The wrinkles caused by the everyday smile, laughing and frowning are the result of muscular contraction. The facial muscles have threads of attach- ments to the skin. When the muscles contract, the skin buckles resulting in the mimetic wrinkles. The more you show your emotions, the deeper and more wrinkled you appear. We have been relatively unsuccessful treating these deeper mimetic wrinkles until now. The most recent advance is a procedure known as cosmetic denervation using BOTOX® Cosmetic. This is used to improve and soften the appearance of crow's feet, frown lines, laugh lines, and other dynamic wrinkles. 

BOTOX® Cosmetic works by blocking the neural impulses to fine muscles which pull the skin; this "denervation" relaxes the muscles and prevents contraction. While the remaining larger facial musculature provides facial expression, the overlying skin is smoother in appearance and less wrinkled. BOTOX® Cosmetic has been used safely and successfully for many years in treating voice disorders, ophthalmologic and neurological disorders. Now it is rapidly becoming a popular treatment to erase some of the signs of aging. Frequently, it is combined with other simple procedures such as laser resurfacing or eyelid procedures to provide optimal results. 

Treatment With BOTOX® Cosmetic

The procedure is simple. A micro-needle with an exact amount of BOTOX® Cosmetic is precisely injected into several locations of the face and then massaged into place. The discomfort is minimal, comparable to a mosquito bite. Because no sedation or anesthesia is necessary, you may resume your daily activities and drive home or back to the office. The most common side effect is minor, temporary bruising easily covered with makeup. Occasionally, weakness of nearby muscles may occur temporarily. 

Following this treatment, dynamic mimetic wrinkles can be smoothed and softened in appearance. This provides a more youthful appearance, however, does not improve wrinkles and actinic changes caused by aging, sun damage, and cigarette smoking since they are not related to muscular motion. Furthermore, bagging and sagging skin usually treated with eyelid, eyebrow, or facelift surgery are not improved with cosmetic denervation. 

At this point, BOTOX® Cosmetic treatments provide a temporary treatment for the mimetic muscles, lasting from four to twelve months. Initially, you will need treatments two to three times a year. Fortunately, early studies conclude that the effective duration of the treatments increases with time therefore requiring less frequent treatments in the future. 

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