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Warding Off Your Wrinkles-- by Alexa Geist


Botox®, formally known as botulinum toxin, is the most common cosmetic injection currently performed in the United States. Botox® is a neurotoxin that inhibits the neuromuscular junction, meaning that the nerve becomes unable to tell the muscle to contract and move. When most people think of Botox®, their mind most likely goes to the cosmetic indications—wrinkles. However, Botox® is used for much more than cosmetic reasons, including migraines, TMJ pain, and hyperhidrosis (excessive sweating) in the palms or armpits.


When we think of wrinkles, there are two main types we encounter in our facial features. The first would be dynamic wrinkles, which are visible when the muscles under the skin move. Think of the wrinkles next to your eyes (crow’s feet) and your expression lines that appear when you smile. Dynamic wrinkles generally develop first, and overtime lead to the second types of wrinkles—static wrinkles. Static wrinkles are visible when your face is static, or not moving. As you age, your skin loses collagen and volume causing it to no longer be able to maintain it’s tightness over your face, leading to these static wrinkles. Botox® is used to treat facial wrinkles, specifically dynamic wrinkles. Since Botox works to keep the muscle from moving, it helps treat the wrinkles that are seen during muscle movement. Knowing this, Botox® is not always the most helpful treatment for static wrinkles, which often respond better to fillers or other treatments.


We already established that dynamic wrinkles tend to appear first and eventually develop into static wrinkles. This leads us to the idea of preventative Botox®—beginning Botox® treatment when initial dynamic wrinkles are developing to reduce the development of static wrinkles later in life. That means that even if you think you’re too young for Botox®, the truth is you’re probably not. If you’re looking for the best results with Botox® later in life, its better to start sooner rather than later!


Now that we know about Botox® and how it works, we should understand how to prepare for treatment and what kind of results to expect. Before treatment, patients are recommended to stop any medications that act as blood thinners or anticoagulants for two weeks. Since Botox® is an injection, there is some expected bruising at the treatment sites and discontinuing these medications can help to minimize this discoloration. After injection, results can be seen in as little as three days, but maximum results are seen two weeks post treatment. These results last up to three or four months, and so it is recommended to repeat treatment every three months.



Currently, there are three areas that are indicated by the FDA for cosmetic Botox® injection: horizontal forehead lines (frontalis), frown lines between your eyebrows (glabellar complex), and crow’s feet at the corner of your eyes. In addition to these areas, there are “off-label” areas that are also commonly treated, including bunny lines on the nose and lines around the mouth. Since Botox® is an injection, treatment is sold in the number of units injected. In a “full treatment,” this is about 64 units. However, this number varies based on location of injection and desired results. To learn more about what treatment may look like for yourself, schedule your free consultation today!


this blog post was guest-written by Alexa Geist, a Clemson University 2022 Graduate with a BS in Chemistry and a minor in Mathematical Sciences and the Medical Office Assistant at Cardona Direct Primary Care

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