BOTOX® Cosmetic Treatment

BOTOX® Cosmetic is a neurotoxin that blocks the signals from the brain that cause muscle spasms. It therefore relaxes muscles at the site of the injection. At Cape Fear Eye Associates, we use BOTOX® injections both cosmetically and therapeutically, depending on the nature of the patient’s needs. BOTOX® injections are highly effective, minimally invasive, and virtually pain-free. In addition, they are provided on an outpatient basis and require little or no downtime, making them a convenient way to manage certain eye conditions and achieve substantial cosmetic improvements.

BOTOX® Injections to Treat Blepharospasm

Blepharospasm is an uncontrolled muscle spasm that generally causes twitching of the eyelids. It is sometimes associated with other conditions as well, including dry eye syndrome and Tourette’s syndrome, and can adversely affect vision as well as self-confidence. Small injections of BOTOX® Cosmetic administered to the upper and lower lids of the affected eye typically provide a temporary solution to the problem, with results lasting as long as six months. Additional treatments may be necessary every three to six months, depending on the severity of the condition.

BOTOX® Injections to Treat Strabismus

Strabismus typically begins in childhood and is characterized by a misalignment of the eyes. People afflicted with this condition usually have double or blurred vision caused by overactive or under active eye muscles, which make one of the eyes focus poorly. In adults, the onset of strabismus may be stimulated by diabetes, thyroid disease, or a stroke. When strabismus results from an overactive eye muscle, BOTOX® injections can provide an effective solution. By injecting small amounts of BOTOX® Cosmetic into the affected eye muscle, our doctors are able to stabilize its movements, thereby resolving or improving symptoms. Repeat treatment may be necessary for some patients.

BOTOX® Cosmetic to Treat Facial Wrinkles

For patients seeking to improve their appearance through non-surgical wrinkle reduction, we administer BOTOX® Cosmetic. BOTOX® Cosmetic, approved in 2002, is highly effective at temporarily improving the appearance of moderate to severe frown lines and facial wrinkles, especially those in the forehead and around to the eyes. Using a very fine needle, we inject small amounts of the substance into the facial muscles, thereby relaxing them and relieving the tension that causes wrinkles to form. BOTOX® Cosmetic can have dramatic results, including significant reduction of facial wrinkles and a substantially improved appearance overall. Effects often last from three to six months, after which repeat treatment is usually required to maintain cosmetic improvements. Many of our patients choose to combine eyelid surgery with BOTOX® Cosmetic to achieve maximum rejuvenation results.

BOTOX® for Migraines

BOTOX® (onabotulinumtoxinA) is a prescription medicine that is injected to prevent headaches in adults with chronic migraine who have 15 or more days each month with headache lasting 4 or more hours each day in people 18 years or older.

It is not known whether BOTOX® is safe or effective to prevent headaches in patients with migraine who have 14 or fewer headache days each month (episodic migraine).

Whether you’re considering BOTOX® treatment, or have already received treatment, here’s what you need to know.

Your first treatment

For Chronic Migraine patients, the FDA has approved a specific dose and injection pattern for BOTOX® treatment—31 injections are given over 7 key areas of the head and neck once every 12 weeks to prevent headache days.

Here’s what to expect during your first treatment:

  • Injections to 7 key areas of the head and neck

    • Very fine needles are used for 31 total injections

    • Injections feel like tiny pinpricks—you may feel mild discomfort

  • The most common side effect in Chronic Migraine clinical studies was neck pain experienced by 9% of BOTOX® patients (vs 3% in placebo)

    • Other side effects include headache, migraine, slight or partial facial paralysis, eyelid drooping, bronchitis, musculoskeletal stiffness, muscle weakness, pain in 1 or more muscles, ligaments, tendons, or bones, muscle spasms, injection-site pain, and high blood pressure

    • This does not cover all the possible serious side effects of BOTOX®. Please see the Important Safety Information including Boxed Warning and Medication Guide and talk to your doctor

BOTOX® Injection Sites

*Injections are on both the right and left side of the head.

When to expect results

In clinical trials, BOTOX® provided a significant reduction in headache days after the first treatment. After the second treatment (at 24 weeks), BOTOX® prevented up to 9 headache days a month (vs up to 7 with placebo injection).

Why commit to 2 treatments?

Committing to 2 treatment sessions is important in order to see how BOTOX® is working for you, since BOTOX® showed significant reduction in headache days at 24 weeks. Talk to your doctor about your progress, and as you start to see changes in the amount of headache days you’re having each month, keep track with your headache diary. 

What happens next: a 12-week treatment schedule

Based on your progress, you and your doctor will discuss re-treatment every 12 weeks. Remember: BOTOX® is a preventive treatment, which means it’s taken to prevent headaches and migraines from occurring. So, it is recommended that treatment be given once every 12 weeks.

