
At UCSF Medical Center, our dermatologic and plastic surgeons are specially trained to administer botulinum toxin injections, commonly known as Botox or Dysport. Although botulinum toxin has become a popular procedure and is often performed in non-medical settings, it is best to receive injections from a trained and experienced doctor in a sterile, well-equipped medical facility.
Botulinum toxin works by inhibiting muscle movement that leads to lines and furrows. It is used to improve:
Botulinum toxin may also be used to treat hyperhidrosis, a condition that causes excessive sweating, most commonly in the underarms and palms. This is a debilitating problem that often interferes with work, social interactions and daily activities. Botulinum toxin is typically used for patients with hyperhidrosis who have not responded to other medical therapies.
If you are considering botulinum toxin injections, you will first meet with a surgeon for a consultation to discuss your cosmetic goals. You will also discuss your medical history, including previous surgeries, present and past health problems, medications, as well as nutritional and herbal supplements you are taking or have taken at some time.
Your surgeon will examine your skin to determine if botulinum toxin is the right treatment for you. Not all facial wrinkles will benefit from botulinum toxin injections, such as those that are caused by sun damage or prior trauma.
In addition, injections cannot be performed on women who are pregnant or nursing, people who are allergic to any ingredient in botulinum toxin, or who have an infection at the site where an injection will be made.
Botulinum toxin injections are performed in our clinics. Depending on the number of injections, the procedure lasts from 10 to 20 minutes. It is relatively painless, although the injection may cause some slight discomfort, similar to a prick. Local anesthesia is not used, but pain can be reduced by proper injection techniques and by numbing injection sites with a cold pack or anesthetic cream.
During the procedure, your surgeon will ask that you contract the muscle area to be treated to determine the best injection sites. These areas may then be numbed with an ice pack or a topical numbing agent. Finally, your dermatologic surgeon will administer several tiny injections of botulinum toxin directly into the muscle. This precise technique ensures that only the treated areas will be affected.
As with any medical procedure there are possible risks and side effects of botulinum toxin. Since this is a non-surgical procedure, the risks and possible complications are generally uncommon, minimal and temporary.
Common side effects include very slight discomfort from the injection, redness or bruising around the injection site. These are temporary and generally resolve quickly and can be covered by makeup. In rare instances, there can be some temporary eyelid droop or heaviness.
Patients being treated for hyperhidrosis in the palms may experience slight muscle weakness in their hands for several weeks after treatment. Actions involving fine motor skills like opening a jar or turning a key may be temporarily difficult.
You will notice improvement from botulinum toxin 24 to 48 hours after the injections; however, it typically takes between three to seven days for final results to become apparent. You may experience some mild and temporary bruising, numbness or redness around the injection sites.
The majority of patients can return to most of their normal activities immediately after their injections, although strenuous activity should be avoided for 24 hours. In addition, to avoid spreading the toxin to other muscles, you should not rub or massage the area injected, and remain in an upright position for two hours following your procedure.
The results of the injections generally last for three to four months. Most patients return for repeat treatments as soon as the results fade.
Reviewed by health care specialists at UCSF Medical Center.

Dermatologic Surgery and Laser Center
1701 Divisadero St.
San Francisco, CA 94115
Phone: (415) 353–7878
Fax: (415) 353–7838
Facial Plastic and Reconstructive Surgery
2330 Post St., Fifth Floor
San Francisco, CA 94115
Phone: (415) 353-9500
Fax: (415) 885-7800