Dr Penny Lim - North Sydney & North Shore Dermatologist

Botox Injection Introduction

Botulinum toxin or Botox is a muscle relaxant commonly used to treat facial lines and wrinkles. The effect lasts for 3-6 months. Therefore you would need repeat injections in 6 months to maintain the effect. Botox effect is not immediate and not permanent. It takes 2-7 days to start working and up to 2 weeks to see the maximum effect and it is a time when you see your doctor.

Depending on the area treated, the dose used and how well each individual responds to the injections, each treatment usually lasts between 3 to 4 months. You will normally expect to require maintenance injections approximately 2-3 times per year to retain the required effect and over time you may be able to reduce the number of treatments as the muscles retrain and cease contracting in a previous manner.

What happens during the treatment

You will discuss your expectations of the outcome of treatment and whether this is the best treatment for you. Our dermatologist will take a medical history to make sure Botulinum toxin is suitable for you.

Before and after photographs may be taken with your face relaxed, smiling, and frowning to show how successful your treatment has been.

Prior to injection, you will be asked to sign a consent form.

What should I expect after the treatment?

Successful therapy is indicated by muscle weakness that begins between 48 and 72 hours after treatment, and peaking at 7 to 14 days.

Minor reactions may include brief pain or a mild headache. The affected area may look a little red for up to 6 hours after treatment.

Bruising may occur

Mild headache

Redness at the site of injection

What are the contraindications for Botox injection treatment?

Botox injections are not recommended if you are pregnant and/or breast feeding or have a neuromuscular condition such as Multiple Sclerosis, Myasthenia Gravis, and Bell’s Palsy.

If you are taking medications such as penicillamine, Aminoglyocide antibiotics, and calcium blockers then you should not have Botulinum toxin. Please discuss with our dermatologists any medications that you take and any allergies that you have.

If you have an Infection overlying the injection site

Blood thinners — including aspirin, warfarin, and dabigatran — increase the risk of significant bruising from injection sites

Side effects and managements

Botox is a very safe treatment with no long term risks being reported.

The most common adverse effects of botulinum-A are related to the injection, rather than to the botulinum toxin itself. These adverse effects include pain, bruising, swelling, and redness at the injection site.

  • For the pain during the injection anaesthetic creams will apply half an hour prior to inspection and it helps significantly to make the pain tolerable.
  • Bruise last 1-3 weeks. Ensure that you don’t have important events after inspection.
  • Headache last 1-2 days. Take 2 Panadol if you experience that and contact us if it doesn’t get better.
  • Eyelids dropping/ eyebrow drop is a rare side effect. It is not common and if it happens it is not permanent. It last for 3-6 weeks before get back to normal.
  • Mild swelling at the injection site
  • Infection at the injection site, please contact our dermatologist immediately
  • Under correction (not enough effect) or overcorrection (too much effect)

Uncommon and rare effects include

  • Puffy eyes
  • Paralysis of a nearby muscle leading to a droopy eyelid, double vision, inability to close eye, difficulty whistling or drinking from a straw
  • Immediate hypersensitivity reactions including anaphylaxis
  • Permanent loss of muscle tone with repeated injection

What should I do after Botox injection?

Ice pack if bruised for the next 48 hours

Keep head upright for 3 hours

Take 2 Panadol if you experienced a headache Not manipulating the area for the next 3 days (avoid facial massage)

Avoid aspirin and vitamin E and please let us know if you are going to start any medication in the following two weeks