Close-up female face with a big wrinkles on her forehead - isolated on white

  • Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months
  • Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, trouble swallowing

BOTOX® Cosmetic dosing Units are not the same as, or comparable to, any other botulinum toxin product.

There has not been a confirmed serious case of spread of toxin effect when BOTOX® Cosmetic has been used at the recommended dose to treat frown lines, crow’s feet lines, or both at the same time.

Frequently Asked Questions

Q. What is Botox® Cosmetic?

A.  Botox is a toxin produced by a bacteria called Botulinum. Botox blocks the chemicals that cause muscles to contract, thereby relaxing them. Botox has been used for over 15 years to treat a variety of medical conditions. The same product with dosing specific to cosmetic indications was approved in 2002 as Botox®Cosmetic. The wrinkles caused by overactive facial muscles and repetitive facial expressions are called dynamic wrinkles. They include frown lines, crow’s feet, forehead wrinkles and lip wrinkles. Botox can dramatically improve and often eliminate those wrinkles.

The lines and creases that appear in the face result for repetitive muscle movement and the passage of time. For instance, the frown lines between the brows are created by two specific muscles, when they contract, the brows are drawn together. As skin becomes less elastic overtime, repeated frowning will result in moderate to severe lines between the brows. Injecting Botox into those muscles will relax the muscles with improvement or elimination of the frown lines.

Q. Do Botox® Cosmetic injections hurt?

A. At Vista Family Health Center we use the smallest available needle in the market called the “Gucci Needles.” Most people experience no pain whatsoever; and some may experience brief mild discomfort as they are being injected. If needed, the areas to be injected are numbed with ice or a local anesthetic cream.

Following injection recovery is immediate, and you can return to work immediately.

Q. How long does Botox® Cosmetic last?

A. You will begin to see changes in your wrinkles within 24 hours and continue to see improvement for the next 5 days. Visible results can last up to 4 months. After that, you may be ready to return for a follow-up treatment. Your own results may vary (the range varies from 3 to 6 months). The effects of Botox are not permanent, and are only effective for dynamic wrinkles. [Return to Top]

Q. Is Botox® Cosmetic safe?

A. Botox has been used safely for over 20 years. It has an excellent safety record and a low incidence of side effects. A few patients may experience mild bruising that disappears within a few days. The most common side effects following injection of Botox® Cosmetic include headache, respiratory infection, Flu syndrome, temporary eyelid droop and nausea. [Return to Top]

Q. How much does Botox® Cosmetic injections cost?

A. Most doctors charge by area of injection without disclosing to the patient how many units of Botox®Cosmetic will be injected in each area. You must be aware that dilution matters, ask the doctor how much saline solution he or she uses to dilute the vial of Botox® Cosmetic and how many units will be injected in each area. Each vial contains 100 units and should be diluted with no more than 4 cc of saline. If the doctor dilutes the Botox with more then 4 cc of saline, then you will be getting a smaller dose of Botox® Cosmetic which will be less effective and shorter lasting.

When comparing Botox® Cosmetic injection prices among different offices, be sure to ask each office how much they dilute the pure Botox. Be aware that a physician who offers Botox injections at very low prices may be suspect for over diluting the Botox. Highly diluted Botox® will usually give a short and less than optional result – NOT what you want!

You are better off asking the doctor to charge you the Botox® Cosmetic injections by the unit, rather than by area of injection. Vista Family Health Center charges Botox® Cosmetic injections by the unit. [Return to Top]

Q. How do I know if Botox® Cosmetic injections are right for me?

A. If you are between the ages of 18 and 75 you may be a candidate for Botox® Cosmetic. You should not be treated with Botox® Cosmetic if you have an infection at the proposed injection site. Patients with certain neurological disorders such as ALS, myasthenia gravis, or LAMBERT-EATON syndrome may be at an increased risk of serious side effects. [Return to Top]

Q. What cosmetic conditions can be treated with Botox at the Vista Family Health Center?

A. Although many physicians offer Botox to treat frown lines and forehead creases, few have the experience and artistic skills to correct dynamic wrinkles in other areas of the face and body. Provider at Vista Family Health Center have large experience and excellent results with the use of Botox for the correction of the conditions listed below:


