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Botox Frequently Asked Questions

Is Botox® safe for injection?


BOTOX® made by Allergan, Inc., is an incredibly safe product with a 30-year track record. However, as with all drugs, there is the potential for side effects, and this risk can be made worse with improper administration by an inexperienced injectors. Risks of Botox include a drooping eyelid, double vision and drooping mouth.  Even the small doses of BOTOX® used for cosmetic applications can produce significant side effects if improperly injected, or if “bootleg” botulinum toxin A is injected rather than BOTOX® from Allergan as a dishonest way to attempt to reduce costs and maximize profit. Dr Thiagarajah, an oculoplastic surgeon and neuro-ophthalmologist has the training in the facial ad eyelid anatomy and takes the time to reduce the risk of botox complications.


I’ve heard that BOTOX® can be absorbed by my nerves and transported into my brain. Is this true?


Botox has an excellent safety rating and a great track record. The central neuron effect of botox may be partially the reason that it works very well. There are no reported cases of central neuron problems from Botox. Though the medicine does not literally travel to the brain, there is a “learned effect” from the paralysis of the muscles from botox which over time give a great effect. This would analogous to tying your right hand behind your back for three months. After three months you reflexly use your right hand less because your brain has adapted to the fact you could not use it before.


The Botox I had before worked and now it is not working as well. What is up with that?


It is extremely unusual to get botox resistance or immunity at the cosmetic dosage level. Sometimes over time the dosage has to go up. Rarely in some practices, the dosage of botox is reduced at each visit. Dr Thiagarajah does not do this practice. Dr Thiagarajah can evaluate you from a neurological standpoint and cosmetic one to see the underlying cause of the reduced effectiveness of the botox. 


I developed a droopy eyelid after a BOTOX® service in Denver a few years ago. What are my chances of developing another droopy eyelid if Dr Thiagarajah treats me?


A droopy eyelid can occur when BOTOX® drifts deep into the eyelid muscle called the levator palpebrae. This generally is only going to happen if the person injecting the botox places the needle too deep, injects too close to the levator palpebrae muscle or pinches up the eyebrow. As an eyelid surgeon, Dr Thiagarajah has a detailed knowledge of the anatomy around the eyelid and attempts to minimize this risks with his technique.


How much downtime will I need after my BOTOX® treatment?


Most patients may have small bumps where the botox is given for 20 minutes or so immediately after treatment. It is recommended that patients refrain from heavy exercise or alcohol for 24 hours after treatment. Bruising from botox is usually minimal. Usually patients feel they are fine for others to see them within 30 minutes of the injection.


What can I do to minimize the risk of bruising after BOTOX® treatment?


The risk of post-injection bruising can be mitigated by avoiding blood-thinning medications (i.e. Aspirin, ibuprofen, NSAIDS), and to refrain from consuming alcohol for 24 hours after treatment, as these substances tend to promote bruising. Some patients take arnica montana and bromelain orally before treatment. Many patients feel the risk of bruising is so low after botox and any pretreatment with herbal medicine is unnecessary.




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