What does Botox feel like when it starts to work
- Medical Community Member - January 13th 2018
- General Public
Will I feel Botox Work Once It’s Injected?
Many patients undergoing Botox treatment for the first time will have questions and concerns regarding the procedure. This post aims to help put their minds at ease by providing a step-by-step guide on warning signs to watch out for and what to expect after a Botox treatment.
What is Botox used for?
Botox is used in many medical situations. Due to its unique and useful mechanism of action, where it causes a local paralysis in striated tissue, Botox is extremely versatile and can be used to treat many movement and pain disorders, including chronic migraines, certain types of spasticity, and cervical dystonia. Botox is also used to treat some bladder symptoms, such as urinary incontinence, and symptoms of excessive underarm sweating, which is known as severe primary axillary hyperhidrosis. For the purposes of brevity, however, this article will discuss the patient experience in the context of using Botox for cosmetic treatment, specifically the treatment of lines and wrinkles on the face.
Botox works by preventing the release of acetylcholine, a neurotransmitter, at the motor endplate. This stops muscle contraction and therefore diminishes the appearance of dynamic facial wrinkles. This mechanism of action is reversible and temporary.
Immediately after treatment
Botox injections are usually administered in the upper face to correct frown lines (also known as glabellar lines), crow’s feet (also known as lateral canthal lines), and forehead lines. The practitioner should follow an established protocol that involves injecting 4 units of Botox into multiple sites across the region being treated. More specifically, there should be five sites treated in the corrugator and procerus muscles for glabellar lines, three sites for each side of the lateral orbicularis oculi muscle for treating lateral canthal lines, and five sites in the frontalis muscle for the treatment forehead lines. Simultaneous treatment of two or more indications (for example, lateral canthal lines and forehead lines) is possible.
The patient experience with Botox varies. Some patients have reported minor but transient discomfort during the injection process that feels like a pinch. Patients concerned about discomfort can opt for pain-relief measures, like applying ice to numb the area or using topical numbing cream before starting the treatment. Some inflammatory-type reactions to the injection should be also anticipated, and these include redness, bruising, and swelling. These effects usually wear off soon after the injection. Some patients can also experience what is commonly termed as a “Botox headache,” which is a mild, dull headache that occurs right after the injection and lasts for several hours. This can usually be alleviated with analgesic medications, like paracetamol. As Botox begins to take effect, some patients report sensations of tightness or heaviness and less control over their forehead, as the patient cannot move their forehead as freely as before the Botox injection. Sensations of tightness or heaviness will usually subside in 1–2 weeks. Results are not noticeable immediately after treatment, so it should not concern your patient if they do not see a difference right away.
Days and weeks after treatment
In the days and weeks that ensue, Botox begins to work, taking full effect about 1–2 weeks after treatment. By then, patients should be able to see a visible diminishment of the treated wrinkles and smoother skin, which is an effect that typically lasts around three to four months before slowly diminishing as the treated muscle(s) returns to normal. It is around this time that the patient will need to return for a repeat injection to maintain the results. Retreatment is usually required to correct static lines, which are lines that are still seen when the face is at rest, or expressionless. This is especially true in cases where full movement has returned. In cases of deep-set wrinkles, it is better to avoid full movement in the area in order to allow the lines to soften.
Overall, patients may notice a “heaviness” or “tightness” in the injected area as it begins to work.
Getting Botox injections is an experience that will be different for each patient. Injector experience and technique, patient response, and area of treatment are some factors that will determine if the patient will ultimately feel satisfied with the treatment outcomes.