BOTOX Cosmetic does not cause wrinkles, though it may appear that it does. This is because BOTOX Cosmetic works by blocking the signal that results in muscle contraction. If a given muscle or area of muscle cannot contract due to the signal being blocked, adjacent muscles or adjacent areas of the injected muscle may try to compensate and work harder to accomplish what the muscle did before it was injected with BOTOX Cosmetic. This compensation may make it appear as if BOTOX Cosmetic "caused" wrinkles, though in actuality it does not.
The other issue to consider is that wrinkles that remain after the BOTOX Cosmetic takes effect may appear more obvious to you than they did before BOTOX Cosmetic was injected. This is because of the contrast between those wrinkles and the smoother areas where BOTOX Cosmetic was injected.
One needs to understand that BOTOX Cosmetic will not remove any wrinkles or lines that are already etched in the skin. For these, one needs to consider other treatment alternative such as skin resurfacing procedures (e.g., laser, chemical peels, dermabrasion) and/or injectable filler materials (e.g., Juvederm, Restylane).
It is important to communicate your goals before you receive an injection of BOTOX Cosmetic. Many patients want a natural look which allows you to still move those facial muscles without looking "frozen." Communicating with your physician is of paramount importance to obtaining a result with which you will be happy.
