Injections of botulinum toxin may seem like a simple procedure to you, since it’s just a few shots. But it’s actually both an art and science that only an experienced healthcare professional should do.

There are 43 muscles in your face and it’s vital that the person who performs botulinum toxin injections understands and pinpoints the correct spots to optimize your treatment.

A very thin needle is used to inject small amounts of botulinum toxin into specific muscles. By carefully choosing specific muscles, your healthcare provider weakens only the wrinkle-producing muscles, preserving your natural facial expressions.

Botulinum toxin treatment injections usually take less than 15 minutes. The number of injections you need will depend on multiple factors, including your facial features and the extent of your wrinkles. Crow’s feet, for example, usually demand two to three injections. Furrows above your brow could take five or more.

No anesthesia is required. There is no down time or recovery time.

You may notice results within a few days, but it can take up to a week to see the full effect. This improvement typically lasts about three to four months. When the effects of botulinum toxin begin to fade, your muscle reactions and the wrinkles will return.

You may resume normal activities immediately. One note of caution: Don’t rub or massage the treated areas after the wrinkle treatment because it can cause the botulinum toxin to migrate to another area of your face. If this happens, you could have temporary facial weakness or drooping.

Although generally safe, side effects and complications can include:

• Bruising and pain at the injection site
• Redness
• Headache
• Flu-like symptoms
• Nausea
• Temporary facial weakness or drooping
• Very rarely, the toxin can spread beyond the treatment area, which can cause botulism-like signs and symptoms such as breathing problems, trouble swallowing, muscle weakness and slurred speech.

Botulinum toxins won’t fix all types of skin problems. For example, while it can diminish under-eye wrinkles, it can’t repair the damage caused by the sun. Your skin thickness, type, and the degree of wrinkling all play a role in determining the effectiveness of botulinum toxin.  A qualified plastic surgeon is the best person to evaluate the appropriateness of this treatment for you personally.

Cost is always a consideration in elective procedure or treatment. The cost for botulinum toxin treatments may vary based on the expertise and qualifications of the person performing the treatment, time and effort the procedure or treatment requires as well as geographic office location.

In 2009, the American Society of Plastic Surgeons estimated national surgeons’ average fee was $405 for botulinum toxin treatment. Many plastic surgeons offer patient financing plans, so be sure to ask.

Additional fees may include:

• Surgical facility costs
• Anesthesia fees
• Prescriptions for medication

Be sure to ask your surgeon about all costs involved in your procedure.

Your satisfaction involves more than a fee

When choosing a plastic surgeon for botulinum toxin, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the procedure.

Most health insurance does not cover cosmetic surgery or its complications.

• Are you certified by the American Board of Plastic Surgery?
• Were you specifically trained in the field of plastic surgery?
• Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
• Am I a good candidate for Botulinum Toxin?
• What will be expected of me to get the best results?
• Who will perform the Botulinum Toxin injections?
• Have they been specifiaclly trained in this procedure?
• Where and how will you perform my procedure or treatment?
• How long of a recovery period can I expect?
• What are the risks and possible complications associated with my procedure?
• How can I expect to look over time?
• Do you have before-and-after photos I can look at for this procedure
• What results are reasonable for me?

To find a qualified plastic surgeon who performs this wrinkle treatment, visit the online referral service of the American Society of Plastic Surgeons (ASPS). ASPS, founded in 1931, is the largest plastic surgery organization in the world and the foremost authority on cosmetic and reconstructive plastic surgery. All ASPS physician members are certified by the American Board of Plastic Surgery (ABPS) or the Royal College of Physicians and Surgeons of Canada.

Caution: In the wrong or inexperienced hands, botulinum toxin can be dangerous. In addition to seeking a doctor who is trained and qualified in plastic surgery, make sure the physician has specific experience with these types of injections. Even though the injections may ultimately be delivered by another healthcare professional in the surgeon’s office, it will be with the surgeon’s close supervision.