works: A group of often nervous, but excited, middle-aged men and women mingle in a common area. Sometimes refreshments are served. One by one, as their name is called, each slips away for about 15 minutes to a private exam room. He or she pays a fee and signs an informed consent agreement. Anesthesia is rarely needed, but sedatives and numbing agents may be available. The practitioner injects about one-tenth of a teaspoon of toxin into specific muscles of the forehead most often targeted for the effect. The person then rejoins the group.

Scott A. Greenberg, M.D., a board-certified plastic surgeon in Winter Park, Fla., has been hosting monthly "BOTOX® Happy Hours" in his medical office since the drug's approval in April. Greenberg feels that these by-invitation-only events to previous patients "are an opportunity to treat a lot of people at one time in a relaxed but professional atmosphere." Greenberg says there is no difference between treating 10 people during individual office visits throughout the day and treating 10 people individually, but in a more socialized setting. "The important thing is that the identical standards of medical care are maintained at these gatherings as in a routine daytime office consultation."

The FDA is concerned that BOTOX® has the potential for being abused. The ASAPS recently reported that unqualified people are dispensing BOTOX® in salons, gyms, hotel rooms, home-based offices, and other retail venues. In such cases, people run the risks of improper technique, inappropriate dosages, and unsanitary conditions. "BOTOX® is a prescription drug that should be administered by a qualified physician in an appropriate medical setting," says Toombs.

Although there is no chance of contracting botulism from BOTOX® injections, there are some risks associated with the procedure. If too much toxin is injected, for example, or if it is injected into the wrong facial area, a person can end up with droopy eyelid muscles (ptosis) that could last for weeks. This particular complication was observed in clinical trials.

Other common side effects following injection were headache, respiratory infection, flu syndrome, and nausea. Less frequent adverse reactions included pain in the face, redness at the injection site, and muscle weakness. These reactions were generally temporary, but could last several months.

While the effects of BOTOX® Cosmetic don't last, still, people don't seem to mind repeating the procedure every four to six months in order to maintain a wrinkle-free look. Battling the signs of aging in a non-invasive way, after all, is part of the allure of the product--that and the fact that there are no unsightly scars, and that there is very little recovery time with the procedure.

The FDA recommends that BOTOX® Cosmetic be injected no more frequently than once every three months, and that the lowest effective dose should be used.

The horizontal wrinkles of the forehead, the vertical "frown" wrinkles of the brow (between the two eyebrows) and the crow's feet beside the eyes are the areas best suited to treatment with BOTOX®.

The action of BOTOX® is temporary. Results will be apparent within 24 to 48 hours and will last from two to five months; treatment must then be repeated.

Side effects of BOTOX® treatment include minor swelling and bruising, headache and/or nausea. And although unusual, there is a possibility that the muscles that elevate the eyebrow could be paralyzed, causing the upper brow to droop for a week or more.

There are no drugs that an otherwise healthy patient would be taking that are known to interact with BOTOX®.

back to top

BOTOX® Cost

BOTOX® is priced per unit used and is priced at $11.00 per unit. Depending on the size of the area treated, numbers of areas treated and condition being treated, the price will be dependant on the amount of BOTOX® used. This can be estimated for you during your complimentary consultation.

We fully educate our patients about treatment and pricing at the time of consultation. Because each patient’s needs are unique, the required number of units of BOTOX® to achieve desired results will vary. Hopkins Clinic uses UPP (Unit Pricing Policy) to determine the cost of a BOTOX® procedure. UPP allows patients to pay for only what they need to treat an area, rather than charging a flat rate for an area. With this method our patients know a close estimate of how many units of BOTOX® they will be purchasing for their given treatment. The current fee for BOTOX® at Hopkins Clinic is $11.00 per unit.

Typical BOTOX® treatments use:

Glabellar lines: (between and just above the eyebrows) 20-40 units of BOTOX®
Upper forehead lines: 25-40 units of BOTOX®
Crow's feet: (wrinkles and squint lines radiating outwards from the outer corners of the eyes) 10-20 units of BOTOX®
Anterior neck: (to reduce jowls, and to reduce vertical and horizontal lines on the anterior neck) 30-40 units of BOTOX®

All prices are subject to change at any time. During your complimentary consultation, you will be provided a written price quote that will remain in effect for 30 days from the date of the consultation.

back to top

FREE BOTOX® Consultation

Dr. Gianoli performs BOTOX® treatments in our clinic. As with all procedures we offer, an initial  medical evaluation by our staff and Dr. Gianoli will provide you with the essential information on this procedure regarding expectations, cost, risks and potential side effects.

Call us today at 727-544-3330 for more information and to see if BOTOX® is right for you.

back to top