Botox glabellar before and after

Botulinum toxin (known most commonly by the brand names Botox® and Xeomin®) can be used to make various facial wrinkles less prominent.

Treatable areas include lines on the forehead, above the nose, the outside of the eyes, and around the lips.

If you have unwanted facial wrinkles, we may be able to help!

Botulinum toxin (known most commonly by the brand names Botox® and Xeomin®) is a neurotoxin produced by the bacterium Clostridium botulinum A. This neurotoxin is what causes botulism, a rare but serious (and potentially fatal) disease that can cause weakness or paralysis of many muscles in the body. The recorded history of botulism began in 1735, when the disease was first associated with the consumption of sausage. In 1870, John Muller, a German physician, derived the name botulism from the Latin word for sausage (“botulus”). Clostridium botulinum was first discovered by a Belgian scientist named Emile Pierre van Ermengem following a botulism outbreak in Belgium. By the 1920s, scientists at the University of California, San Francisco, first tried to isolate the botulinum toxin. However, it took 20 years before the botulinum toxin was finally isolated in crystalline form by Dr. Edward Schantz in 1946. In the 1970s, scientists started using botulinum toxin to treat strabismus (crossed eyes). While testing this treatment on monkeys, researchers noticed that botulinum toxin reduced wrinkles in the glabella (the skin between the eyebrows). After botulinum toxin proved successful in the treatment of strabismus, Allergan licensed the treatment and branded it as Botox®. Subsequently, Botox® received FDA approval for a variety of medical and cosmetic uses.

Botulinum toxin (known most commonly by the brand names Botox® and Xeomin®) binds to nerve endings of muscles, which prevent the nerve endings from moving the muscles for a period of about 3 months. After this time, the nerves create new end receptors and the effect wears off. In a purified form, and in controlled amounts, botulinum toxin can be used therapeutically to reduce the strength of targeted muscle tissues. Muscles of the face that can cause wrinkles from repeated movements can be injected with botulinum toxin and temporarily weakened/paralyzed. This decreases the extent to which wrinkles on the face can be made, and also gives the skin time to smooth out since the wrinkles are not being formed.

There are some complications that are possible with Botulinum toxin injections, which are reviewed in detail prior to any proposed treatment. But for Botulinum toxin to be truly toxic (and cause botulism), you would need a very high dosage. Botox® is measured in units, and generally comes in vials of 100 units. A patient receiving Botox® for multiple sites on the face may receive 50 to 60 units (example: glabellar lines usually take 20-30 units). A lethal dose of Botulinum toxin would consist of 2,500-3,000 units (25-30 vials)! This far exceeds the amount that anyone would ever receive for esthetic or therapeutic purposes in one sitting.


Camargo, CP, et al. Botulinum toxin for facial wrinkles (Protocol). Cochrane Library. 2014.

Dorizas, A, Krueger, N, Sadick, NS. Aesthetic Uses of the Botulinum Toxin. Dermatologic Clinics. 2014; 32(1):23-36.