Medical information Wipe away wrinkles and creases

The synopsis

How to eliminate facial wrinkles

  • BOTOX® can target wrinkles and creases on your face, smoothing them away with a simple, nonsurgical injection treatment.

BOTOX® At A Glance

  • Used Wrinkles For
  • Lasts 3-4 Months
  • Results in 5-10 Days
  • Per $10 Unit
  • Look Years Younger

How BOTOX Cosmetic® works

Of all the aesthetic medical procedures available today, surgical or nonsurgical, the most popular is the injection of Botulinum toxin type A. Known more commonly worldwide by the brand name, BOTOX®, this procedure is based on the therapeutic benefits of Clostridium botulinum.

Clostridium botulinum

Clostridium botulinum is a bacteria that produces a toxin containing different types of serology, labeled A to G. BOTOX® is based on Type A, which is considered to be the most potent. Type A is approved by the FDA for the treatment of several health conditions, including strabismus, cervical dystonia, blepharospasm and chronic migraines. Over a decade ago, it was also approved for the cosmetic treatment of frown lines between the eyebrows (glabellar lines).

How BOTOX® works for wrinkles

BOTOX® relaxes the muscles that are creating the offending wrinkle by something called selective muscle denervation. A medical term, selective muscle denervation involves disabling a muscle’s ability to contract by affecting the nerves and chemical, acetylcholine.

The neuromuscular junction is the place where a nerve and muscle meet. Acetylcholine is released from the nerves when your brain signals the desire to contract a muscle, and it binds to the muscles to begin everything that is involved in contracting that muscle. BOTOX® blocks the transmission of acetylcholine to the muscle, thereby preventing contraction. Without the ability to contract, the skin that is located over the muscle no longer creases. In fact, this same process is how it works for other concerns. For example, by relaxing the muscles in the jaw, the jawline becomes less prominent and square to create a more feminine facial contour. An injection can also subtly lift the corners of your mouth (so you don’t look like you’re sad or frowning) or resolve excessive sweating.

Different sizes of microcannulae can be used to inject fillers of nearly any type of level of viscosity. Extremely flexible, long microcannulae, for example, can be used to employ the “fanning technique”, a method that allows for treatment of a large area through a single puncture point. Please note that blunt-tip microcannulae are often too large to be used in injecting filler to fine lines.

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Areas you can smooth away wrinkles with BOTOX®

  • Forehead
  • Between the brows (glabellar lines)
  • At the outer corners of your eyes (crow’s feet)

Contact Edelstein Cosmetic at (416) 256-5614 to schedule your consultation.

Are you a candidate?

BOTOX Cosmetic® is for men and women who dislike the appearance of wrinkles and creases on their upper face and are seeking a nonsurgical solution.

Our injectable specialists minimize the risk of breathing difficulties by always making sure to use appropriate dosing for any treatment targeting the neck. This significantly reduces the risk of these issues.

Spread of toxin effects: In rare cases, BOTOX® can affect areas that are far from the injection site, leading to these symptoms: blurred vision and drooping eyelids, double vision, loss of bladder control, loss of strength and muscle weakness all over the body, hoarseness or change or loss of voice (dysphonia) and trouble saying words clearly (dysarthria). These symptoms occur hours to weeks after a BOTOX® treatment. However, please note that there was no severe case of spread of toxin effect when BOTOX® was used at the recommended dose to cure blepharospasm, strabismus, underarm sweating or frown lines.

BOTOX® has been proven time and time again as one of the safest medications in the world. That’s why millions of treatments are performed every year on men and women, for cosmetic and therapeutic reasons.


