Many of my patients come to me for Botox® Cosmetic, a revolutionary enzyme that makes wrinkles virtually disappear. At very high doses, it is considered a toxin, but to treat wrinkles, a dilution 3 million times less than the toxic level is used. The Botox enzyme has been used safely and successfully since the 1980s for a number of conditions, including muscular disorders. Side effects do not occur frequently but could be potentially serious, including: