Who is the ideal candidate for BOTOX?

The ideal candidate for Botox is a woman with wrinkles in her upper face which are caused by muscle action and not loose skin. For example, some women get lines running across the brow because they have excess skin on the upper lids which they are trying to get off the lashes by raising the brow. In such a case it is better to remove the excess skin surgically which solves the problem for years than to try and treat the wrinkles with Botox which will only last a few months. Similarly, some women have been frowning so long the lines are actually etched into the skin. Such lines are difficult to erase with Botox. They may lessen, but I warn such patients they may need fillers as well as the Botox. Also the candidate should not have a personal or family history of any neurological disorders such as myasthenia gravis, ALS or acetylcholine esterase inhibitor deficiency. Such individuals could be unusually sensitive to Botox.

How does BOTOX work?

Botox works by permanently binding with the neuromuscular plate.This is where the nerve that tells the muscle to contract joins the muscle. By binding with this area, it blocks the action of the nerve. These plates are regenerated by the body every four months so that is why the effect of the toxin wears off. Thus it paralyzes the muscle during that time, causing the relaxation of the wrinkle. That was the mechanism of action of the botulinum poison; if you ate a bad can of beans, the poison would paralyze the muscles of breathing, causing death by suffocation. Incidentally, the germ that produces the toxin lives in conditions with low oxygen, so that is why improperly prepared canned goods could cause botulinism. Another source of problem many moms don't think about is honey. Honey is dangerous for children under a year old. Their guts cannot properly process the bacterium and they can develop botulinism from eating honey!