Botox in Roanoke, Virginia

Botox in Roanoke, Virginia

What is Botox® Cosmetic?

BOTOX® Cosmetic (onabotulinumtoxinA) is a prescription cosmetic injectable treatment derived from the purified but naturally occurring botulinumtoxin protein. It is injected into the muscles of the face to reduce the appearance of frown lines and wrinkles between and around the eyebrows.

BOTOX® Cosmetic (onabotulinumtoxinA) was the first of its kind and was initially approved in 2002 to temporarily improve moderate to severe lines in the forehead. In 2013 it became the first and only FDA-approved treatment to temporarily improve both moderate to severe frown lines between the brows and crow’s feet in adults. Since BOTOX® Cosmetic got FDA-approval in 2002, over 10.9 million vials have been sold in the United States. It is approved for cosmetic use in 78 countries, making it the #1 selling product of its kind in the world.


Wrinkles are the result of a combination of factors but the most critical cause is the contractions of muscles in the targeted zones:

  • The contraction of muscles between the brows when we frown or concentrate
  • The strain of muscles around the eyes when squinting (Crow’s Feet)

BOTOX® Cosmetic targets the underlying muscle activity by temporarily blocking the nerve impulses in the muscle which reduces its activity and encourages a visible smoothing of these lines and wrinkles.

Botox in Roanoke, Virginia

Because BOTOX® Cosmetic is temporary, and lasts 3 months on average, it is important to establish a treatment plan so that you can maintain optimal results. BOTOX® Cosmetic is a technique-sensitive treatment which is why our providers are licensed, and highly trained in facial anatomy, enabling our office to effectively treat those problem areas while allowing you to maintain an expressive face without the wrinkles!

Benefits of BOTOX® Cosmetic:

  • Diminishes wrinkles between the brows, in the forehead, and around the eyes
  • Lift the brows
  • Non-surgical
  • Decreases sweating

Botox in Roanoke, Virginia

How are BOTOX® Cosmetic Injections Performed?

Using a very fine needle, it is most often injected into the forehead and around the eyes, BOTOX® Cosmetic injections temporarily paralyze the targeted muscles to reduce their movement and diminish lines and wrinkles. The procedure is complete within minutes.

Botox in Roanoke, Virginia

There is a very small degree of discomfort associated with BOTOX® Cosmetic. The ‘pain’ is comparable to being pricked by a pin. We will usually ice the area prior to injections to help prevent bruising.

Preparing for BOTOX® Cosmetic:

Dr. Wray’s physician assistant, Natalie Roseman, or our nurse injector, Katie Vaughan, will evaluate the patient’s overall health and the sites where the BOTOX® is to be injected. They may also combine the procedure with a cosmetic filler to diminish fine lines and/or rejuvenate facial volume.

BOTOX® Cosmetic Recovery:

Recovery is quick, with only minor irritation and swelling at the injection sites. These will go away within a matter of hours. Bruising is possible but is usually minor. Your results will start to show within 2 weeks.

Is BOTOX ® Cosmetic Right for me?

The professionals at The Center for Plastic Surgery screen all of our patients carefully to ensure safe and effective BOTOX® Cosmetic treatments. Please keep in mind that a dose of BOTOX® Cosmetic is not the same as, or comparable to, any other botulinum toxin product so one product cannot take the place of another.

A few things to know before your treatment:

Typically, patients who receive BOTOX® Cosmetic are between the ages of 18 & 65.
Women who are pregnant or breastfeeding must postpone this procedure until they are no longer pregnant or breastfeeding.
BOTOX® Cosmetic is not to be used when there are signs of infection at the injection site.
BOTOX® Cosmetic is not to be used in individuals with known hypersensitivity to any ingredient in the formulation.
Patients with neuromuscular disorders such as ALS, myasthenia gravis, or Lambert-Eaton syndrome, may be at increased risk of serious side effects.

How Much Does BOTOX® Cosmetic Cost?

The cost of BOTOX® Cosmetic depends on the size of the targeted area and the number of injections. We accept cash, checks, and credit cards including VISA®, MasterCard®, Discover®, and American Express®. We also offer financing through CareCredit® . Payment in full is required prior to or at the time of your procedure.

