What is a botox injection?
A botox injection is an injection (shot) of purified toxin from the bacteria that causes botulism or lockjaw. Botox has been given in tiny, calibrated amounts to help people with over active muscles. Botox injections have been used successfully in patients with spastic dysphonia, hemifacial spasm, facial creases and synkinesis. One of the problems that occurs after the facial nerve heals from injury is synkinesis. The facial nerve trunk contains over 7000 motor fibers, and each is specialized in moving either the brow, eye, lower lid, nose or mouth. When injury occurs, the nerve fibers become scrambled, and after regrowth of the nerve, each area of the face will have a jumble of brow, eye, nose and mouth nerve fibers going to it. As a result, mass movement, or sinkinesis occurs. This means that when you want to move one area on one side of your face, all areas on the side of your face move.

Is there anything I can do to prevent synkinesis?
Although physical therapy helps considerably, there is no effective way of preventing synkinesis entirely.

Who is a good candidate for botox injection?
If your doctor feels that one area of the face is hyperkinetic or moves too much, you may be a good candidate for botox. Be sure to tell your doctor if you have any symptoms of spasm or drawing in one or more areas of your face.

How is botox injection performed?
Since botox is very expensive, several patients are usually treated on a given day. The surgeon will use an electromyogram (EMG) to be sure that the injection is given into the muscle itself. A small needle is then inserted into the muscle and the medication is given. It takes only a few minutes in the doctors office.

What should I expect after a botox injection?
You should notice improvement in the spasm within 48 hours or so. The effect of the botox is temporary, but it may last for 8-10 weeks. If you notice that the muscle of your face become too weak for a time, be sure to let our doctor know. Repeated doses of botox can be given every three months. At times larger doses need to be given to produce the same effect.

When can I go back to work?
You should be able to resume any normal activity the same day.

Will my insurance pay for this?
Most insurance companies consider botox injection a functional procedure and do provide coverage.