Your Cleveland Medical Center for Botox

Botox® (Allergan’s trade name for botulinum toxin) is a product of the bacterium Clostridium botulinum that works by  blocking nerve impulses.  Initially identified as the cause of botulism, a rare paralytic illness often linked to food poisoning, it is now more recognized as a tool used in cosmetic medicine to treat moderate to severe brow furrow (glabellar lines),  wrinkles, and facial creases.  Botulinum toxin has been used for quite some time for many medical indications including muscle spasticity, esophageal problems, vocal cord abnormalities to name a few. I also use botulinum toxin to treat excessive sweating (hyperhidrosis) , usually of the underarms or hands.

For cosmetic purposes, the product is diluted and injected into the muscles we wish to paralyze. The result usually takes three or four days to start working and the results on average last four to six months. To maintain the results re-treatment is essential. Many patients note a marked improvement in not only the wrinkles but a general feeling of less stress, fewer headaches, and less fatigue over time. Although minimally invasive (the medication is injected with a very small needle) there are risks. The most common risks include bruising and/or discomfort at the injection site, tiredness, headache, and  drooping eyelids among others. Fortunatly, adverse and side effects are rare and resolve as the effects of the medication wane.

This is a powerful technique when used for the right indications.

Botox® is not usually covered by insurance. More information about the financial arrangements for cosmetic surgery can be found on the Consultation Page.

I would be happy to provide you with more information or answer any other questions and can be contacted by phone at 1-216-778-2245 or by email at

Dr. Bram Kaufman

A possible treatment for some cases of depression

Some studies have indicated that Botox used for aesthetic purposes can help people with mental illness. A study published in Dermatologic Surgery found that treating clinically depressed patients with Botox on the frown lines of their faces actually got rid of their depression.

How does Botox work?

Botox works to relax the contraction of muscles by. The result is muscles that can no longer contract, and so the wrinkles relax and soften. It usually takes two to four days to see cosmetic improvement and the effects tend to last from four to six months. Most patients require retreatment to remove wrinkles and lines as they begin to reappear, but after each injection the wrinkles return as less severe as the muscles are trained to relax

How is Botox administered?

Botox procedures do not require anesthesia and usually take just a few minutes to perform. The protein is injected into the muscle using a fine needle in order to minimize discomfort and maximize accuracy. It is recommended that patients avoid alcohol for about a week before the procedure. In order to minimize bruising, patients should stop using aspirin and anti-inflammatory medications about two weeks before treatment. For cosmetic procedures, a study published in Dermatologic Therapy found that men need a higher dose of Botox than women.

Is Botox better than a face-lift?

According to the American Society of Plastic Surgeons, whether Botox gives better results than a facelift (surgery) depends on the age of the patient. People in their 30s who have had limited exposure to sunlight usually show signs of aging in their eyes and temple area first, with crow’s feet and some bulging of the eyelid. As they have not lost much volume at this point, fillers or Botox usually smooth out the lines that people want to get rid of.

When people enter their 40s the middle of the face starts to shift as the cheeks lose some of their fat and laugh lines set in. The cheeks become deflated towards the end of the 4th decade, and the jowls start to sag. A combination of Botox as well as minimal lifting procedures will provide the best results.

What are the side effects of Botox?

The most common side effect of Botox injections is temporary bruising. Other possible side effects include:

  • Headache
  • Respiratory infection
  • Flu syndrome
  • Blepharoptosis (drooping of the upper eyelid)
  • Nausea
  • Indigestion (heartburn)

Doctors in the USA and the UK have reported that some patients “binge” on Botox to the point where their faces look frozen. They refer to the term “Wrinklerexia” – when some Botox-devotees become so obsessed with their wrinkle-free image that they start seeing lines where there are none and binge on Botox to obtain a freeze-frame face. [/toggle]