Long term use of Botox and time of onset

Botox has been in use for well over 30 years. Some of the advocates of the cosmetic uses, namely a husband and wife physician team, recently reported a well tolerated and excellent safety record of many patients receiving Botox over a 15 year period.

To date, there have been no recommendations regarding limitations on the long term use of Botox.

With regard to time of onset following injection, the package insert describes a 3-5 day period. However, I have injected and observed many patients who demonstrate a response witihn 24 hours.