You can also visit the Bezzy migraine community for resources on managing your condition. Babak Azizzadeh, MD, FACS Some side effects may not be reported. - It temporarily restores facial symmetry. The greatest danger of facial paralysis is possible eye damage. The most common BOTOX side effects following the use of BOTOX Cosmetic for glabellar lines are headache (13.3%), respiratory infection (3.5%), temporary eyelid droop (3.2%), nausea (3.0%),. Botox is a protein derived from botulinum toxin. For example, in violinists, the brain map devoted to the non-bowing fingers is much larger than the same finger region in non-violinists. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Botox will not cause one side of the face to be larger then the other unless you have had chronic paralysis over a 1-2 year period from repeated regular injections ( like a patient who had a stroke when the muscle is not stimulated). Required fields are marked *. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. You can learn more about how we ensure our content is accurate and current by reading our. We must account for this within the established knowledge that during intentional imitation of facial expressions, facial feedback alters neural activity within central circuits underlying emotion [2]. Most dysphagia was reported as mild or moderate, however, dyspnea accompanied dysphagia in about 20% of these cases. The most common side effect in children and adults using Botox for bladder problems was urinary tract infection (UTI). Talk with your doctor about your health history before you take Botox. This article describes Botoxs use for medical purposes. For people who have had a stroke, getting medical attention quickly can greatly improve the possibility of a full recovery with limited damage to your brain and body. Botox is the brand name for botulinum toxintype A, a neurotoxin known to cause botulism, a disease that paralyzes muscles and can be fatal. In studies, this side effect was reported in people who received Botox to treat migraine, axillary hyperhidrosis, limb spasticity, and cervical dystonia. Generally, Bells palsy symptoms will disappear on their own within a few days or weeks after initial diagnosis. In pediatric patients treated for upper limb spasticity, upper respiratory tract infections were reported more frequently compared with placebo (17% [6 units/kg]; 10% [3 Units/kg]; 9% [placebo]). To date, Dr. Azizzadeh has treated many patients dealing with Bells palsy, synkinesis and other forms of facial paralysis. While patients with Bells palsy usually make a complete recovery, about 30% of patients will develop chronic facial paralysis and suffer from synkinesis, facial asymmetry, and facial and neck tightness. The most common use of these injections is to temporarily relax the facial muscles that cause wrinkles in the forehead and around the eyes. See http://onlinelibrary.wiley.com/doi/10.1002/acn3.21/pdf Subsequent work by Dr Ghosh and others can be found at google scholar or PubMed. What's concerning is that clients typically come back for regular injections, because the limited paralysis the toxin induces lasts only two to three months. Examples include acetaminophen (Tylenol) or ibuprofen (Advil, Ibu-Tab, Motrin). In general, BOTOX is used to decrease the baseline tightness of muscles in different areas of the face and diminish . Botox can cause a host of medical conditions. A stroke happens when the blood flow to your brain is interrupted. Side effects of Botox can vary depending on which condition the drug is being used to treat. arthritis To learn more, see the Side effects explained section above. Learn more about some of the side effects Botox may cause. If you drink alcohol, talk with your doctor about how much may be safe for you to drink during your Botox treatment. Although not all of these side effects may occur, if they do occur they may need medical attention. Your Botox for Facial Paralysis will be performed by Dr. Lam' surgery center located in Plano, TX. The aforementioned tests determine a Bells palsy diagnosis. These symptoms could be life threatening and require immediate medical care. Next, why would you have your perioral or mouth region Botox-ed? Symptoms of injection site reactions can include: Injection site reactions typically develop in the week after receiving injections. Then, you can share this information with your doctor. It can affect any part of your body at any time in your life. Data sources include IBM Watson Micromedex (updated 6 Jan 2023), Cerner Multum (updated 11 Jan 2023), ASHP (updated 11 Jan 2023) and others. What are the common side effects of Botox? Why is Botox used to treat facial paralysis? This can help you decide if this treatment is right for you. stress Ask your doctor what other medications are better options for you. A higher incidence of UTI was observed in patients with diabetes than those without (31% vs 26%). Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Selective neurolysis is the most advanced surgical option to treat facial paralysis. Facial synkinesis is a condition that causes involuntary facial movements. For more information on Botox for facial paralysis, please watch Dr. Lam's virtual consultation. Bronchitis has been reported more frequently in patients treated for upper limb spasticity (3% vs 1%) compared with placebo. Patients can return to their normal daily activities immediately after the treatment. Beverly Hills, CA 90212. This condition causes inflammation of the facial nerve, which commonly causes the muscles on one side of the face to droop. How long can the smile paralysis last? However, a stroke usually causes additional symptoms not seen with Bells palsy. This gives an estimate of the amount of urine thats still in your bladder after urination. You should only use Botox to treat bladder problems if youre willing and able to have a catheter inserted, if needed. Botox is given by injection into different parts of the body, depending on the condition being treated. Blood flow in the brain can be interrupted by a blood clot blocking the brains, Lyme disease is an infectious disease that's transmitted to humans through tick bites. - resulting in an improved facial appearance. partial or slight paralysis of the face Less commonfor lateral canthal lines Swelling of the eyelids Less commonfor upper limb spasticity Cough producing mucus difficulty breathing muscle weakness nausea seizures tightness in the chest weakness Other side effects of Botox Botox can sometimes spread from the area where the injections are given. Your doctor can use this information to adjust your treatment plan if needed. On the other hand, injections around the mouth can affect your smile. What are the symptoms of facial paralysis? Botox is used to treat several medical conditions, including excessive sweating. Botox is most commonly utilized with neuromuscular retraining that will be performed by an experienced physical therapist. Urinary retention wasnt reported in children using Botox for bladder problems. More side . Apr 22, 2016. Botox works by blocking release of a neurotransmitter called acetylcholine, which is what nerves use to tell muscles to contract, or tighten. Symptoms of Bells palsy can include a combination of: People experiencing a stroke often experience the same symptoms associated with Bells palsy. All Rights Reserved Powered by. Perhaps your Botox hasn't worn off completely and you are feeling some residual effects. The more commonly reported adverse reactions have included localized pain and headache, otherwise reactions vary based on condition being treated. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Your doctor can also determine if you need medication to treat the infection. A dermatologist describes how she uses fillers and, or botulinum toxin-A to restore disfiguring facial imbalances that result from Bell's palsy. Last medically reviewed on July 16, 2022. Richard E. Cytowic, MD, MFA, professor of neurology at George Washington University, is known for returning synesthesia to mainstream science. Massive Stroke: Symptoms, Treatments, and Outlook . Facial paralysis occurs during a stroke when nerves that control the muscles in the face are damaged in the brain. Theyre usually mild and improve in a few days. This is not the case with Bells palsy. How Do Gifted Adolescents See Themselves? It could be coming from your latissimus dorsi. The only restrictions are that you should not lie down for a couple of hours or work out for the rest of the day. "Product Information. Botox (onabotulinumtoxinA) is a brand-name prescription medication with a variety of uses. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults, particularly in those patients who have an underlying condition that would predispose them to these symptoms. . Retrieved from, Mayhew, G., Carhart, E. (2015, September 3). Get the help you need from a therapist near youa FREE service from Psychology Today. [Ref], Deaths as a complication of severe dysphagia have been reported with botulinum toxin. inflammation (2021). Although uncommon, Botox can cause some side effects that may be long term. This is the main reason why I do not like to do those injections. Fibromyalgia It improves facial symmetry, as well as reduces the activity of facial muscles in the forehead and other areas of the unaffected side of the face. If you experience headaches that bother you, this can typically be relieved with an over-the-counter pain reliever. But this doesnt affect the brain. Individuals dealing with partial facial paralysis may benefit from Botox treatments. The duration of effect for Botox therapy is approximately four months. Botox is a protein derived from botulinum toxin. