Cosmetic denervation is a procedure used to improve the appearance of worry lines, frown lines, crow's feet, laugh lines and so-called dynamic wrinkles. Dynamic wrinkles occur when we smile, laugh or frown, and the delicate muscles underlying aging skin contract. In cosmetic denervation, botulinum toxin (BOTOX®) is injected into these muscles. BOTOX® works by weakening these tiny facial muscles precisely. After treatment, the overlying skin remains smooth and unwrinkled while untreated facial muscles contract normally, allowing normal facial expression to be unaffected.

The diagram below demonstrates how BOTOX® works to prevent frown lines.

Before BOTOX® Injection
(transmission occurs)

After BOTOX® Injection
(no transmission)

BOTOX® Injections are $12 per unit (minimum 10 units/treatment)

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BOTOX® blocks neuromuscular transmission through a step process. BOTOX® works to block the release of acetylcholine and, as a result, the muscle doesn't receive the message to contract.

Our doctors will determine exactly where to administer several tiny injections to achieve the best results. No anesthesia is required, although some doctors may choose to numb the area with a cold pack or anesthetic cream prior to injecting. The entire procedure takes approximately 10 minutes. Discomfort is minimal and brief—most patients compare the sensation to a bug bite. It is unlikely you will develop significant side effects, although some people may develop slight temporary bruising at the injection site, which can easily be covered by makeup. You may resume normal activity immediately. Within days, you'll see a marked improvement which may continue to improve for as long as a week and should last up to four months.

Though cosmetic denervation is a relatively new treatment for dynamic wrinkles, BOTOX® injections have been safely and effectively used for over a decade for many neurologic and ophthalmologic disorders. 

Cosmetic denervation is a simple and safe procedure. A very small amount of BOTOX® is injected with a very fine needle into several locations in the face. Because the needle is so fine and only a small amount of liquid is used, the pain associated with the injections is minimal. Many people say the sensation is similar to a fly or an ant bite. No sedation or local anesthetic is required, and you will be able to drive and engage in all of your usual daily activities immediately after your injections. You may have slight temporary bruising of the skin at your injections sites, but otherwise, there will be no visible signs of your treatment.

Bruising is relatively uncommon, but if it occurs, is usually very mild. Because the medication can sometimes migrate, this may cause temporary weakness of nearby muscles; rarely there can be drooping of an eyelid or asymmetry of facial expression. The risk of any side effects depends on the muscles injected. Because BOTOX® effects are completely reversible, any side effects are temporary, lasting only a few weeks.

If dynamic wrinkles are making you look older than you should, cosmetic denervation can smooth these out and give you a more youthful appearance. However, this procedure will not improve the more common "static" wrinkles that are unrelated to facial muscle contraction. You should also understand that cosmetic denervation will not improve loose or sagging skin and does not serve the same function as a face-lift.

BOTOX® Cosmetic relaxes the overactive muscles whose repeated contractions cause the lines between your brows to form. So you can frown, smile, or look surprised—without the furrows, creases, and wrinkles. The most common side effects are headache, respiratory infection, flu syndrome, temporary eyelid droop, and nausea. BOTOX® Cosmetic should not be used if there is an infection at the injection site.

Unfortunately, cosmetic denervation is not a permanent solution to the problem of dynamic wrinkles. Because the injections only last about four to six months, treatments typically should be scheduled two to three times a year.

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