Wrinkles are divided into two types: the dynamic wrinkles (due to muscle overactivity, and disappear when the muscles are not active, or rested) and the static wrinkles (which form because of prolonged muscle activity, causing semi-permanent creases in the skin).  It is the dynamic wrinkles which we are concerned about now, as these are the ones that can be helped by botox cosmetic injection, which is given in the form of tiny injections into the muscles.  Static wrinkles can be helped only by injection of fillers, or in more extreme cases, by surgical facelifts.  It is primarily because prolonged contraction of muscles around the eyes tend to convert dynamic wrinkles to static wrinkles that early treatment with botox cosmetic injection is considered necessary.  (Think of a piece of paper that you keep folding again and again – these creases in the paper become permanent).
Botox cosmetic injection given directly into the appropriate muscles will cause the muscles to stop contracting.   The skin thus does not crease.  Usually you will feel the skin tightening at the injection site within 1/2hour from the time of injection.  The effect of wrinkle elimination will be very obvious after 4 days or so, and is expected to last between 4 to 6 months.

Botox Cosmetic Injection for Crows' Feet

Look at yourself in the mirror before the Botox injection, without smiling.  Then smile naturally and note the creases form by the outer corners of your eyes.  These are called crow’s feet.  These are the wrinkles that will disappear after your Botox cosmetic injection.  The disappearance of these wrinkles are what will make you look 10 years younger.

See your local aesthetic doctor for your injection.  These are professionally trained personnel who will know best how, where and when to give you your botox cosmetic injection.

Look into your mirror.  Frown.  See the frown lines form in between your eyebrows.  Imagine how unpleasant you would look if you wore this frown day in, day out.  And yet this is what happens to a lot of people.  Most times they are not aware of it, and only know about it if they involuntarily catch themselves in the mirror, of if some kind(?) soul tells them they are frowning all the time.  This kind of look would be disastrous for people in sales, or those who have to meet people in the course of their work or daily activities.  A persistent frown on your face tends to make people feel that you are a very unpleasant character.  Friends avoid you.  Sales drop.  Even if you are the CEO of a big company, it is important for you to look pleasant and approachable.

Botox Cosmetic Injection for Frown Lines

So what do you do?

Go to your local esthetic doctor.  This will either be a dermatologist, a plastic surgeon, or a physician trained in the use of, and licenced to use Botox for cosmetic purposes.  He will see you and assess your condition to see if you are a suitable candidate for botox (also commonly known as botax).

Certain major factors are not thought to give one good results for botox cosmetic injection.  AGE is one factor.  If you are above 65 years old, the muscles are lax already and will not respond well to a botox cosmetic injection.  If you have been frowning for a long time, the creases are permanent and will not respond.  Instead, fillers, threadlift or surgery will be recommended.  By and large, however, you will fall into the category of good responders.

The botox cosmetic injection is performed so fast that it is considered a lunchtime procedure.  All one has to do is to take a couple of hours off during lunch, keep your doctor’s appointment, have some local anesthetic applied on to the site of treatment on your face, go through a simple 10minute course of injections, and voila! you’re done.  Now get back to work.  Nobody will notice you have had a course of injections.  The needle marks on the face are so tiny nobody will see them.  Your friends and colleagues will only notice that after 4 days you look so amazingly pleasant they will not hesitate to be around you.  However take note that the effects last only between 4 – 6months,  after which you should go back to your doctor for a repeat round of Botox Cosmetic Injection.

Get a friend to stand in front of you.  Ask him to raise his eyebrows.  The horizontal lines you see on his forehead are commonly called forehead or surprise lines.  These, although you may imagine will only form when you are surprised, are surprisingly (no pun intended) present in a lot of people who are not.  They very often present in slightly older people whom, when age comes, have a problem of droopy eyebrows, and unconsciously raise them in order to see better.  And this action results in a permanently surprised look on the face.  However there is another group of younger persons who, perhaps unconsciously, try to look more alert to their colleagues, or perhaps to increase their field of vision, tend to look very surprised or earnest all the time.  These are the ones who will benefit from botox cosmetic injection (also known as botax )for forehead lines.

