Botox: The Truth About This Anti-Aging Treatment

Botox injection is one of the most frequently utilized aesthetic services.   It is used to temporarily diminish forehead wrinkles, glabellar frown lines and crow’s feet. Most people who use Botox do so on a regular basis (4-6 months apart). Those who use it, “can’t live without it”, while some who never used it think, “that stuff is dangerous”. What are the real facts about Botox? In this article, I will go over the ABC’S of Botox/Dysport.


Botox and Dysport are neuromodulators which effect the nerves that control muscle movements. Both Botox and Dysport are produced from the toxin of a bacterium called Clostridium Botulinum. Botulinum toxins are safe in small amounts when given to humans. Dysport is a slightly smaller molecule than Botox so the number of units of Dysport needed would be 2 ½ to 3 times greater than Botox units in the same patient.

How Do Botox / Dysport Work?

Both Botox and Dysport are injected in small quantities into the muscles of the forehead, glabellar region (between eyes) and around the lateral eye for Crow’s feet. These injections are typically performed in a qualified injector’s office. Nurses may inject them after proper training and under supervision of a medical doctor. Usually no anesthesia is administered because the needle used is like an insulin injection needle, however, an ice pack may be applied to the area before and after the injection for added comfort. These injections work by temporarily relaxing the muscles so that the skin above them becomes smoother. You may want to consider getting Botox if you are not getting desired results with wrinkle creams or serums.

What are the Side Effects of Botox/Dysport?

Minor effects include bruising, redness, discomfort at injection site, and headache (up to 9%)

Less common side effects include:

  1. Lid ptosis (drooping) in 3%
  2. Brow drop (ptosis) may last up to 6 weeks in 2%
  3. Flu-like symptoms/nausea
  4. Unwanted changes in expression
  5. Distant spread of the product (unlikely with cosmetic use)

Spread of Toxin Effect:

Although there have been no serious adverse event reports of distant spread of toxin effect associated with dermatological use of Botox Cosmetic at the labeled dosage range, there have been adverse reactions for unapproved use of Botox. Severe effects include difficulty breathing or swallowing if the toxin moves into areas that effect these functions.

Who should not receive Botox?

  1. Those who are hypersensitive to botulinum toxin
  2. Allergy to eggs. Botox is prepared with albumin from eggs.
  3. Infection in the treatment area
  4. Pregnancy (relative contraindication, category C)

FDA- Approved indications for Botox/Dysport Use

There are 3 FDA-approved indications for Botox Cosmetic use for facial treatment. These are forehead, glabella and crow’s feet.


There are more off label uses of Botox on the face and neck than there are FDA-approved indications. Some are listed below:

  1. Muscles (depressor arguli oris) pull down edges of lip forming a frown. Botox/Dysport is injected into both sides of face to correct this appearance.
  2. The masseter muscle which connects the cheekbone to the lower jaw is used for chewing. Botox is injected into the masseter muscle for improvement of TMJ symptoms and to slim down the face over time.
  3. Chin: The mentalis muscle may cause an “orange peel chin”. Botox diminishes this appearance and may last up to 6 months.
  4. Nose and Upper Lip

Nasalis Muscle. Nasalis movement can cause “bunny lines” that appear on the bridge of the nose under the skin below the eyebrows. Botox/Dysport are injected high upon the nose on either side and diffuses down to the nasalis muscle. The “bunny lines” are diminished.

  1. Gummy Lines show an excessive amount gum tissue when you smile. The responsible muscle is the risorious, a large muscle located on both sides of the mouth. Botox/Dysport injected into this muscle near the lower nose and upper lip reduce the muscle’s activity and lessons the amount of gums exposed when smiling.


As you can see there are many usages of Botox/Dysport in the field of Aesthetics. Proper training and qualification are critical to minimizing side effects and complications of their use. The power of Botox/Dysport to minimize signs of aging is phenomenal. Many who start the process of minimizing signs of aging at an earlier age really defy their age. In this article we have covered most of the cosmetic usages of Botox/Dysport, their side effects, indications, adverse reactions and off-label uses. I hope this information is helpful to you.