Dynamic wrinkles are caused by contractions of the delicate underlying facial muscles every time you smile, laugh or frown. The more emotion you show, the deeper these wrinkles and lines tend to be. While you may have earned every one of your worry lines, you don't have to show them anymore. Now, thanks to a new approved drug, dynamic lines can be dramatically softened. The procedure known as cosmetic denervation uses Botox injections to improve the appearance of worry lines, frown lines, crow's feet and other dynamic wrinkles.

HOW DOES BOTOX WORK?
Botox blocks impulses from the nerve to the tiny facial muscles that are related to expression lines. Botox relaxes the muscles so they do not contract. After treatment, the overlying skin remains smooth and unwrinkled while the untreated facial muscles contract, allowing normal facial expression to be unaffected. The Botox takes effect in three to four days. Gradually over three to five months the Botox effect will fade, and the muscle action will return. When the frown line starts to reappear, a simple repeat treatment is all that is necessary to maintain the desired result.

ARE BOTOX TREATMENTS SAFE?
Botox injections have been used safely and effectively for over ten years to treat many ophthalmological and neurological disorders. Each year thousands of patients receive Botox treatments for a variety of conditions and it is quickly becoming a popular treatment for reversing the visible signs of aging.

WHAT IS THE TREATMENT LIKE?
Cosmetic denervation with Botox is a simple and safe procedure. Using a tiny micro needle, a very small amount of Botox is injected, very precisely, into several locations on the face. Because the needle is so small and only a small amount of liquid is used, the pain associated with the injections is minimal. Most patients compare the sensation to a bug bite. No sedation or local anaesthetic is required, and you can resume normal activities immediately. You can even drive yourself home or back to office. Some patients experience a slight temporary bruising at the injection site. This can be covered with make-up.

HOW HAS BOTOX BEEN TESTED?
Botox is the trade name of Botulinum Toxin Type A, a purified toxin produced by the bacterium Clostridium botulinum. In large amounts, this toxin blocks the nerve impulses to muscles, causing a form of paralysis. By using extremely small doses of Botox, injected directly into a specific muscle, only the action of that muscle will be paralysed. For example, the frown line between the eyebrows is caused by the action of a muscle called the corrugator. Once the muscle is paralysed, it cannot contract, and the frown line gradually fades away. Botox has been used since 1980 for the treatment of strabismus (lazy eye), and blepharospasm (uncontrolled eye blinking). The use of Botox for forehead wrinkles was pioneered in 1989 by Dr. Carruthers an Ophthalmologist of Vancouver. A major study of this technique was completed in 1995.

WHAT RESULTS CAN I EXPECT?
If dynamic wrinkles make you look older than you are, then cosmetic denervation can smooth these out and give you a more youthful and pleasant appearance. However, this procedure cannot improve wrinkles due to aging and sun-damaged skin since they are unrelated to facial muscle contractions. Botox injections will not improve sagging skin or replace the need for a facelift or brow lift.

WHAT ARE THE LIMITATIONS OF BOTOX INJECTIONS?
Unfortunately, Botox injections are a temporary solution for the treatment of dynamic wrinkles. The effects of the injections last from four to six months. You will need to have injections about two to three times a year. The early clinical studies indicate that the duration of treatment benefits is increased over time so that you should require injections less frequently in future. Also, the duration of effect varies from patient to patient and may be less effective in those over 65 years of age.