Cosmetic Denervation, commonly known as Botox, is a procedure used to improve the appearance of worry lines, frown lines, crow’s feet, laugh lines, and other so called “dynamic wrinkles.” Dynamic wrinkles occur when we smile, laugh, or frown, and the delicate muscles underlying aging skin contract. Thousands of Botox injections are performed each year for a variety of conditions, and it has emerged as an exiting new treatment for ameliorating the visible consequences of aging. In cosmetic denervation, Botox is injected into these facial muscles and weakens them precisely.

After treatment, the overlying skin remains smooth and unwrinkled while untreated facial muscles contract normally, allowing normal facial expression to be unaffected. It must be remembered that the best candidates are individuals desiring a correction of dynamic wrinkles, static wrinkles that are unrelated to facial muscle contraction will not be improved. Botox will not improve loose or sagging skin and does not serve the same function as a face lift.


Avoidance of alcoholic beverages, anti-inflammatory medications, and aspirin may be recommended by some physicians before treatment.


Cosmetic denervation is safe and simple. No sedation or local anesthetic is required and normal activities can be resumed immediately after the injections. A small amount of Botox is injected with a very fine needle into several locations in the face. Pain associated with the injections is minimal due to the fine needle and small amount of liquid used.


Slight temporary bruising is common at the sites of injection, but otherwise there will be no visible signs of treatment. Unfortunately, cosmetic denervation is not a permanent solution to the problem of dynamic wrinkles. Since, injections usually last about four to six months, one may need treatment two to three times a year. However, results from clinical trials suggests that the duration of benefit increases with time so one may only require injections infrequently in the future, but this can vary from person to person. Furthermore, Botox injections may be less effective past age 65.


The risk of any side effects depends on the muscles injected. Transient weakness of eye closure, drooping of eyelids, or asymmetry of facial expression are some side effects since the medication can sometimes cause excessive weakness of the muscles. However, Botox is completely reversible and any side effects are temporary, lasting only days or weeks.