Brilliant Distinctions Program®


Our office proudly participates in the Brilliant Distinctions Program® and manages your account for you so that you never lose your points! BOTOX® Cosmetic, Juvederm® XC, Juvederm® Ultra XC, Juvederm Voluma™ XC, KYBELLA® and all SkinMedica™ products and treatments are eligible for points accrual and redemption to save money on future treatments and products through Allergan’s Brilliant Distinctions Program®.

Postmarketing reports indicate that the effects of BOTOX® Cosmetic and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have an underlying condition that would predispose them to these symptoms. In unapproved uses, including spasticity in children, and in approved indications, cases of spread of effect have been reported at doses comparable to those used to treat cervical dystonia and upper limb spasticity and at lower doses.
Glabellar Lines
BOTOX® Cosmetic (onabotulinumtoxinA) for injection is indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adult patients.
Lateral Canthal Lines
BOTOX® Cosmetic is indicated for the temporary improvement in the appearance of moderate to severe lateral canthal lines associated with orbicularis oculi activity in adult patients.
BOTOX® Cosmetic is contraindicated in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation.
Lack of Interchangeability between Botulinum Toxin Products
The potency units of BOTOX® Cosmetic are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of BOTOX® Cosmetic cannot be compared to nor converted into units of any other botulinum toxin products assessed with any other specific assay method.
Spread of Toxin Effect
Please refer to Boxed Warning for Distant Spread of Toxin Effect.
No definitive serious adverse event reports of distant spread of toxin effect associated with dermatologic use of BOTOX® Cosmetic at the labeled dose of 20 Units (for glabellar lines), 24 Units (for lateral canthal lines), 44 Units (for simultaneous treatment of lateral canthal lines and glabellar lines) have been reported.
Serious Adverse Reactions With Unapproved Use
Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received BOTOX® injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of BOTOX® to the site of injection and/or adjacent structures. In several of the cases, patients had pre-existing dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions associated with the unapproved uses of BOTOX®. The safety and effectiveness of BOTOX® for unapproved uses have not been established.
Hypersensitivity Reactions
Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur, further injection of BOTOX® Cosmetic should be discontinued and appropriate medical therapy immediately instituted. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent and, consequently, the causal agent cannot be reliably determined.
Cardiovascular System
There have been reports following administration of BOTOX® of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors including pre-existing cardiovascular disease. Use caution when administering to patients with pre-existing cardiovascular disease.
Pre-existing Neuromuscular Disorders
Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junction disorders (eg, myasthenia gravis or Lambert-Eaton syndrome) should be monitored when given botulinum toxin. Patients with neuromuscular disorders may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia, and respiratory compromise from onabotulinumtoxinA (see Warnings and Precautions).
Dysphagia and Breathing Difficulties
Treatment with BOTOX® and other botulinum toxin products can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing (see Boxed Warning).
Pre-existing Conditions at the Injection Site
Caution should be used when BOTOX® Cosmetic treatment is used in the presence of inflammation at the proposed injection site(s) or when excessive weakness or atrophy is present in the target muscle(s).
Human Albumin and Transmission of Viral Diseases
This product contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases. A theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD) also is considered extremely remote. No cases of transmission of viral diseases or CJD have ever been identified for albumin.
The most frequently reported adverse event following injection of BOTOX® Cosmetic for glabellar lines was eyelid ptosis (3%).
The most frequently reported adverse event following injection of BOTOX® Cosmetic for lateral canthal lines was eyelid edema (1%).
Co-administration of BOTOX® Cosmetic and aminoglycosides or other agents interfering with neuromuscular transmission (eg, curare-like compounds) should only be performed with caution as the effect of the toxin may be potentiated. Use of anticholinergic drugs after administration of BOTOX®Cosmetic may potentiate systemic anticholinergic effects.
The effect of administering different botulinum neurotoxin products at the same time or within several months of each other is unknown. Excessive neuromuscular weakness may be exacerbated by administration of another botulinum toxin prior to the resolution of the effects of a previously administered botulinum toxin.
Excessive weakness may also be exaggerated by administration of a muscle relaxant before or after administration of BOTOX® Cosmetic.
BOTOX® Cosmetic is not recommended for use in children or pregnant women. It is not known whether BOTOX® Cosmetic is excreted in human milk. Caution should be exercised when BOTOX® Cosmetic is administered to a nursing woman.
Please see BOTOX® Cosmetic full Prescribing Information including Boxed Warning and Medication Guide.