Botox for Wrinkles, Sweating, Migraine and Other 

Botox Toronto/Botox Mississauga 

Botox Cosmetic 

Botox is an extremely safe and effective treatment for lines and wrinkles, particularly around the eyes and forehead. Only medical personnel with a detailed knowledge of muscular anatomy, and proper training are qualified to inject Botox. Dr. Weinberg has almost a decade of experience injecting Botox Cosmetic. He is endorsed by Allergan, the manufacturers of Botox Cosmetic, as one of their most experienced injectors and was invited to demonstrate his expertise on television for Beauty By Design TV, and with Mike Wallace on his medical show. At Mississauga Cosmetic Surgery Clinic over 2000 patients have been treated with Botox Cosmetic, with excellent results.

What is Botox?

Botox Cosmetic is a naturally derived protein that is purified in a laboratory, and works by preventing muscle contractions. Botox does this by blocking the action of a chemical called Acetylcholine, which is a neurotransmitter that is released by nerves to cause muscles to contract. Botox is metabolized and completely eliminated by the body, and after approximately 3 months the communication between the nerve and muscle is restored. Botox has been used for medical purposes for over 20 years. It was first used by opthalmologists and neurologist to treat a variety of conditions, and was safely used at high doses, even in children, before it was discovered that very small doses could be used to eliminate fine lines and wrinkles. Botox cosmetic was approved for use in treating wrinkles, and for treatment of excessive sweating by Health Canada in 2001. It continues to be used for neurologic conditions, like hemifacial spasm and dystonia, and is also used routinely for other indications, such as in the treatment of migraine and chronic daily headache.

Use of Botox for Wrinkles and Cosmetics

Gabellar Lines = Frown lines above the nose, between the brows
Crows Feet = lines around the eyes
Forehead Lines
Bunny Lines= lines on either side of the nose, typically seen on smiling
Brow Lift
Smokers Lines = lines above the lips
Gummy Smile = visibility of the gums seen when smiling
Neck bands = visible bands of muscle in the neck

Botox is most often used to treat frown lines (so called glabellar lines), crows feet, and wrinkles in the forehead. Glabellar lines not only age one’s face, but tend to give people the appearance of a worried or unhappy mood. In addition to achieving a more youthful appearance, Botox in theses areas often gives people a more pleasant, less “grouchy” facial expression. Small amounts of Botox at the brow can also achieve a pleasant “brow lift”. It is also used to treat fine lines above the lip (so called “smokers lines”), and bands in the neck. Other uses include the elimination of fine lines that appear on either side of the nose during smiling. The appearance of one’s smile can also be improved by treating muscles that tend to pull the lips up too much, revealing a lot of the gumline. As we age repetitive contaction of muscle that tend to pull the corners of the mouth down can give a sagging appearance, Botox can be injected into these muscles (depressor anguli orus) to counteract this.

The treatment typically involves 3 to 12 injections, depending on how many areas are treated. The needle used is very small, and the injections are so brief that most patients experience virtually no discomfort. The full benfits of treatment are seen within a few days, to up to 2 weeks after treatment. The effects of Botox typically last 3 to 4 months.

Because the blockade of acetylcholine neuromuscular transmision is completely reversible, there are no long lasting side effects of Botox. However, with repeat injection, the benefits of Botox can be cumulative and more long lasting. Lines and wrinkles form over time because of repetitive folding of overlying skin by contractions of underlying muscles. By preventing repetitive contracions, Botox Cosmetic can actually prevent the formation of new wrinkles.That is why some patients in their 20s opt for Botox injection, to help preserve their complexion and prevent signs of aging before they occur.

Botox "Facelift" 

A very new technique using Botox "intradermally" has been developed recently. In this technique Botox Cosmetic is injected very superficially in numerous locations within the skin, not the muscle, in very tiny dilute amounts. This has been shown to improve skin quality, reducing very fine lines and improving skin texture, giving it a tauter, more shiny appearance, and providing subtle "lift" to the structures of the face. The results of this technique are subtle but pleasing, and best results are often seen when both intramuscular and intradermal injection are done in combination . 

