What is Botulinum Toxin (Botox)?

Botulinum toxin is obtained from a bacterium called “Clostridium botulinum”. In other words, it is not snake venom as it is mentioned among the people. This substance partially blocks the nerve impulses to the target organ and creates a temporary and reversible paralysis in the target area.

For what purposes is Botox used?

It’s used cosmetically in the treatment of superficial / medium and deep wrinkles, for eyebrow lifting, in cases where there is excessive sweating in areas such as armpits / hands / feet (hyperhidrosis), excessive teeth clenching and masseter hypertrophy, in cases where the gums appear more than normal when talking or laughing (gummy smile) and in the treatment of chronic migraine. In addition to these, it is also indicated in spasticity, cerebral palsy, spasmodic torticollis, blepharospasm, hemifacial spasm, cervical dystonia, and bladder spasm.

What is a “gummy smile”?

It is the appearance of the gums more than normal when the person is talking or laughing since the muscles that lift the upper lip are working more actively than normal.


How does Botox application affect the gummy smile?

This application temporarily paralyzes some of the nerves that go to the muscles that lift the upper lip (upper lip elevator muscles). Therefore, the visibility of the gums decreases when talking or laughing.


How is Botox applied?

There is no need for operating room conditions for this procedure. It is one of the applications that can be done easily in office conditions where sterility principles are taken into account. Injections are made to the target areas with the help of very small needles. The process takes an average of 5 minutes. After the procedure, you can return to your daily life.

When does the effect start after application?

The effect of the application begins after 1-2 weeks.

How long does the effect of this application last, what are the factors affecting the permanence?

The effect of botulinum toxin made for this purpose lasts for an average of 6 months. The duration of botulinum toxin application varies according to the individual factors. Age, smoking, nutrition and personal reasons are among the most important of these variable factors. There may be situations where the effect is not as long and effective as expected. In this case, the development of resistance is investigated, dose adjustments are made, or other subtypes of botulinum toxin can be applied. It should be noted that results may vary from person to person. If you have been treated with botulinum toxin too often before, or if the dose was too high, your body may start to produce certain substances called antibodies to the botulinum toxin, and these substances can reduce the effect of the newly injected botulinum toxin.


How often should this application be repeated?

Repetitive applications prolong the duration of action. Especially 3 applications with 3 months intervals are recommended for permanent effect. The interval between two botulinum toxin treatments should not be shorter than 3 months.


What should be considered after Botox application?

In order to prevent the unwanted spread of botulinum toxin on the day of application, the application areas should not be massaged and the swelling should not be tried to be distributed. Activities such as hammam, sauna and heavy exercise are not recommended on the application day. You can return to your routine life the day after the application.


Is Botox application painful?

Since the injection needles used are quite small, the pain is minimal. Patients describe the situation with expressions such as “as much as a mosquito bite”. Local anesthetic injection is not recommended before the procedure, as it will affect the distribution of Botox. If necessary, topical anesthesia can be provided with creams.


Will there be bruising after Botox application?

Rarely, small bruises may occur due to damage to the small vessels in the application area. This does not change the effect and result of botulinum toxin treatment. After the procedure, it is recommended to apply ice to the bruised area without massaging and pressing hard. If a bruise occurs, it will go away in 3-4 days, and the use of foundation during this time will mask the bruise.


What are the other problems encountered after Botox application?

Botox application to this area may rarely cause breathing problems and asymmetries depending on anatomical variations and structural factors. This situation is temporary. Very rarely, an allergic reaction may develop after botulinum toxin injection. If you experience difficulty in breathing, swallowing or speaking or if you experience hives, swelling (including swelling of the face and throat), wheezing, fainting, and shortness of breath after the injection, contact your doctor or nearest healthcare facility immediately, as these are possible signs of a severe allergic reaction.


Who is Botox not applied to?

Botox injection is not applied in the presence of active infection in the area where the injections are planned, in neurological or neuromuscular diseases (Motor neuropathies, ALS, Myasthenia Gravis, Eaton-Lambert Syndrome…), in drug use such as aminoglycosides (gentamicin…) and curare-like non-depolarizing blockers, in case of lactose and albumin allergy, during pregnancy and breastfeeding.


Botulinum toxin (Botox) injections are simple and highly effective applications used in the treatment of gummy smile. Approximately 5 minutes of application provides a serious improvement in the appearance of the gummy smile. The duration of the botulinum toxin application varies according to the previous applications, the treated area, and the individual factors. Please do not compare the application with other applications and yourself with other people. The possibility of complications increases after overdose application and unfortunately it is not reversible. Instead, I prefer to have the effect I want with the least possible dose, and I do my applications accordingly. There are two possibilities after the first application. Either the dose applied will be sufficient and no additional dose will be needed, or the effect will be seen, but you will need a little more. If we need a little more dosage, we will take care of it in your control visit. Like I said, it’s much safer to underdose and do extra doses if needed, than to overdose. Medical aesthetic applications such as botulinum toxin application should be applied by doctors who have both theoretical and practical knowledge and experience in skin and subcutaneous anatomy, have a deep knowledge of the subject, can manage the complications and are experts in their field. Best regards.