Botox ® Cosmetic

botox(Botox) is the name of injectable medication used to smooth out facial wrinkles. Botox is a muscle relaxant. It acts at motor nerve endings (the areas where nerves connect to muscles). Many lines and wrinkles on the face are created by the movement of facial muscles. These muscles relax and cannot contract after treatment with Botox. This results in a reduction of wrinkles, and smoothing and rejuvenation of the skin. In many cases the improvement is very dramatic. Botox is among the most common and popular cosmetic treatments.

botox before and after
Botox is a non-invasive (non-surgical) injection performed every three to four months. Many of the patients in my practice who have had Botox injections for years are able to stretch time between injections to about 6 months. After Botox “wears off”, the appearance of the face will not worsen. In fact, some studies suggest that wrinkles will be less deep than before the treatment.

While Botox is not permanent, it also does not carry serious risks that surgery does. The risks related to Botox are very mild and temporary. The main risks are bruising, headache, and rare temporary drooping of eyelid. A rather welcome side effect for some patients is the disappearance of tension and migraine headaches. The safety of Botox has been confirmed in multiple studies. Millions of patients have had Botox treatments all over the world with no long-term side effects.

The procedure takes 5 to 15 minutes with no downtime. Because very fine needles are used, the treatment is almost pain-free. Botox is most commonly used for treatment of wrinkles around the eyes and on the forehead (upper third of the face). The chin area, lip wrinkles, and neck bands may also be treated. Botox treats a multitude of other conditions ranging from sweating to crossed eyes.

botox before and afterMany patients are concerned about having a “paralyzed” look after Botox treatment. If done correctly, Botox injections produce a refreshed and relaxed look without any unnatural features. Yet, results depend on the skill of the physician using Botox. Many physicians in non-cosmetic specialties (family practice, internal medicine, gynecology, etc) and even non-physicians now inject Botox. Their prices may be less expensive and therefore, more enticing. However, I would recommend using only a board-certified dermatologist, plastic surgeon, or oculoplastic surgeon for your Botox injections. The skill, experience, and training of these physicians are paramount. A weekend course in Botox treatment does not replace years of residency training. Doing your homework and checking the credentials of a potential provider will ensure that best possible results.


Alexander Doctoroff, D.O., F.A.O.C.D.
Assistant Chief of Dermatology, Veterans Administration Medical Center
East Orange, New Jersey
Assistant Clinical Professor of Medicine,
University of Medicine and Dentistry of New Jersey