Botulinum (Tox) injections involve a series of small subcutaneous or intramuscular injections designed to weaken certain muscles that cause skin wrinkling. Weakening of the injected muscles begins to be apparent after 2-3 days with the peak effect being reached after 14 days. Results can last 2-5 months. The procedure can be repeated after 3 months; however, injections given at less than 3 month intervals may not produce a noticeable effect.

Botulinum toxin (tox) A should not be used by patients who have severe allergies and with a history of anaphylaxis, pregnant or nursing, under the age of 18, in areas of active infection, or have any neurological diseases. Patients taking Aminoglycoside antibiotics, Penicillin, Quinine may potentiate the effects of Botulinum Toxin A.

Botulinum should not be administered to a pregnant or nursing woman.

Every procedure involves a certain amount of risk, and it is important that you understand the risks involved. An individual’s choice to undergo a procedure is based on the comparison of the risk to the potential benefit. Although the majority of patients do not experience these complications, you should discuss each of them with your provider to make sure you understand the risks, potential complications, and consequences of BOTULINUM injections. 

• Bleeding: It is possible, though unusual to experience localized bleeding episode during or after the procedure at the site(s) of injection. Do not take any aspirin or anti-inflammatory medications for 10 days prior to your BOTULINUM injection appointment. 

• Bruising: Following the procedure, it is not uncommon to bruise at the injection site. Bruising usually resolves in 3-4 days. ● Infection: Infection is unusual. Should an infection occur, additional treatment including antibiotics may be needed. 

• Unsatisfactory Results: You may be disappointed with the results of the procedure. The procedure may result in unacceptable visible deformities, loss of function and/or loss of sensation. 

• Allergic reactions: In rare cases, local allergies to botulinum toxin A preparations (including BOTULINUM) have been reported. Systemic reactions, which are more serious, may result from any medications or substance used during the procedure. Patients that are allergic to milk protein (not related to lactose intolerance) should not have BOTULINUM.

• Drooping of the eyelids (ptosis): This is a rare transient complication occurring in 2-5% of patients. The incidence can be minimized by positioning post injections. Ptosis usually resolves within several weeks but may take longer. 

• Additional Procedures: Should complications occur, other treatments may be necessary. Even though risks and complications occur infrequently, the risks are the ones that are particularly associated with Botulinum injections. Although good results are expected, there cannot be any guarantee or warranty expressed or implied with regard to the results that may be obtained. 

• As Botulinum injection is not an exact science, there might be an uneven appearance of the face with some muscles more affected by the Botulinum than others. In most cases this uneven appearance can be corrected by injecting Botulinum in the same or nearby muscles. However in some cases this uneven appearance can persist for several weeks or months. 

• Headaches: patients may occasionally experience headaches following injections. Headaches may last for 1-7 days following procedure.

This list is not meant to be inclusive of all possible risks associated with Botulinum as there are both known and unknown side effects associated with any medication or procedure.

Follow these tips to ensure the best results: 

 1. Feel free to wash your face gently with your normal cleanser. 

 2. Avoid lying flat for 2-3 hours following treatment. 

 3. Do not massage or manipulate the areas of injection. 

 4. Avoid facial procedures (peels, micro-dermabrasion, facials, lying face down on a massage table, etc.) for at least 72 hours following treatment. 

 5. Avoid use of hats or anything that would apply pressure to treated areas. 

 6. Avoid plucking/waxing eyebrows for 24 hours.