Botox comes as a sterile, vacuum-dried form of purified botulinum toxin, type A, produced from a culture of Clostridium botulinum. Botox causes a temporary localized muscle paralysis by chemical denervation.

Indications

Benign essential blepharospasm (FDA approved)

Hemifacial spasm (FDA approved)

Cosmetically objectionable glabellar lines in patients younger than 65 years (FDA approved)

Cosmetically objectionable forehead wrinkles or laugh lines (also called crow’s feet) (not FDA approved)

Many other functional and cosmetic applications are in clinical use, though not FDA approved

Contraindications

Allergy to human albumen; pregnancy; preexisting neuromuscular disease, current use of aminoglycosides

Preoperative Procedure

1. Discuss with patient the indications and use of Botox. A patient’s response to specific doses is highly variable. Several treatments may be required before determining optimum dosing and toxin placement.

2. Botox is not currently FDA approved for cosmetic purposes, except for treatment of glabellar lines.

Instrumentation

Botox (botulinum toxin, type A) purified neurotoxin complex.