Botox® at re*be® of Okoboji in Northwest Iowa

Frequently asked questions about Botox®

• Does injecting Botox® hurt?
• Does injecting Botox® make me look older later?
• Are the Botox® changes permanent?
• How should I care for the area after my Botox® treatment?
• How long does the Botox® treatment take?
• Why do you choose Botox® over other medications that do similar things?
• Is Botox® expensive?
• Botox® is poison, do people die from treatments?
• What else is Botox® used for?
• Do I see results from Botox® injections right away?

Does injecting Botox® hurt?

Yes but not very much usually but it can be briefly uncomfortable for some people. We have several ways to help control the pain. Simply pressing the skin firmly before injecting the tiny needle will often minimize the brief discomfort. We use tiny needles and apply gentile sharp pressure to the injection sites to help minimize the pain you might experience. Botox® is mixed with normal saline to make it match your body tissues closely minimizing the immediate reaction to the injections. Great care is taken to inject the Botox® into the proper depth where your facial muscles sit. Touching the needle to the bone during an injection will be uncomfortable but the chances of this happening are less when you choose a Botox® injection clinic with experience. If you hold still during the injection this too helps to minimize the discomfort. Most people can tolerate the pain and do not benefit from using any local anesthetic. At re*be® we can use a topical anesthetic to prepare your skin for the injections but prefer not to if you don't need it. Cold compress after the injections can be used briefly to reduce your discomfort also if necessary.

Does injecting Botox® make me look older later?

There is no evidence at all of this. If you use Botox® regularly for several years and then stop for several years you should end up looking just like you would have without ever having tried the Botox®. If you maintain the Botox® injections many wrinkles can look like they will have changed permanently and for the better. If you stop and begin using the treated muscles with full strength this benefit will go away.

Are the Botox® changes permanent?

No. The changes will usually last about 4 months but some lingering effects can be seen after that for a while. If the changes were permanent it would not be a good idea to use Botox® at all as your face changes with time and the technique used for injecting the Botox® changes. It is interesting that the Botox® injected is actually gone in less than 10 days. The effects on your muscles linger for quite a bit longer than that. The nerve endings that control your muscles are removed by the Botox® effects and wearing off is actually caused by growing new nerve endings to the muscle. Everybody is different but growing the nerve endings usually takes about 4 months. Most working people who pay for Botox® injections will come back in about 6 months to have the Botox® treatment repeated.

How should I care for the area after my Botox® treatment?

Once treatment is completed you should avoid manipulating the area as to do so will move the Botox® into a new location. If you move the Botox® especially into your eyelid it can cause this to droop for several weeks. The injection sites do not require covering and your makeup can be reapplied as soon as the sites are dry. The 'bumps' in your skin also do not require any treatment as they will generally go down before you get your car started to leave the clinic. We would like you to stay upright for 3-4 hours after Botox® injections as this will minimize the chances of the Botox® moving to an unwanted area. Sunlight does not seem to hurt the Botox® injection sites or the Botox® effect however laser skin treatments can. We recommend you wait at least 4 days and preferably 7-10 days before a laser face treatment. The laser energy can penetrate far enough into your skin to break the Botox® molecule before it has done its job reducing its effectiveness. Keeping the injection sites clean can minimize the low chances of an infection. Generally there are no other special care instructions other than keeping an eye on the injection site and returning to re*be® for any problems.

How long does the Botox® treatment take?

Depending on the number of areas treated most treatments take 5-15 minutes. Talking with the doctor and evaluating other cosmetic or sometimes medical issues can make your appointment last longer.

Why do you choose Botox® over other medications that do similar things?

There are now more choices for muscle relaxation, Botox® from Allergan® Myobloc® or rimabotulinumtoxinB and Dysport® from Medicis® and others. We have much greater experience with Botox® and are very happy with the Allergan® company. Botox® has a long track record and the experience with it has been very positive in this industry. Dysport® is a similar muscular relaxant to Botox®. The dosing of Dysport® is different as it takes more of the Dysport® molecules to give you the same effect as Botox® but what this means is controversial. There is a concern that requiring higher doses of Dysport® may cause your immune system to develop resistance to the effects of both medications. Dysport® is still relatively new to the cosmetic market and if it survives the test of time we may consider using it at re*be® in the future. Myobloc® is used for muscle spasms away from the face. It is not yet being used often at all for cosmetic purposes. Myobloc® may be useful for the rare person who develops immunity to Botox® (causes the Botox® to have no effect).

Is Botox® expensive?

Somewhat expensive but the effects many feel are well worth the cost. We think our prices are comparable or better than others providing similar services. Botox® is sold by the unit. Our current price for one unit of Botox® is $11 and re*be® patrons pay $10. A treatment session for the area between your eyes and the "crow's feet" (corner of eyes) usually takes about 32 units. For men the usual dose is slightly higher because their muscles are thicker. re*be® participates in Allergan®'s Brilliant Distinction program which can provide an at the cash register discount of about 10%.

Botox® is poison, do people die from treatments?

Very unlikely if done properly. There are deaths reported from injecting Botulinum toxin type A however there are extenuating circumstances in most cases. There are people with underlying muscle weakness conditions such as myasthenia gravis or multiple sclerosis who probably should not have Botox®. People who get larger doses for abnormal muscle spasticity have also had problems. To kill someone the size of Dr. Kolegraff would be expected to take about $40,000 worth of Botox®. The usual dose given at re*be® is $300 to $400 and considered well within the safe limits. In ways the safety for dosing Botox® is similar to Aspirin where it has numerous wonderful safe uses at lower doses but is toxic to the point of being deadly at higher doses.

What else is Botox® used for?

Botox® is currently being used for many reasons, some of which are covered by insurance some are not. Some other conditions Botox® is used for are:

• Eyelid spasms
• Headaches
• Stiff muscles
• Excessive sweating (hyperhidrosis) hands|feet|armpits
• Hemorrhoids
• Anal fissures
• Bladder spasms (new FDA approval)
• Low back pain
• Vaginismus
• Drooling

Do I see results from Botox® injections right away?

No. It will take several days to start to see the effects of Botox® after it is injected into your facial muscles. It can take up to 10 days to see the full improvement you will get ultimately. The crow's feet on the corner of your eyes seem to continue to get better for several weeks after the injections. Everybody has a little different experience but these results are typical.