Michael H. Moses, MD, FACS

Botox® Cosmetic & Dysport®

Botox® Cosmetic works by weakening the muscles where it is injected. Once the resting tone of the treated muscles is weakened, the pull of the muscles relaxes, the overlying skin flattens, and the wrinkles they cause disappear. This approach is different from fillers for the aging face. Fillers such as Restylane®, Juvéderm®, and Sculptra®, as well as autologous fat transfer all work by filling in wrinkles and depressions. By weakening the muscles that cause the wrinkles, Botox® and Dysport® prevent the wrinkles from occurring.

Injection of Botox® Cosmetic or Dysport® into the small muscles between the brows, in the forehead, and around the eyes causes those specific muscles to be paralyzed, thereby improving the appearance of those wrinkles. This paralysis is temporary, and re-injection is necessary within three to ten months if desired.

Botox® Cosmetic and Dysport® are very similar, but are made by two different companies. Very small amounts of Botox® Cosmetic or Dysport® are injected through a tiny needle into the muscles to be paralyzed. Discomfort is minimal and lasts only a few seconds. If desired, we offer patients the option of administering numbing creme, and/or nitrous oxide (“laughing gas”) with their Botox® Cosmetic and/or Dysport® injections.

There are few known side effects to Botox® Cosmetic. If any of the Botulism toxin reaches a facial muscle not being treated, partial weakness of that muscle may last for several months. (It is for this reason that you are requested not to massage the injected areas for 12 hours following injection.) In the event of an area of unwanted muscle weakness, the only “treatment” is to wait for the effect of the toxin to wear off in a few weeks to several months.

Botox® Cosmetic and Dysport® have been used safely in the treatment of facial wrinkles for over 15 years. The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All procedures have some degree of risk. Minor complications that do not affect the outcome—such as a short-term headache or bruising that lasts up to a few days—occur occasionally. Major complications are rare.