More Botox FAQ’s

Although I have written extensively about Botox in this blog, I still receive many questions about Botox and its use.  Here are some of the questions I have been asked over the past several weeks:

I understand what Botox is, but how does it work?

Botox is a protein which works by temporarily blocking a nerve ending, stopping the signal, between a nerve and a muscle, that causes muscle movement.  This nerve blockade results in a relaxation of the offending muscle and typically lasts about 3 months.

Is Botox safe?

Botox has been used for eye, nerve and muscle treatments.  For over ten years now, doctors have injected Botox hundreds of thousands of times.  In fact, Botox injections have been consistently ranked as the most common cosmetic medical procedure in the world.  I personally have injected Botox in several hundred people every year with minimal side effects.  The most common side effect is usually local bruising at the injection sites, which clears up in a few days.

Are the Botox injections painful?

Botox injections are administered into the skin through a very small needle about the size of needles diabetics use to inject insulin.  Many people feel a mild sensation, similar to a bug bite, followed by pressure.  Redness at the site is usually short-lived and easily covered by makeup.  I frequently call it the “black fly bite look”.

Will Botox help my headaches?

Botox is FDA-approved for the treatment of migraine headaches, although I have yet to find an insurance company that will cover this therapy.  Many migraine patients who receive Botox for cosmetic reasons between the eyes notice a significant drop in the intensity and frequency of their migraines.  Many others who have tension headaches and headache from eye strain also notice substantial improvements with Botox therapy.

Will Botox make my face look frozen?

When I inject the usually recommended doses of Botox to the facial muscles, contraction of muscles that produce wrinkles is prevented, but the person is still able to make natural facial expressions.  My goal is always to use minimal dosage of Botox, which will allow natural appearance but will avoid the frozen look of some Hollywood stars.  Most of my patients say that very few people will ever spot the fact that they use Botox, mostly they are told that they look relaxed.

What actually causes my frown lines, forehead lines, and smile lines or crow’s feet?

These types of wrinkles or lines are called dynamic wrinkles.  Lines on the upper face are caused by overuse of certain muscles that are used to make facial expressions.  Squeezing the muscles between the eyes can cause “scowl lines” to appear, which makes people look angry even when they are not.  Repeatedly raising your eyebrows can cause horizontal forehead lines and make people appear older.  “Crow’s feet” due to repeated smiling and animated facial expressions radiate from the corners of the eyes and also contribute to appearing older.

Can Botox be used to prevent new wrinkles from forming?

When Botox is used to target muscles of facial expression, it can be considered a preventive measure.  Many people frequently tell me that everybody older than them in their families have certain lines between or around the lines.  In those cases, I can target the offending muscles as soon as the earliest sign of lines begins to appear with appropriate injections.  Also, if Botox is consistently injected every 3-4 months or as soon as the effects of Botox begin to wear off, the facial expression muscles will become weaker and the deep furrows caused by the muscles will fade away.  Preventing facial lines will promote a younger and more relaxed look.


I know there are more questions about Botox, and I would be happy to answer them not only during office visits, but also on the comments section of this blog, and on our Facebook page.  Thank you, and I look forward to reading your questions and comments.

About Dr. John Burke

John Burke M.D. has practiced medicine for over 25 years, and is the founding partner of MidMaine Internal Medicine. He established Maine Laser Skin Care in 2004 after devoting years to learning the latest in laser and dermatologic technology. Dr. Burke has treated patients from all over the United States. He is one of Maine's busiest practitioners in laser treatments, and in the use of Botox for upper facial lines and excessive sweating.
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