BOTOX® is one of the world’s most famous brand names. Every year since 2002, when the FDA approved this neuromodulator to treat wrinkles on the top third of the face, BOTOX® injections have been the most popular cosmetic procedure worldwide. BOTOX® has been around far longer, treating conditions such as involuntary eyelid spasms, but when BOTOX® was approved for wrinkle treatment, it took off.

So, why is BOTOX® so popular? It works. BOTOX® is the master of what are called dynamic wrinkles. These are wrinkles formed by muscle contractions on the upper third of the face. Dr. Palu offers BOTOX® Cosmetic at his New York practices.

What is BOTOX® Cosmetic?

BOTOX® basically is the botulinum toxin type A, along with some additional proteins. The botulinum toxin is the same neurotoxin that causes botulism, but in the 1950s scientists discovered that if the toxin was injected into a muscle in very minute doses it effectively paralyzed that muscle for a period of time.

Originally, BOTOX® was used to treat issues with muscles contracting involuntarily, such as eyelid spasms, TMJ disorder, and other muscle spasm conditions. More recently, BOTOX® has been approved to treat migraine headaches.

But when it was approved to treat facial wrinkles, BOTOX® became famous.

How Does BOTOX® Stop Wrinkles?

Human skin develops two kinds of wrinkles: static wrinkles and dynamic wrinkles. Static wrinkles show themselves at all times. They usually form from a combination of decreasing collagen production (a natural part of aging), sun damage, and other environmental factors. BOTOX® doesn’t improve these wrinkles at all — static wrinkles are the domain of dermal fillers.

BOTOX® works in a wholly different manner. As noted above, when injected in minute doses into a muscle BOTOX® can temporarily paralyze that muscle. When we perform certain expressions such as frowning or squinting, we use muscles on the upper third of our face. Over time, these repeated muscle contractions form wrinkles on the skin above the muscle. These are known as dynamic wrinkles. BOTOX® blocks the messages sent from the brain to the nerves in the muscles. When the brain’s message can’t get to the muscle, the muscle doesn’t contract to form the wrinkle above it.

Am I a Candidate for BOTOX®?

The answer to the question if BOTOX® would eliminate your wrinkles depends on the wrinkle type. If you want to address your crow’s feet, the lines between your eyebrows, and forehead wrinkles, BOTOX® is the answer. But, if your wrinkles are always there — static wrinkles — BOTOX® is not the right treatment. These wrinkles are addressed with dermal fillers such as Juvederm.

What Areas Can Be Treated With BOTOX®?

BOTOX® works on mainly the upper third of the face. This is the area of the face where we make expressions, and it is these muscles that create wrinkles on the surface skin above. BOTOX® is excellent for masking crow’s feet, the 11s (vertical lines that form between your eyebrows), and forehead lines.

How long does a BOTOX® session last and what’s involved?

A BOTOX® session with Dr. Palu takes only 15 minutes or so. Because BOTOX® in injected with such a tiny needle, numbing cream is not necessary (but is available if desired).


BOTOX® doesn’t show immediate results. This is because the botulinum toxin needs to first get to work stopping the contractions of the targeted muscles. This takes from three to seven days to fully take effect.

BOTOX® stops dynamic wrinkles for four to six months. This span is due to different rates of absorption by different people. At some point, your body will absorb the now-inert BOTOX® and the wrinkles will return. When that happens, it’s time for another session with Dr. Palu to maintain your results.

Is BOTOX® a Dermal Fller?

Many people lump BOTOX® in with dermal fillers, but they are not at all the same. As mentioned above, BOTOX® works on dynamic wrinkles formed by muscle contractions under the skin. BOTOX® does not work on wrinkles that show themselves at all times, such as wrinkles from sun damage. Because these wrinkles have nothing to do with a muscle contraction, these wrinkles must be filled in from below. That’s what dermal fillers such as Juvederm and Restylane do, fill the space and push the skin back up.

BOTOX® Side Effects

BOTOX® has been used hundreds of millions of times since its 2002 aesthetic debut, and there have been few side effects. The main issue can be slight redness or bruising at the injections sites, but this usually passes within just a few hours. Headaches are also possible, but they are very rare.

It’s important after your session for the patient not to rub the areas where the BOTOX® was injected for 12 hours. This can cause the BOTOX® to migrate to an unwanted muscle, which can lead to temporary drooping of an eyelid or other unintended effects.

Dr. Palu’s Experience

The skill and facial knowledge of your injector is important to obtain the best results with BOTOX®. Dr. Palu has extensive knowledge of the facial anatomy surrounding the eyes. This ensures your BOTOX® is injected into the proper location, something that isn’t always the case with inexperienced injectors.

Schedule a Consultation

To learn more about Botox or to schedule a consultation at one of our offices in New York or New Jersey, please call 212-213-2002

For more information on our services, call our office to make an appointment.

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