Immediately after injection, there may be minor redness. This can easily be concealed with makeup and fades quickly. One can return to normal activities including work, or sports, immediately. Patients are recommended not to lie down for 4 hours, and not  to rub the area around the injection site.

Botox for Excessive Sweating

Hyperhydrosis affecting underarms, hands and feet can also be successfully treated with Botox injections. Botox works by interrupting the action of nerves on sweat glands. About 80% of people with Hyperhydrosis will gain substantial improvement with Botox.  Most cases of excessive sweating are benign, but occasionally people may have an underlying medical cause. Therefore it is best to be evaluated in a clinic such as Mississauga Cosmetic Surgery Clinic, with extensive experience in the evaluation and treatment of hyperhydrosis. Treatment involves a number  of small injections into the affected area. It may take up to 2 weeks to see the full benefits. Reduction in sweating is typically sustained for 6 months, and often longer. Many private Health Insurance plans cover the cost of Botox for hyperhydrosis. MCSC participates in the Botox Access Programme, a programme run by Allergan, the makers of Botox, to help individuals obtain coverage from their insurer.

Botox For Headache

The usefulness of Botox in treating migraine, tension headaches and chronic daily headache was discovered by happenstance, when patients who had Botox injections for wrinkles reported improvement in their headaches. The exact mechanism by which Botox prevents headache is unknown, but it is thought to inhibit the release of chemicals involved in pain transmission. A well designed scientific study involving 123 migraine patients demonstrated a significant improvement in the frequency and severity of migraines and reduction in use of other migraine medications, in one  group of patients, 2 and 3 months after receiving 25 units of Botox. Other studies have also shown benefit, and some have suggested multiple treatments with Botox enhances the benefit.

The use of Botox to prevent headache is an “off label” use, meaning that Botox has not been explicitly  approved for this use by health Canada. However, based on the outcomes of sound scientific studies, Botox has become a standard treatment in virtually all headache clinics. Techniques for Botox injection for headache is somewhat different than for wrinkles, and migraine specialists have tended to use one of 3 recognized protocols for treating headaches. Most headaches are benign in nature, but occasionally headaches are due to serious underlying medical conditions. It is therefore recommended that headache patients be assessed by a neurologist. Fortunately at MCSC we have a fully qualified neurologist on staff, Dr. Laura Schiffer,  who has extensive experience in the evaluation, diagnosis and in all treatment modalities for headache, including injection of Botox Cosmetic.

Many private Health Insurance plans routinely cover the cost of Botox Cosmetic when it is used for headache. However they will often require a letter from a neurologist to do so.

Other Uses of Botox

Botox Cosmetic remains an excellent treatment for a variety of other neurologic conditions in which certain muscle groups are overactive, including two conditions that respond particularly well to Botox; hemifacial spasm, and blepharospasm. At MCSC our resident neurologist, Dr. Laura Schiffer, is ideally suited to help treat these problems.

Who Shouldn’t Have Botox

Botox should not be used in the following people; Pregnant women, nursing women, people with neuromuscular diseases like Myasthenia Gravis or Eaton Lambert Syndrome, people with an allergy to egg products, or hypersensitivity to any of the components of Botox Cosmetic.

Side Effects of Botox Cosmetic

Botox Cosmetic is a very safe medication that has been used for over 20 years in all age groups from infants to the elderly at doses that far exceed the doses typically used for wrinkles, hyperhydrosis or headache. Mild swelling or bruising can follow Botox injection. Rarely Patients receiving Botox in the forehead or around the eye can have transient drooping of the eyelid or brow. Occasionally headache or flu-like symptoms can occur shortly after injection. People receiving Botox in the hands for hyperhydrosis may experience transient mild weakness of the hands affecting fine motor activities. People receiving Botox injections can develope antibodies to Botox, resulting in reduced response to subsequent injection. This is quite rare with the small doses typically used to treat the above conditions.

Occassional media reports of more significant systemic side effects with Botox have invariably been due to injection by unqualified inividuals without proper medical credentials and training, usually with other forms of Botulinum Toxin that are chemically different from Botox Cosmetic.

For the convenience of our patients we operate a drop in Botox clinic on Saturdays.