The best way for you and your doctor to know if BOTOX® is meeting your treatment needs is to give it time to work, so talk to your doctor, and stay on track.

 

Ways to stay on track 
Want to make sure you stay on schedule? Make your next appointment right after each treatment session—before you leave the office—so you don’t forget.

Feeling your progress is one thing, seeing it on paper is another. As you begin to have fewer headache days, use your headache diary to track your progress, and see how far you’ve come!

Botox for Migraines FAQ

Frequently Asked Questions (FAQ) ~ BOTOX® and Chronic Migraine

What is BOTOX®? 

BOTOX® (onabotulinumtoxinA) is part of a group of drugs known as biologics—biologic medicines are made from living things. BOTOX® is a purified protein that is made from a type of bacteria calledClostridium botulinum type A.

BOTOX® is injected to prevent headaches in adults with Chronic Migraine who have 15 or more headache days each month with headache lasting 4 hours or more each day in people 18 years or older.

 

It is not known whether BOTOX® is safe or effective to prevent headaches in patients with migraine who have 14 or fewer headache days each month (episodic migraine).

 

Who makes BOTOX®?

BOTOX® therapy is made only by Allergan—a US-based specialty drug and medical device company offering innovative products in approximately 100 countries. Allergan is committed to significant and ongoing investment in research and development to pursue discoveries and treatments.

How can I be sure I am receiving authentic BOTOX®?

Allergan takes many steps to ensure that the distribution of BOTOX® (onabotulinumtoxinA) is safe and effective for patients.

Look for “Allergan” hologram

 

Only BOTOX® manufactured by Allergan is FDA approved and federally licensed to be sold and used in the United States. Products imported by foreign or unlicensed suppliers are not FDA approved and may be counterfeit.

 

There are a couple of easy ways to ensure you are receiving authentic BOTOX®:

  • The carton will have a US license number on the side

  • The vial will have the BOTOX®logo as well as a hologram (rainbow) image that says Allergan

How is BOTOX® treatment given to appropriate Chronic Migraine patients?

BOTOX® is injected by a doctor into 7 specific areas in the head and neck with very fine needles. A complete injection pattern has 31 total injections

What are the side effects with BOTOX®? 

The most common side effect seen in Chronic Migraine clinical trials was neck pain, experienced by approximately 9% of people in the BOTOX® group vs 3% in placebo group. Other side effects (experienced by ≥ 2% of people treated with BOTOX® and more frequent than placebo-treated patients) include headache, migraine, slight or partial facial paralysis, eyelid drooping, bronchitis, musculoskeletal stiffness, muscle weakness, pain in 1 or more muscles, ligaments, tendons, or bones, muscle spasms, injection-site pain, and high blood pressure. This does not cover all possible side effects of BOTOX®. Please see the Important Safety Information including Boxed Warning and Medication Guide and talk to your doctor.

What serious and/or immediate allergic reactions have been reported? 

These reactions include itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint. Tell your doctor or get medical help right away if you experience any such symptoms; further injection of BOTOX® should be discontinued.

How often will I need BOTOX® treatment? 

BOTOX® injections are given every 12 weeks by your doctor. Your doctor will decide if you need an ongoing therapy.

Can I still take acute medication for my migraines once I begin BOTOX® treatment? 

BOTOX® is a preventive medication for headaches in adults with Chronic Migraine. BOTOX® is a prescription medicine that is injected to prevent headaches in adults with Chronic Migraine (15 or more headache days a month with each headache lasting 4 hours or more). BOTOX® is not approved for adults with migraine who have 14 or fewer headache days a month.

 

BOTOX® may not prevent all your headache days. Acute medications may still be taken while you are on BOTOX therapy. Your doctor will recommend a complete treatment plan that’s right for you.

 

Chronic Migraine

What’s the difference between headaches and Chronic Migraine? 

Frequent or re-occurring migraines may often be referred to as chronic, or “chronic migraines.” However, Chronic Migraine is a medical condition that is defined by having headaches on 15 or more days per month, with each headache lasting 4 hours or more. If you have Chronic Migraine, at least 8 of your headache days are associated with migraine. Learn more about Chronic Migraine.

Am I able to get assistance for costs associated with BOTOX®? 

Allergan, the maker of BOTOX®, is committed to helping you receive timely and appropriate treatment. See if you qualify for:

  • BOTOX®Savings Card helps qualified commercially insured people who need assistance with their out-of-pocket costs for BOTOX® treatment

  • BOTOX PATIENT ASSISTANCE®Program provides BOTOX® treatment at no charge to financially eligible people (uninsured or underinsured) who can’t otherwise afford treatment

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