  • Frown lines
  • Crows feet
  • Forehead creases
  • Brow shaping (Botox injections can be used to alter the shape of the eyebrows to create a more aesthetically pleasing appearance)
  • Brow elevation (lift)
  • Correction of eyebrow asymmetry (to elevate the lower eyebrow to the same level as the higher eyebrow)
  • Elevation of the corners of the mouth
  • Upper/lower lip creases
  • Marionette lines, “drool grooves”
  • Lip lengthening to correct gummy smile
  • Chin softening (peach pit chin and excessive cleft)
  • To improve the appearance of new and old facial scars.

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Q. What is the difference between Botox® Cosmetic and facial fillers?

A. Botox® Cosmetic temporarily corrects or eliminates the dynamic wrinkles due to overactive facial muscles by blocking the chemicals that cause the facial muscles to contract resulting in muscle relaxation. Botox is only effective for the correction of dynamic wrinkles. Skin sagging and wrinkles of the face start to develop as we get older, they are the result of thinned and broken collagen. These types of wrinkles are different from the dynamic wrinkles and require the use of fillers to fill out and plump up the depressed areas. The intradermal injection of the filler mask the wrinkle by adding volume. There are several available fillers, they include Restylane, Captique, Collagen, Sculptra, Cosmopast, Cosmoderm, Hylaform and Radiesse.

Because a significant number of women have a combination of both types of wrinkles, Botox® Cosmetic and facial fillers are frequently used in combination, complementing each other. [Return to Top]

Q. Can Botox be used to treat Hyperhidrosis (excessive sweating)?

A. Botox injections have proven to be very useful in diminishing excessive sweating (hyperhidrosis). Hyperhidrosis is a common and extremely distressing condition with a prevalence of 2.8% of the population. For those affected, the condition is debilitating with serious impairment in activities of daily living, social interaction, and occupational activities. It is divided into primary or idiopathic hyperhidrosis which is usually focal and limited to axilla, palms, soles and face, and secondary hyperhidrosis which can be local or generalized affecting the entire body. Secondary hyperhidrosis is due to a variety of causes including underlying medical conditions, drugs, or exaggerated physiological responses to heat, humidity, or exercise.

The most common type is primary idiopathic hyperhidrosis; however, it is critical to be aware of the secondary causes when evaluating a patient with excessive sweating.

Primary hyperhidrosis is defined as focal visible excessive sweating or at least 6 months duration without apparent cause and associated with at least two of the following characteristics:

  • Bilateral and relatively symmetrical
  • Impairs daily activities
  • Frequency of at least one episode per week
  • Age of onset less than 25 years
  • Positive family history
  • Cessation of focal sweating during sleep

Topical treatment: It works only in mild cases of focal hyperhidrosis, aluminum chloride hexahydrate is the most effective topical agent.

Oral treatment: Anticholinergic drugs are the most effective oral treatment. Because the side effects associated with their use (dry mouth, blurred vision, constipation, urinary retention, and palpitations) they are generally not tolerable by most patients.

Surgical treatment: They include curettage or liposuction to remove glandular sweat tissue, excision of the axillary vault to remove sweat glands, and sympathectomy. Surgical treatments are generally reserved for patients who fail to respond to other noninvasive modalities.

Botox Treatment of Hyperhidrosis: Our staff’s experience treating patients with hyperhidrosis using Botox have proven to be well tolerated, safe, and effective. It offers a viable minimally invasive alternative for the treatment of hyperhidrosis.
The injections of Botox in the axilla create a localized, prolonged, yet reversible decrease in chemical transmission to the sweat glands that results in a diminished sweat production.

Vista Family Health Center offers the Botox injection alternative to patients who have failed to respond to topical therapy. The effect of Botox is 6-7 months. Dosages for injection range from 50/200 units/axilla. The usual starting dose is 50 units/axilla. Side effects include rare bruising and minimal discomfort.

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