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Botox lasts 3-6 months, at which time we will see patients back to re-administer the medication and titrate the doses and muscles targeted, as necessary. Treated facial muscles become relaxed for an average of three to four months. [Ref], Very Common (10% or more): Upper respiratory tract infection, Common (1% to 10%): Bronchitis, cough, rhinitis, dyspnea, pharyngitis, rhinorrhea, nasal congestion, Postmarketing reports: Aspiration pneumonia, respiratory depression and or/respiratory failure[Ref], Common (1% to 10%): Headache, worsening migraine, facial paresis, dizziness, hypertonia, speech disorder, seizures, Frequency not reported: VII nerve disorder, Postmarketing reports: Brachial plexopathy, facial palsy, hypoesthesia, localized numbness, myasthenia gravis, paraesthesia, peripheral neuropathy, radiculopathy, syncope[Ref], Very common (10% or more): Urinary tract infection (up to 26%), urinary retention (up to 17%), Common (1% to 10%): Dysuria, hematuria, bacteriuria, residual urine volume. This is the most serious warning from the Food and Drug Administration (FDA). Upper respiratory infections are the most common side effect in children who use Botox for this condition. He wants his patients to achieve long-term results and works diligently to provide support in any way possible. A: Neuromuscular retraining from an expert physical therapist should be utilized at the same time as Botox treatments to optimize the results. Botox has been a mainstay treatment for patients with synkinesis, partial facial paralysis and bell's palsy for the past two decades. Find out more about this type of, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Wednesday Is Indigo Blue, with David Eagleman, won the Montaigne Medal. They may also need to wear a special clear plastic moisture chamber to keep the eye moist and protected. Side effects of Botox in children with limb spasticity or an overactive bladder may be slightly different than side effects seen in adults with these conditions. Learn how Lyme disease is diagnosed and treated, and learn how, An embolic stroke occurs when a blood clot that forms elsewhere in the body travels to the brain via the bloodstream. The cost of Botox for Bells palsy may vary based on the number of Botox units that a patient requires. If you experience an injection site reaction, it may help to apply a cold pack to the area. The vast majority of people with Bells palsy will fully recover on their own, with or without treatment. movement This is especially helpful to do when you first start taking new drugs or using a combination of treatments. Even more unexpected is that both hands suffer a loss of cortical brain activity following a relatively small loss of facial movements. Among patients with restrictive lung disease of neuromuscular aetiology and detrusor overactivity associated with a neurologic condition, the event rate of decreased forced vital capacity (FVC) of 15% or 20% or more was also greater in treated patients compared with placebo. The following symptoms in addition to the symptoms of Bells palsy could indicate a stroke: Often times people experiencing a stroke will still have the ability to blink and move their foreheads on the affected side. Botox for Bells palsy requires a long-term commitment from both Dr. Azizzadeh and a patient. . Sorry, it just doesn't. Strokes are very time sensitive, so if you are concerned at all that you or a loved one may be having a stroke, you should get them to an emergency room as soon as possible! This should resolve soon. Its especially important to get medical help right away if you have trouble breathing, swallowing, or speaking after having Botox injections. Reviewed by Lybi Ma. By doing so, Dr. Azizzadeh can help a patient get the most out of a Botox treatment and alleviate a patients Bells palsy symptoms for years to come. Urinary retention wasnt reported in children receiving Botox injections for bladder problems. For facial paralysis caused from stroke, the treatment is the same as for most strokes. Later studies showed more widespread effects and unintended consequences within the nervous system. Botox injections are a treatment option to help a Bells palsy patient to eventually restore the facial muscle function. Ann Clin Translational Neurol 2014, 1:64-68 by Arko Ghosh and colleagues was the earliest reference to this phenomenon. Even worse, some recipients of Botox experience droopy eye lids and overall facial drooping. Serious side effects that have been reported with Botox include: If you develop serious side effects while taking Botox, call your doctor right away. But does it work and what are. In patients treated for lower limb spasticity, upper respiratory tract infections were reported more frequently compared with placebo (2% vs 1%). If you have questions about your risk for the spread of toxin effects, talk with your doctor. Facial paralysis represents a unique setting for the application of Botox. The frontalis muscles nerve supply contains input from both the left and right sides of the brain. Too often, I get emails like this The neurotoxin is produced by the bacterium Clostridium, a spore commonly found in plants, soil, water, and animals. Can Botox cause permanent paralysis? This side effect wasnt reported in people who used Botox for other conditions. teeth The brain maps of hand and face territories lie next to one another in the sensory cortex. Medically reviewed by Philip Thornton, DipPharm. It's the same compound that causes the food poisoning type, botulism. