Oculoplastic Surgery

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Chemical Injections

Injections for facial muscle spasms

Blepharospasm and hemifacial spasm are conditions characterized by involuntary contractions of the facial muscles. Contractions of the muscles around the eyelids can become so severe that vision is severely affected and patients are unable to open their eyes. Other associated symptoms include frequent tearing, dry eyes, and sensitivity to sunlight. 

In cases of blepharospasm, no further investigation is necessary, but cases of hemifacial spasm need to be investigated with CT or MRI, as a small portion of these cases may be associated with neurologic lesions. People with new onset of uncontrolled muscle spasms should be evaluated as soon as possible.

Chemical injections, such as Botox® Cosmetic, have long been used successfully in the treatment of muscle spasms associated with hemifacial spasm and blepharospasm. The effect of the injections is temporary, typically lasting between three and six months. Repeat injections are usually necessary to maintain its effect.

Side effects from injection treatments are rare, the most common being mild bruising at the injection site. A small percentage of patients being treated around the eyes will develop temporary drooping of the eyelid due to migration of the injection, which is why patients should not rub the eyelid for 12 hours and should not lie down for three hours after the injection.

Injections for cosmetic purposes

Botox® Cosmetic chemical injections have been approved by the FDA for cosmetic indications since 2002 and have gained widespread popularity as a non-invasive method of reducing wrinkles produced by facial expressions. Approximately 11.8 million patients have been treated with Botox since 2002.

Wrinkles are caused by repeated contractions of the muscles of facial expression over time. Botox works by blocking nerve impulses to these muscles, effectively paralyzing them. Its effects are most pronounced in the area of the crow's feet (outside corner of the eyelids), glabella (between the eyebrows), and forehead. Its effects are only temporary, lasting between three and six months. To retain its full effect, the injections will likely need to be repeated; however, wrinkles may appear somewhat less prominent even after the chemical's affect has worn off.

Injectable fillers such as Juvéderm® and Restylane® may also be given to fill in deep wrinkles that do not go away when the face is relaxed. These fillers are often used as a complement to Botox injections but also have other applications, such as treatment for traumatic deformities and facial atrophy.

Side effects from chemical injection treatments are rare, the most common being mild bruising at the injection site. A small percentage of patients being treated with chemicals around the eyes will develop temporary drooping of the eyelid due to migration of the injection, which is why patients should not rub the eyelid for 12 hours and should not lie down for three hours after the injection.

Cost and insurance

Injections for blepharospasm and hemifacial spasm are covered by most insurance plans.

At your office consultation, our oculoplastic surgeon will discuss with you the areas that could most benefit from chemical injections.