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Botulinum toxin

Botulinum toxin forms part of the treatment options which come under the collective term ‘non surgical facelift’. In the right hands, botulinum toxin offers some of the most dramatic results the cosmetic field has ever been associated with. BOTOX is the commercial name of Botulinum toxin marketed by Allergan, and is the most widely used preparation of botulinum toxin A. Since the potency and the efficacy of the toxin differs per batch and brand, the information below relates to the toxin as marketed as BOTOX.

What is BOTOX?

BOTOX is the trade name of Botulinum toxin, marketed by Allergan. This toxin acts by causing certain groups of facial muscles to not contract thereby helping in removing wrinkles.

How does botulinum toxin work?

BOTOX acts by causing weakness of the targeted muscle. It does this, by inhibiting the release of a chemical called acetylcholine from the nerve terminals – this results in decreased contraction of the injected muscles. So when injected into muscles that cause wrinkles on the face, BOTOX causes a visible and significant improvement by reducing wrinkles, taking years off your face, and making you look less tired, more relaxed!

Will BOTOX work for any wrinkle?

BOTOX works for dynamic wrinkles. Basically, the lines or wrinkles on our face, can be divided into static and dynamic lines. The static lines are those that are present in the face at rest – i.e., lines which are seen even when you are not making any facial expression. Dynamic lines, are those which appear only on making an expression – say, when you frown, laugh, raise your eyebrows up and so on. It is these dynamic lines that can be effectively treated with BOTOX. In general, wrinkles on the face need a combination approach. While BOTOX takes care of the dynamic lines, static lines are so much improved with a filler.

How soon can I see the results of the procedure?

Maximal response to the procedure usually occurs around 2 -3 days following the injection, and can take up to 4 weeks to develop fully.

How long does the effect last?

Though the muscle tends to recover around 90 days after the injection, partial effects has been known to last for up to 6 months. The duration of the effect seems to vary with the muscle or muscle group injected, the dose, as well as the ethnicity. However, anywhere between 3 and 6 months is a reasonable average.

When can I have the next BOTOX injection?

A repeat session can be planned as soon as you feel the effect waning off, which should be around 3 -6 months after the first treatment. With time and repeat sessions, the wrinkles become much improved and the interval between sessions tends to increase. In other words, with regular BOTOX treatment, the wrinkles take longer and longer to reappear!

Who needs a BOTOX injection?

BOTOX gives great results for those with any of the following issues.

Dynamic forehead lines

Otherwise known as worry lines, these occur in an exaggerated fashion when your lift your brows up. This can give the face a tired or an aged look. BOTOX is injected into the muscle called ‘frontalis’ that is responsible for causing these lines. This is a straight forward treatment, but injecting too much, too low, or too laterally can lead to complications, and it is best to go with experienced and conservative injectors for best results. Because with BOTOX, less is more!

Glabellar frown lines

These are lines that appear between your brows when you frown – they typically form a ’11’ when you frown. There is a muscle group called the ‘ glabellar complex’, that is responsible for these lines, and the injection of BOTOX in this area, needs to be precise and accurate to avoid unwanted side effects.

Crow’s feet

These are the radiating lines that appear on the outer side of the eye, when you laugh. This crinkling around the eye can add years to the face, and its treatment with BOTOX dramatically takes those years away giving great results!

Medical brow lift

For droopy brows, and for those who prefer a refined look, this simple and super-fast procedure makes an instant impact. Also since only a few units are required for this treatment, this is an inexpensive procedure and so, is simply great value for money!

Widened jaw

Some of us have the habit of clenching the jaw almost as a habit, and more so during sleep. Over time, this builds up the masseter muscle, which is present near the angle of the jaw. Thickening of this muscle causes the jaw to look unnaturally widened and crude. In women, especially, this gives a more aged and manly look. Injecting the masseters makes a big difference in reducing the widening of the jaw, restoring a feminine look to the face. Also, it gives the muscles a good rest, and relieves the pain brought on by constant jaw clenching.

This injection of the masseter muscles does not affect chewing, whistling or any other function of the lower face. Since side effects may occur if neighboring muscles are injected, it is important to choose a skilled dermatologist for this treatment.

Excessive sweating over palms, soles and underarms

Also known as hyperhidrosis, excessive sweating over the palms, soles and the armpits can be a very embarrassing and discomforting problem. Injecting BOTOX into these areas prevents the sweating and provides relief. The results can be quite dramatic, which is a good reason why we get so many faithful consumers, who come back for the BOTOX, once the effect of the previous session starts waning off. The injections are given over the areas of sweat production after identifying these with the help of a starch iodine test.

Gummy smile

Another area, where BOTOX injections can give great results is in treating a gummy smile. Injecting into an area near the nasal ala, this treatment reduces gum exposure during smiling, in those with a gummy smile. The result is a greatly improved and confident smile. Conservative and accurate toxin placement is the key in this area, to avoid unwanted diffusion of toxin to neighboring muscles. Again, this is a great value for money treatment, since less units are required to give good results.

Nasolabial folds

This is a relatively new use for BOTOX. Nasolabial folds are lines that run from the sides of the mouth to the sides of the nose, and can cause an aged appearance. While BOTOX can give a small improvement, fillers are the best choice for these lines. Combining both these options works quite well indeed. This being a new application, the opinions are divided on its use. At Dr Renita Rajan Skin & Hair Clinic we find that keeping the number of units injected to less than 2, and staying accurate on toxin placement, give good results in this area.

Since it is a toxin, is not botulinum harmful?

The dose of botulinum toxin used for cosmetic indications is less than about 100 units per session, which is 1/30th of the lethal dose in humans. In fact, patients with neurological conditions like spasticity receive up to 400 – 600 units per session with no adverse effects.

Which type of patients is this procedure not suited to?

  • Patients with allergies to components of the toxin
  • Psychologically unstable patients
  • Those with unrealistic expectations
  • Pre-existing neurological conditions

What is the possibility of developing allergic reactions to BOTOX?

Each vial of BOTOX contains in addition to the toxin, albumin and saline. Hence patients allergic to any of these components are not good candidates for the procedure.

Is BOTOX safe in pregnancy?

Although there are no known adverse effect of the toxin on pregnancy/ fetus, data are not adequate to come to a conclusion regarding its safety in pregnancy. Hence all women of child bearing potential need to consider this factor, before planning a BOTOX injection.

Will I need to sign a consent form?

All procedures done at RENDER Skin & Hair (formerly, Dr Renita Rajan Skin & Hair Clinic) are done after appropriate patient counseling and only for definite indications. A consent is taken prior to all procedures, including botulinum toxin injection.

How can I get an appointment for this procedure?

You can make an appointment for your BOTOX injection at RENDER Skin & Hair (formerly, Dr Renita Rajan Skin & Hair Clinic) here. Approval of this procedure in any individual patient is subject to the discretion of your dermatologist, and only the doctor can decide whether this procedure is indeed suitable for you.