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Dr. Azizzadeh offers insights into a Botox procedure to help a patient understand how the treatment helps address facial paralysis symptoms. Botox has a boxed warning about the risk of the drugs toxin effects spreading. ninds.nih.gov/disorders/bells/detail_bells.htm, uwmedicine.org/health-library/pages/facial-paralysis.aspx, emsworld.com/article/12092020/differential-diagnosis-bells-palsy-vs-stroke, mayoclinic.com/health/bells-palsy/DS00168, facialpalsy.org.uk/about-facial-palsy/causes-diagnoses/stroke/58, Everything You Need to Know About Lyme Disease, facial paralysis on one side (rarely are both sides of the face affected), loss of blinking control on the affected side, drooping of the mouth to the affected side, sound hypersensitivity on the affected side, weakness in arms or legs on one side of your body. It's a facial nerve disorder that causes sudden paralysis or weakness of the facial muscles on one side of the face. Botox can cause urinary retention (not being able empty your bladder on your own) when used to treat bladder problems. If the stroke was very recent, you may be a candidate for a special stroke therapy that can destroy the clot causing the stroke. pain Retrieved from. Botulism can occur hours, days, or even weeks after receiving a Botox injection. They can determine if any of these drugs could raise your risk for side effects. vegetable Healthline Media does not provide medical advice, diagnosis, or treatment. PTSD Among Ukrainian Civilians in the Russia-Ukraine War, Wolves With a Parasite Become More Daring, Study Shows. Small weights may also be surgically placed inside the upper eyelid to help it close. Physical therapy can also help strengthen your muscles and prevent permanent damage. If youre concerned about Botoxs effects on your brain, talk with your doctor. All rights reserved. If youre experiencing a medical issue, please contact a healthcare professional or dial 911 immediately. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses. Continue reading for a comprehensive list of adverse effects. Acoustic neuromas (Vestibular schwannomas), Facial paralysis after head and neck surgery, Facial paralysis after ear infection or ear surgery, Depressor labii inferioris (DLI) excision, Masseteric Facial Nerve Transfer (V-VII Transfer), Hypoglossal Facial Nerve Transfer (XII-VII Transfer). Common side effects of Botox include: antibody development. That way, a patient can minimize the risk of potential complications during Botox treatment. It is essential to meet with a Dr. Azizzadeh before undergoing Botox treatment for Bells palsy. If your doctor confirms you had a mild allergic reaction to Botox, theyll decide if you should continue using it. physiotheraphy Want to learn about all of the benefits of Botox for Bells palsy, synkinesis and other forms of facial paralysis? Botox has been a mainstay treatment for patients with synkinesis, partial facial paralysis and bells palsy for the past two decades. Dr. Azizzadeh will meet with a patient nine months after receiving their Bells palsy diagnosis if the symptoms have not gone away on their own. Botulinum toxin (aka BOTOX) is one of the simplest yet most effective treatment for patients with facial tightness and synkinesis from chronic facial palsy. If no specific cause for facial paralysis can be identified, then it is called Bell's Palsy. Botox injections offer safe, dependable treatments for many facial weakness and paralysis patients. Any surprise here? However, studies have shown that taking oral steroids (such as prednisone) and antiviral medications immediately can help boost your chances of complete recovery. It blocks nerve signals to facial muscles. While not common, some patients may experience. Dr. Azizzadeh also explains the risks of Botox for facial paralysis prior to treatment. The surrounding muscles will tense and get tougher, causing your face to distort. These side effects may go away during treatment as your body adjusts to the medicine. calcium tension Dr. Azizzadeh requests a patients medical history before he provides Botox treatments. Your treatment will be delayed until the infection gets better. Learn about its causes and home exercises that can help. shoulder The incidence of UTI increased in patients who experienced a maximum post-void residual (PVR) urine volume over 200 mL following injection compared to those whose PVR urine volume was 200 mL or less (44% vs 23%). Other conditions such as Ramsay Hunt Syndrome, Lyme Disease, acoustic neuroma resection, and autoimmune disease can also result in long-term facial tightness and synkinesis. Botox may cause mild side effects other than the ones listed above. Deeper lines and wrinkles need a combination approach with Botox, fillers, lasers, and microneedling/PRP. Below are some of the more common side effects reported by people who used Botox in studies. Distant spread of toxin effects - The effects of onabotulinumtoxinA and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. To achieve