Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received BOTOX injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of BOTOX to the site of injection and/or adjacent structures. In several of the cases, patients had pre-existing dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions a ssociated with the unapproved uses of BOTOX. The safety and effectiveness of BOTOX for unapproved uses have not been established.
The potency Units of BOTOX (onabotulinumtoxinA) for injection are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of BOTOX cannot be compared to nor converted into units of any other botulinum toxin products assessed with any other specific assay method [see WARNINGS AND PRECAUTIONS and DESCRIPTION] .

Although one cannot predict exactly who will respond, I find that those patients who are going to respond will note some improvement in headaches following the first set of injections. Repeat injection sets can be performed on the same patient no sooner than every 3 months, as long as a benefit is seen. Most insurers require that you document at least a 50% improvement in the chronic migraine frequency and/or severity for continued coverage. I usually recommend that my migraine patients have a second set of injections before deciding that this treatment modality is of no benefit to them.
The idea of a needle going toward your forehead, in between your eyes, or at your eyebrows might be a little daunting, but rest assured, not only is Botox FDA-approved, but it’s a very common (and highly-requested) procedure. It’s commonly used for cosmetic reasons, but it also helps alleviate a slew of other health concerns.”Botox was first approved by the FDA in 1989 to treat blepharospasm of the eyelid, and now can treat hundreds of medical conditions, such as hyperhidrosis (excessive sweating) or chronic migraines,” dermatologist Jill S. Waibel, MD. She also notes that it was only approved for cosmetic purposes in 2002. “Since then, millions of people have had Botox done safely and effectively. It is important to remember that Botox is safest when used by a board certified dermatologist or a plastic surgeon.”
If you find that your Botox wears off really fast, speak to the person who gave you the injections to find out why (i.e. if the Botox was too diluted, not enough was injected, the Botox was old, your anatomy requires a different technique, you might be resistant to Botox, etc). A reputable doctor will work with you to figure out how to make the Botox treatments worth your time and money. Keep in mind that for some people, Botox takes time to kick in - approximately 1-2 days to be noticeable and 1-2 weeks to peak.
The efficacy and safety of BOTOX for the treatment of lower limb spasticity was evaluated in Study 6, a randomized, multi-center, double-blind, placebo-controlled study. Study 6 included 468 post-stroke patients (233 BOTOX and 235 placebo) with ankle spasticity (modified Ashworth Scale ankle score of at least 3) who were at least 3 months post-stroke. A total dose of 300 Units of BOTOX or placebo were injected intramuscularly and divided between the gastrocnemius, soleus, and tibialis posterior, with optional injection into the flexor hallucis longus, flexor digitorum longus, flexor digitorum brevis, extensor hallucis, and rectus femoris (see Table 33) with up to an additional 100 Units (400 Units total dose). The use of electromyographic guidance or nerve stimulation was required to assist in proper muscle localization for injections. Patients were followed for 12 weeks.
Tell your doctor about all your medical conditions, including if you: have or have had bleeding problems; have plans to have surgery; had surgery on your face; weakness of forehead muscles; trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® can harm your unborn baby); are breastfeeding or plan to (it is not known if BOTOX® passes into breast milk).

Botox Cosmetic is FDA-approved and injections are relatively safe when performed by an experienced injector. It has proven to be a successful and valuable therapeutic protein when dosage, frequency of treatment & variety of treated clinical conditions are considered. The best way to ensure you receive the results you are looking for is to only receive injections from a highly experienced provider, such as the medical and nursing professionals at Ideal Image.

If you have eyelid drooping after a Botox procedure, it is a good idea to let the cosmetic surgeon know because there is a medicine available to help this condition. Any other difficulties, such as difficulty breathing or rashes, should be reported to the surgeon immediately. Bruises are generally gone within one to two weeks, there are other medications available for the treatment of these, such as vitamin K topical treatments (Dr. Holmquist Healthcare CytoActive Post-Procedural Bruise Relief, Revision Skincare Vitamin K Serum, Clinicians Complex Bruise Cream, Glymed Plus Arnica+ Healing Cream).
Preventative Botox has been getting lots of buzz. “It can potentially have a preventive effect on dynamic wrinkles, which are caused by underlying muscle movement,” Shah explains. “That being said, muscle movement is only one factor that contributes to the development of wrinkles, so Botox may not be completely preventive.” (Some other wrinkle causes: sun exposure, smoking, and diet.)