Botox Cosmetic Injection for Forehead Lines

Again, it must be stressed that botox treatments come in the form of injections.  Average Asian foreheads will need roughly 12 – 16units of botox to reduce (not eliminate) forehead lines.  The Caucasian forhead needs about one and a half times that due to thicker muscles and broader foreheads, and if the need is there to completely obliterate the forehead lines, one may need to double that dose.

Usually multiple tiny injections are given from one side of the forehead to the other, in three rows, starting upwards from a row about 1/3 of the way between eyebrows and scalp margin, about 6-8 shots into the forehead muscle per row, and 1-2 units per shot. 

Never try this on your own.  We are not responsible for any mistakes that happen, and you need to consult a qualified doctor who is licenced to give Botox cosmetic injection for this.

The effect comes on about 4days after injections, and tends to last about 4-6months.  However sometimes one has to come back for follow up about 1 week after the injections for a top-up, where undertreatment can be corrected with a further botox cosmetic injection.

Facial Wrinkles: frown lines, forehead lines, crow’s feet. 
These were the original intended usage of botox (also commonly referred to as botax), and were discovered quite by accident when the original promoters of botox (Drs. Alistair and Jean Carruthers) noted that while trying to medically correct squints by injecting botox, the patients lost their wrinkles)
Fine lines of the face (microbotox, mesobotox).
Very dilute solutions are injected in small amounts into the dermal layer of the skin, not into muscles.
Bunny lines along bridge of nose.
While this may be cute in some children, it can become an annoying habit if it persists in adulthood.
Reduction of the nasolabial crease.
With age and gravity, the cheeks tend to droop, and this results in the deepening of the crease lines that run from the sides of the nose to the corners of the mouth.  This causes the sufferer to look older.
Elevation of droopy corners of mouth
Again an age-related problem.  A couple of fine botox injections are placed in strategic corners of the mouth and this results in a slight uplift of the corners.
Smoker’s wrinkles of the mouth.
Persistent and chronic smoking causes the muscles around the mouth to over contract, causing deep wrinkles extending outward from the lips.  Some well-placed shots around the mouth cause the wrinkles to lessen.

Popply chin

Nefertiti effect (enhancing of the jaw contour)
Done by a few shots of botox to the playsma muscle in the neck and at the jawline.  This results in the facial muscles pulling the other way, causing the jawline to be more obvious and attractive.
 
Reshaping of the face
Due to chronic chewing, the masseter muscles of the jaw become extra bulky, and this results in the jaw looking rather square.  Injection of botox into the muscles cause the muscles to weaken and thus reduce in size, and the jawline as a result becomes smooth, slopy and pearshaped.

Platysma bands (turkey neck)
Aging causes the bands in the neck to stand out.  Botox will soften these bands so they are less prominent.

Horizontal crease lines on neck

Fine lines on upper chest
Part of the mesobotox procedure.

Eyebrow reshaping.
Becoming a very popular procedure among the young.  As you can see the above procedures are more often done in the above 30’s when gravity and overuse of muscles start exerting their effects.  In this case botox is used to enhance the features of the face rather than correct what are seen as defects.  One can reshape the eyebrows to one’s satisfaction: curved, bowed, straight, slanting, Spock-like, etc.

Muscle shaping (calves)
Some calves are rather bulky especially if viewed from behind.  Well placed injections of botox into the calf muscles cause some of the muscles to reduce in size, resulting in slimmer, more shapely calves.  One side effect of this is some slight weakening of the gait.

Breast uplifting (with the occasional side effect of persistent nipple erection, which may or may not be desirable)
Done by injecting botox into some muscles in the chest wall that drag the breast downwards, resulting in opposing action of some antagonistic muscles to be enhanced.

Reduction of oiliness and sweatiness of face (in mesobotox), oiliness of palms, armpits, soles of feet.
Many a time we shake hands with some sweaty-palmed people.  Not a very pleasant sensation.  Similarly we see giant patches of underarm sweat especially on ladies wearing white shirts.  These can be easily treated nowadays with well placed multiple botox injections in a more superficial level of palms and soles.

Most times the desired cosmetic effect is due to usage of the paralysing/weakening action of botox on certain muscles or muscle groups, balanced by the opposing action of the antagonistic muscle groups.  Sometimes the mechanism of action is not so well known, as in the reduction of sweating and oiliness of face.

Only some of the above uses are approved by the FDA for use in the United States.  This has resulted in other countries being in the forefront of usage of botox injections in the other areas.