In cosmetic surgery, as in cardiology and other fields, the trend is toward less invasive approaches. Topical applications such as chemical facial peels, lasers and wrinkle creams are often effective supplements to surgery. Botox, a toxin made by botulism bacteria, is used to temporarily paralyze facial muscles that cause wrinkling. In areas of constant motion -- think smile lines around the eyes or frown lines in the center of the brow -- these muscles cause repetitive creases, which lead to permanent wrinkles.
Patients typically receive pretreatment with a prescription-strength cream to numb the skin, and Botox is administered with very small-gauge needles. The plastic surgeon uses knowledge of the anatomy of the facial muscles to systematically inject them with tiny amounts of Botox. This paralyzes the muscle for anywhere from 4 to 6 months, reducing the extent to which it can pull on the skin. While the treatments may make you less able to move your eyebrows to show the full extent of your surprise or anger, people still generally get the message. Botox causes a temporary softening of fine lines and has a smoothing effect on fine wrinkles.