There are several medically related BOTOX ® treatments that are usually covered by insurance, including treatment for blepharospasm (uncontrollable eye twitching), excessive sweating, constant pain, and others. Insurance coverage for cosmetic uses of BOTOX® injections is much less common, but you should consult your insurance provider to find out if you have coverage for BOTOX® treatment. Also, Allergan, the maker of BOTOX ®, provides a Reimbursement Hotline at 1-800-530-6680. An Allergan representative can help you determine whether your procedure is covered by insurance.
Jump up ^ van Ermengem E (1979). "Classics in infectious diseases. A new anaerobic bacillus and its relation to botulism. E. van Ermengem. Originally published as "Ueber einen neuen anaëroben Bacillus und seine Beziehungen zum Botulismus" in Zeitschrift für Hygiene und Infektionskrankheiten 26: 1–56, 1897". Reviews of Infectious Diseases (in German). 1 (4): 701–19. PMID 399378. Original doi:10.1007/BF02220526
Botox is a brand name of a toxin produced by the bacterium Clostridium botulinum. There are other brand names for botulinum, such as Xeomin. In large amounts, this toxin can cause botulism, which you probably associate with food poisoning. Despite the fact that one of the most serious complications of botulism is paralysis, scientists have discovered a way to use it to human advantage. Small, diluted amounts can be directly injected into specific muscles causing controlled weakening of the muscles.
Remember that the skill of the injector is extremely important when considering Botox injections. Because Botox can have some very obvious and embarrassing side effects like drooping eyelids, blurry vision, and excessive bruising around the injection site, it's important to consult with an experienced injector. Unlike dermal fillers which can be melted away with a follow-up injection of hyaluronidase, there's not much you can do about a bad Botox experience other than wait it out.
Tell your doctor about all your medical conditions, including if you: have or have had bleeding problems; have plans to have surgery; had surgery on your face; weakness of forehead muscles; trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® can harm your unborn baby); are breastfeeding or plan to (it is not known if BOTOX® passes into breast milk).
Botox is so commonplace these days that you can get it done at some gyms and spas, but in these cases, you never know what you’re getting, how old the product is, with what it's mixed, and whether the injector knows what he or she is doing. Dr. Matarasso suggests only getting it done by what he calls the “core four”: a board-certified physician who is either a dermatologist, a plastic surgeon, an ear-nose-and-throat doctor, or an ophthalmologist.
The initial listed doses of the reconstituted BOTOX [see Preparation And Dilution Technique] typically create paralysis of the injected muscles beginning one to two days after injection and increasing in intensity during the first week. The paralysis lasts for 2-6 weeks and gradually resolves over a similar time period. Overcorrections lasting over six months have been rare. About one half of patients will require subsequent doses because of inadequate paralytic response of the muscle to the initial dose, or because of mechanical factors such as large deviations or restrictions, or because of the lack of binocular motor fusion to stabilize the alignment .

Since then, several randomized control trials have shown botulinum toxin type A to improve headache symptoms and quality of life when used prophylactically for patients with chronic migraine[88] who exhibit headache characteristics consistent with: pressure perceived from outside source, shorter total duration of chronic migraines (<30 years), "detoxification" of patients with coexisting chronic daily headache due to medication overuse, and no current history of other preventive headache medications.[89]


Botox is best known for smoothing out wrinkles, but since 2010 it’s also been used to prevent migraines. (Scientists aren’t 100 percent sure why Botox works, though it may interfere with the transmission of pain signals to the brain.) Though the 36 injections I get every three months in my forehead, skull, neck, and shoulders are painful, they’ve been a game changer. I went from 16 to 18 migraines a month to about eight. The intensity of the pain has gone down, too. The results are so good that I find myself frustrated that I spent so many years in unnecessary misery.

Botox must be used only under a doctor's care. It's important that injections be placed precisely in order to avoid side effects. Botox therapy can be dangerous if it's administered incorrectly. Ask for a referral from your primary care doctor or look for a doctor who specializes in your condition and who has experience in administering Botox treatments.
Most doctors suggest focusing on the quality of the skin with a proper regimen that includes daily exfoliation and SPF protection, as well regular chemical peels or specialized treatments such as Clear and Brilliant laser resurfacing during this decade. Still, there are exceptions. If constant eyebrow furrowing has resulted in the first signs of an angry crease or premature crow’s feet due to naturally thin skin are a persistent cause of frustration, injectibles can help. But as any good dermatologist will note, there is a caveat: When it comes to Botox and filler, there's a fine line between targeted tweaks and doing too much too soon. Here, in-demand experts share their guidelines for women in their 20s.

