Botox

Technically, onabotulinumtoxinA, has been FDA approved for cosmetic use since 2002 when it was to be used on the glabellar (between the eyebrows) wrinkles. It works on many areas of the face in a cosmetic fashion by weakening muscles which are causing deep furrows or wrinkles. Two other toxins, abobotulinumA or Dysport, and incobotulinumA or Xeomin, work in a similar fashion to Botox.

Areas now commonly treated are:

  • Forehead transverse wrinkles
  • Glabellar wrinkles
  • Lateral Periorbital (crow’s feet)
  • Nasal (bunny lines)
  • Perioral (vertical lip lines)

These areas can all benefit from judicious use of the neuromodulator drugs like Botox. Care in dosing and a knowledge of facial anatomy are crucial to avoid an overdone, paralytic result, and to avoid inadvertent weakening of important muscles of eyelid and mouth control. The neuromodulators all last approximately 90 days with minor variations in time of onset and duration of effect. Interestingly, the Revance company has trials underway of a topical BoNT-A for the glabella and crow’s feet areas. Prices in most offices are per unit. Some rough guidelines to help with cost estimate for treatment are as follows:

  • Glabella: 20-30 units
  • Forehead: 10-20 units
  • Crow’s feet: 15-22.5 units
  • Vertical lip: 2.5-7.5 units
  • DAO (lip corner depressor): 2-5 units
  • Nasal (bunny) 2.5-5 units
  • Platysmal bands: 30-40 units
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