With a medical examination, only a qualified doctor can determine if BOTOX® is the right treatment for you. Before taking it, tell your doctor if any of the following conditions applies or have applied to you:

  • have swallowing, bleeding or breathing (asthma, emphysema) issues
  • have had facial surgery, for cosmetic or therapeutic purposes
  • plan to have surgery
  • are breastfeeding a baby or plan to in the near future
  • are pregnant or planning to become pregnant in the near future
  • have noticed a change in the normal appearance of your face for a known or unknown reason
  • have any diseases that affect your nerves and muscles (Lambert-Eaton syndrome, amyotrophic lateral sclerosis, myasthenia gravis)
  • are allergic to botulinum toxin or any other ingredient in BOTOX®
  • had an adverse reaction after receiving a BOTOX® treatment in the past
  • have facial muscle weakness (trouble raising your eyebrows, droopy eyelids)
  • have received other botulinum toxin injections (Dysport or Myobloc) in the last four months

In addition, you should also tell your doctor about any medications, vitamins, herbs or supplements you are taking. Certain medicines can negatively interact with BOTOX® and lead to severe side effects. During your initial consultation, please bring a list of medications you take so that they can be reviewed.

Your safety is our primary concern. BOTOX® is not suitable for everyone and for this reason, it is crucial that you be honest during your consultation to protect your safety.

Preparing for your treatment

You’ll receive a list of instructions to follow before your treatment. Make your treatment a safer, more effective one by following these instructions, allowing you to prepare for it properly.

Your treatment

Your actual treatment takes only a few minutes to complete. A topical anesthetic can be applied, then the target areas are marked. A series of injections are made, delivering the desired number of units.

Following your treatment

After the actual injection, which takes only a few minutes, the area treated may be a little swollen and bruised. You may also feel a bit of discomfort. These symptoms will go away in a few days. It is important that you facilitate your recovery by following the post-treatment care instructions provided to you.

The following are some tips that can help with your recovery:

1. To minimize swelling or bruising, apply a cool compress. You may also want to consider stopping any medications that thin the blood for about a week before your treatment to minimize bruising. These medications include aspirin, ibuprofen and St. John’s Wort.

After your treatment, you should exercise the treated muscles for a couple of hours to help improve the absorption of the injected BOTOX®. Frown repeatedly if the muscles controlling frowning were targeted. If forehead lines were targeted, raise your eyebrows. For crow’s feet, squint and smile. You may find that performing these facial movements takes a little more effort than usual.

3. Avoid touching or rubbing the area(s) targeted for a couple of hours after your treatment. This is to minimize the risk of the injected BOTOX® spreading to muscles that were not targeted during your treatment.

4. Avoid working out or performing vigorous physical activity for the rest of the day.

5. Sometimes, patients experience a headache after treatment. This can be easily resolved by taking Advil or Tylenol.

Your results

The results of a BOTOX® injection can be typically seen between five to ten days. Some patients see their results in three days, while others see the improvement after two weeks. Wrinkles will be noticeably softer or totally erased, giving you a refreshed and rejuvenated appearance. Results lasting for about four months on average. After this time, the treated muscle will gradually be able to contract again and the aesthetic concern will return.

Please note that BOTOX® is only effective for wrinkles that appear with the contraction of facial muscles. These include forehead wrinkles, crow’s feet and glabellar lines. Wrinkles that are visible without contracting the muscles in the area cannot be treated (injectable fillers are better suited for these). However, BOTOX® can soften these “static” wrinkles to a certain extent.


Like all medications, BOTOX® has its own set of risks and side effects. However, these risks are very rare. The talented medical injectable specialists at Edelstein Cosmetic take great care in applying advanced techniques to minimize any risks associated with your treatment.

Rare risks

Trouble speaking, breathing or swallowing: These issues occur due to the weakening of associated muscles. You are at the highest risk if these issues pre-exist before your BOTOX® treatment, which is why your medical history is reviewed prior to treatment.

Copyright © 2015 Edelstein Cosmetic & Think Basis Inc.
All rights reserved. Any subsequent further processing, publication or permanent storage for commercial or other purposes without the explicit prior permission of Think Basis Inc. is prohibited.

Article credits

Smiling portrait image of doctor Jerome Edelstein.

Dr. Edelstein is a board certified Plastic Surgeon and head of the largest plastic surgery hospital unit in Canada. You can read more about Dr. Jerome Edelstein on his bio page.

  • Reviewed By: Dr. Jerome Edelstein
  • Place: 362 Fairlawn Avenue, Toronto, ON, CA, L4J 8V3
  • Created: 20 Apr 2015
  • Published: 20 Apr 2015
  • Last Modified: 19 May 2015
  • Reviewed: 16 Apr 2015

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