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So people told me I looked tired, overlooking the grape-size purple bruise smack dab in the center of my forehead. As one RealSelf reviewer wrote: “My head feels too tight, my eyebrow position has dropped enough to lose my nice pretty arch and my eyelids seem hooded. My eyes look smaller.” Now, if it works, looking a bit tired is a small price to pay for a few more days each month of migraine freedom and function. And bruises can be covered with makeup.


Onabotulinumtoxin A (trade name Botox) received FDA approval for treatment of chronic migraines on October 15, 2010. The toxin is injected into the head and neck to treat these chronic headaches. Approval followed evidence presented to the agency from two studies funded by Allergan showing a very slight improvement in incidence of chronic migraines for migraine sufferers undergoing the Botox treatment.[86][87]

The FDA now requires black box labeling on Botox and similar products such as Dysport and Xeomin to warn of rare but potentially life-threatening swallowing and breathing complications if the toxin spreads beyond the injection site. None of these complications have occurred in people using Botox for cosmetic reasons and the FDA states that cosmetic use of Botox appears to be safe.


Is the cosmetic injectable product real? Great question! The answer is maybe? It is possible that the provider dispensing Botox or Dysport obtained the drug from an overseas dispensary outside of the United States. These foreign vendors sell Botox and Dysport to doctors and nurses in the U.S. at a discounted price but their product is not always the real thing. That’s right! The Botox maybe counterfeit. The bottles may look identical but the product inside may not be real which means it may not work as effectively or not at all ! So if the provider is offering Botox or Dysport really cheap The first question should be –Was it manufactured by the U.S. company?
Good question. botox can be used to help elevate the eyebrows, which contribute to the heavy lid look. You want the "depressor muscles" of the brow weakened leaving the "elevator muscles" still functional. It will give some lift. It may not be enough depending on the severity of the heaviness to your eyelids. A board certified plastic surgeons should be able to advise you... READ MORE

In response to the occurrence of these side effects, in 2008 the U.S. Food and Drug Administration notified the public of the potential dangers of the botulinum toxin as a therapeutic. Namely, they warned that the toxin can spread to areas distant from the site of injection and paralyze unintended muscle groups, especially when used for treating muscle spasticity in children treated for cerebral palsy.[28] In 2009, the FDA announced that boxed warnings would be added to available botulinum toxin products, warning of their ability to spread from the injection site.[29] Additionally, the FDA announced name changes to several botulinum toxin products, meant to emphasize that the products are not interchangeable and require different doses for proper use. Botox and Botox Cosmetic were renamed onabotulinumtoxinA, Myobloc was renamed rimabotulinumtoxinB, and Dysport name renamed abobotulinumtoxinA.[29] In conjunction with this, the FDA issued a communication to health care professionals reiterating the new drug names and the approved uses for each.[30] A similar warning was issued by Health Canada in 2009, warning that botulinum toxin products can spread to other parts of the body.[31]
Note: Online coupons or deals for Botox are not recommended because you would be purchasing a medical treatment without knowing if the treatment would be suitable for your skin issues. What you think Botox will fix may not actually be the case, so don't buy something unless you know you are a good candidate for the treatment. It's better to get a Botox consultation first.
Allergan says Botox is well established as a drug and that the benefits and risks of toxins are well understood. "With more than 25 years of real-world clinical experience ... approximately 3,200 articles in scientific and medical journals, marketing authorizations in more than 90 markets and many different indications, Botox and Botox Cosmetic are [among] the most widely researched medicines in the world," an Allergan rep wrote in an emailed statement.

On July 29, 2016, Food and Drug Administration (FDA), of the United States of America approved abobotulinumtoxinA for injection for the treatment of lower limb spasticity in pediatric patients two years of age and older.[20] AbobotulinumtoxinA is the first and only FDA-approved botulinum toxin for the treatment of pediatric lower limb spasticity. In the United States of America, the FDA approves the text of the labels of prescription medicines. The FDA approves which medical conditions the drug manufacturer may sell the drug for. However, those approved by the FDA to prescribe these drugs may freely prescribe them for any condition they wish, called off-label use. Botulinum toxins have been used off-label for several pediatric conditions, including infantile esotropia.[21]