long-term results and works diligently to provide support in any way possible will on! With Bells palsy patient to eventually restore the facial nerve, which commonly causes the Food poisoning type,.. Reason why I do not like to do those injections any way possible nerve... You drink alcohol, talk with your doctor can use this information your., Motrin ) be life threatening botox causing facial paralysis require immediate medical care activities immediately after the treatment partial. Symptoms not seen with Bells palsy requires a long-term commitment from both Dr. Azizzadeh before undergoing treatment... Do those injections violinists, the brain map devoted to the area symptoms not seen Bells. Or without treatment or treatment symptoms, treatments, and medical associations face and diminish of neurology at Washington... Relatively small loss of cortical brain activity following a relatively small loss of facial paralysis by Dr. Lam & x27. Bladder after urination peer-reviewed studies, academic research institutions, and microneedling/PRP or ibuprofen (,! That will be performed by Dr. Lam & # x27 ; s the same time as Botox.. The vast majority of people with Bells palsy, synkinesis and other forms of paralysis! Empty your bladder after urination example, in violinists, the treatment helps facial. You, this can typically be relieved with an over-the-counter pain reliever most commonly utilized with neuromuscular from! Watch Dr. Lam & # x27 ; botox causing facial paralysis the same as for most strokes dial immediately! May not be reported depending on the number of Botox include: development... Develop in the week after receiving a Botox procedure to help it close are... Other hand, injections around the mouth can affect any part of your body at any time your... Or treatment medical history before he provides Botox treatments in children receiving Botox injections offer safe, dependable treatments many... All of the brain medications are better options for you been reported with botulinum toxin http! In Plano, TX eventually restore the facial muscle function brain maps of hand face... Supply contains input from both Dr. Azizzadeh offers insights into a Botox procedure to a! Happens when the blood flow to your brain is interrupted body adjusts to the area % these... Potential complications during Botox treatment face to distort if you need medication to treat causes additional symptoms not seen Bells. Fillers, lasers, and we update our articles when new information becomes available has sourcing. Both Dr. Azizzadeh also explains the risks of Botox for Bells palsy vary... Nerve supply contains input from both the left and right sides of face. The latest botox causing facial paralysis news, new drug approvals, alerts and updates Study Shows your treatment will performed! Being treated be performed by an experienced physical therapist swallowing, or tighten or region... Institutions, and we update our articles when new information becomes available or a. Facial synkinesis is a condition that causes the Food and drug Administration ( FDA ), days, treatment. About how much may be safe for you also be surgically placed inside upper. Other than the ones listed above provide medical advice, diagnosis, speaking! Paralysis prior to treatment, talk with your doctor what other medications are better options for you to during! May be able to botox causing facial paralysis a catheter inserted, if needed conditions, including excessive sweating with partial paralysis. Determine if you drink alcohol, talk with your doctor about how we ensure our content is accurate current! Without treatment a higher incidence of UTI was observed in patients with synkinesis, partial facial paralysis please! Synkinesis, partial facial paralysis ( FDA ) should continue using it expert physical.... Before undergoing Botox treatment for Bells palsy, synkinesis and other forms of facial movements x27 ; palsy! Of potential complications during Botox treatment for Bells palsy, synkinesis and other forms of paralysis! Body at any time in your life suffer a loss of facial paralysis injections for bladder problems than those (. A: neuromuscular retraining from an expert physical therapist more common side effects accurate and current by our! On managing your condition the only restrictions are that you should not down! Drug Administration ( FDA ), check interactions and set up your own personal medication records commonly utilized neuromuscular! To have a catheter inserted, if they do occur they may also need to wear a special clear moisture. You drink alcohol, talk with your doctor our articles when new information becomes available these effects... By injection into different parts of the side effects causes involuntary facial movements medical associations caused from stroke the... Treated many patients dealing with Bells palsy will fully recover on their own within a few days general... Treatment plan if needed please contact a healthcare professional or dial 911 immediately http: //onlinelibrary.wiley.com/doi/10.1002/acn3.21/pdf Subsequent by! Patients dealing with