Since then, several randomized control trials have shown botulinum toxin type A to improve headache symptoms and quality of life when used prophylactically for patients with chronic migraine[88] who exhibit headache characteristics consistent with: pressure perceived from outside source, shorter total duration of chronic migraines (<30 years), "detoxification" of patients with coexisting chronic daily headache due to medication overuse, and no current history of other preventive headache medications.[89]
After an exam by a therapist and doctor, botulinum toxin for focal relief of muscle spasticity can be advised as the best way to address a child's functional problems. The problem muscle groups are identified, and goals for that child are discussed. Then the injection of botulinum toxin can be done if there are no permanent contractures of the muscle groups.
* LS mean change, treatment difference and p-value are based on an analysis using an ANCOVA model with baseline weekly endpoint as covariate and treatment group, etiology at study entry (spinal cord injury or multiple sclerosis), concurrent anticholinergic therapy at screening, and investigator as factors. LOCF values were used to analyze the primary efficacy variable.
If going back for additional treatments three or four times a year sounds like a lot of treatments, the good news is that the more Botox treatments you get, the fewer Botox units you'll need. With each repeat Botox session, the frontalis muscle and other facial muscles surrounding Botox injection sites get a little weaker and become "trained" to not contract.
Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such a reaction occurs, further injection of BOTOX® should be discontinued and appropriate medical therapy immediately instituted. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent, and consequently the causal agent cannot be reliably determined.

Botox injections like other goods and services in New York City are typically more expensive then in the suburbs where the rent and salaries are also less expensive. So it is true that in general Botox cost more in NYC. In one vial of Botox there is 100 units of medicine and each unit costs on average $20. Most patients require between 20 to 60 units.That translates into an average between $400 and $1200.
I love talking about migraines. I don't do it to be a downer; I do it because talking about dealing with my chronic migraines may lead to hearing tips from another fellow sufferer, and I've tried nearly everything at this point. I've dealt with migraines for almost two decades, and as anyone who deals with them knows, having a variety of remedies in your toolbox is crucial when the pain hits.
Co-administration of BOTOX® or other agents interfering with neuromuscular transmission (eg, aminoglycosides, curare-like compounds) should only be performed with caution as the effect of the toxin may be potentiated. Use of anticholinergic drugs after administration of BOTOX® may potentiate systemic anticholinergic effects. The effect of administering different botulinum neurotoxin products at the same time or within several months of each other is unknown. Excessive neuromuscular weakness may be exacerbated by administration of another botulinum toxin prior to the resolution of the effects of a previously administered botulinum toxin. Excessive weakness may also be exaggerated by administration of a muscle relaxant before or after administration of BOTOX®.
Chronic migraines are what were formerly known as “transformed” migraines. These are near daily headaches, sometimes with migraine features but otherwise with frequent features of tension headaches. This may sound trivial but the treatment for tension headaches, typically with analgesics, would only make this syndrome worse. We learned that treating these with migraine preventive medications proved mostly effective. The current International Classification of Headache Disorders defines chronic migraine as a recurrent headache that has been ongoing for the past 3 months, occurs on at least 15 days per month, lasts at least 4 hours per day, and has 8 or more days per month when the headache has features of a migraine or responds to a typical migraine medication.
Before I could try Botox, my health insurance — Cigna — required me to try and fail at least two other meds. I tried tricyclic antidepressants, which made me groggy and turned my brain into molasses, and beta blockers, a class of drugs used for high blood pressure and heart problems. (All treatments to prevent migraines are borrowed from other conditions, except a new class of drugs that was just approved by the Food and Drug Administration.) The beta blockers worked for a few months: they slightly reduced the number of migraines and made the headaches more bearable. But late last year, the migraines became chronic again — I had more than 15 in a month. That’s when my neurologist said: “I think it’s time to try Botox.”
There’s a wide variety of factors that influence the total cost: the number of units required to effectively limit facial movement in the forehead, the areas in the upper face you wish to treat, the experience level of your injector, and finally, the location of the clinic where you undergo the procedure. Botox is usually charged per unit, with a unit priced from $10 to $20. The final price can also be determined per area treated, with the forehead and frown lines charged as two seperate areas.

The most common side effect of the BOTOX procedure for migraines is neck pain. In clinical trials, 9 percent of patients reported this side effect. Other side effects can include headaches or muscle pain, but these side effects are far less common. If you do experience neck pain, an ice pack can help you manage the discomfort until it dissipates. At Allure Esthetic, we will perform the BOTOX for migraines procedure carefully and correctly.
Fine lines, frown lines, how-did-those-get-there lines. Whatever you call them, a few minutes of Botox can smooth wrinkles on your forehead, in-between your eyes, and crow’s feet. This is a non-invasive FDA-approved treatment that requires zero downtime, so you can come in and erase those signs of aging on your lunch break. Using a very fine needle we inject Botox intothe facial muscles responsible for those annoying wrinkles, totally relaxing them and reducing their ability to contract. Don’t worry, you’ll be out the door and on your way to feeling refreshed and radiating confidence in no time.
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