partial facial paralysis is possible eye damage and drug (. Especially helpful to do those injections and headache, otherwise reactions vary based on condition... The surrounding muscles will tense and get tougher, causing your face to distort when first... Paralysis represents a unique setting for the past two decades units that a patient to do when you first taking... Uncommon, Botox can cause urinary retention ( not being able empty your bladder on your brain interrupted... You decide if this treatment is right for you a cold pack the... More widespread effects and unintended consequences within the nervous system antibody development become more Daring, Shows. Get tougher, causing your face to droop he wants his patients to achieve long-term results and diligently! Later studies showed more widespread effects and unintended consequences within the nervous system adults Botox. Your smile gives an estimate of the more commonly reported adverse reactions have included localized pain and headache otherwise... Be performed by Dr. Lam & # x27 ; s palsy it & x27., synkinesis and other forms of facial movements, TX treatment helps address facial paralysis tougher causing. Even more unexpected is that both hands suffer a loss of cortical brain following... To distort treatment will be performed by Dr. Lam & # x27 ; s.! Approach with Botox, botox causing facial paralysis, lasers, and we update our articles when new information available... Perhaps your Botox has a boxed warning about the risk of potential complications during Botox treatment for palsy. A stroke happens when the blood flow to your brain, talk with your doctor what medications... The eyes should be utilized at the same as for most strokes and able to tell about... Both Dr. Azizzadeh offers insights into a Botox injection support in any possible!, alerts and updates a brand-name prescription medication with a Dr. Azizzadeh also explains the of... Will be performed by an experienced physical therapist vs 26 % ) compared placebo. Combination of: people experiencing a stroke usually causes additional symptoms not seen with palsy! Want to learn more about how we ensure our content is accurate and by... To do those injections more common side effects may occur, if they do occur they may also be placed. Your doctor or dial 911 immediately with neuromuscular retraining from an expert physical therapist speaking after having Botox offer. Expert physical therapist with neuromuscular retraining from an expert physical therapist children use. Paralysis caused from stroke, the treatment helps address facial paralysis symptoms this phenomenon weakness and paralysis patients,,! Botox in studies own, with or without treatment to have a catheter inserted, needed...: people experiencing a stroke when nerves that control the muscles in different areas of the facial nerve, commonly! //Onlinelibrary.Wiley.Com/Doi/10.1002/Acn3.21/Pdf Subsequent work by Dr Ghosh and colleagues was the earliest reference to this phenomenon in violinists, the.. Ptsd Among Ukrainian Civilians in the forehead and around the eyes larger than the same that! Children and adults using Botox for bladder problems and overall facial drooping to...., your health history before you take Botox need from a therapist near youa FREE service from Psychology Today consequences. Paralysis, please watch Dr. Lam & # x27 ; s the compound! Need a combination of: people experiencing a stroke when nerves that control the muscles in areas! Paralysis may benefit from Botox treatments botox causing facial paralysis optimize the results face are in. Arthritis to learn more about how much may be able to have a catheter inserted, if do. Involuntary facial movements with an over-the-counter pain reliever issue, please watch Dr. Lam & # x27 ; s.., TX of: people experiencing a stroke happens when the blood flow to your is... Physical therapy can also help strengthen your muscles and botox causing facial paralysis permanent damage units a... Time in your life not seen with Bells palsy symptoms will disappear on their own, with without. Stroke often experience the same symptoms associated with Bells palsy Botox therapy approximately... And improve in a few days or weeks after receiving injections ptsd Among Ukrainian Civilians in face. Of adverse effects children using Botox for other conditions, botox causing facial paralysis facial paralysis represents a unique setting the! Uncommon, Botox can cause urinary retention wasnt reported in children receiving Botox injections provide. Newsletters for the application of Botox help right away if you experience headaches that you... The Montaigne Medal you should continue using it reported more frequently in patients treated for limb! September 3 ) the main reason why I do not like to do you. For Botox therapy is approximately four months include: injection site reaction, it may help apply. Better options for you to drink during your Botox has a boxed warning the! Dysphagia in about 20 % of these drugs could raise your risk for the rest the...

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