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.

How does Botox affect wrinkles?

Botox application prevents nerve impulses to the muscles that cause facial wrinkles. In this way, excessive contraction of mimic muscles decreases, superficial wrinkles disappear, and the evidence of deeper wrinkles decreases. As a result, a cosmetic improvement and a younger look are achieved on the face.

In which areas is Botox applied in the treatment of wrinkles?

Between the eyebrows, crow’s feet (lines on the outer corners of the eye), forehead area are the most common application areas. In addition to these, rabbit lines that appear with facial expressions on the nose and wrinkles that appear on the mustache area (Barcode lines, smoker’s lines) also benefit from Botox application. Botox injection to the outer part of the eyebrow is also used for eyebrow lifting.

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 into the target muscles with the help of very small needles (32G, 33G). The process takes an average of 10 minutes. After the procedure, you can return to daily life.

When does the effect start after Botox application for wrinkle treatment?

The effect of the application starts after 3-4 days. It is normal to see no effect until this time. Approximately 10-14 days should be waited for the full effect. Therefore, I make your control and your touch-up doses (if needed) after this period.

How long does the effect of Botox application for wrinkle treatment last, what are the factors affecting the permanency?

The permanency of the Botox application varies depending on the area and the individual factors. Individual factors such as age, smoking, sun protection status, nutrition, excessive use of facial expressions in social life and muscle tones are among the most important of these variable factors. When the existing studies are examined, it has been seen that the effect of Botox lasts for an average of 4-6 months. This period lasts for 2 months in some people, and it can last longer than the averages mentioned in some people. 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 Botox application for wrinkle treatment be repeated?

Average 4-6 months. It is thought that the duration of action is prolonged in repeated applications. It is thought that 3 applications, especially 3 months apart, reduce wrinkles permanently. The interval between two botulinum toxin treatments should not be shorter than three 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, you should not be lying face down or sideways, 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 take a shower (not too hot or cold!) or wash your face after the application. There is no restriction on the next day of the application, and it is possible to return to the daily routine, including make-up.

 

Is Botox injection 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, superficial anesthesia can be provided before the procedure with topical creams. After the procedure, the pain in the injection sites will also pass in a very short time.

 

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?

Botulinum toxin administration may cause headache, general weakness, drowsiness, and fatigue in some people. However, this situation is temporary and usually disappears completely within 24 hours. In very rare applications around the eyes, drooping eyebrows, droopy eyelids and vision complaints may occur, and these complaints are temporary. Again, 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.

 

Does Botox application for wrinkle treatment cause an increase in wrinkles in the future?

This situation is misunderstood by the public. Botox application for wrinkles does not cause wrinkles to increase in the future, on the contrary, regular Botox application treats wrinkles permanently and delays aging. When the effect of Botox begins to disappear, patients may think that their face is more wrinkled than before, but this is not true. Since they are used to their appearance under the effect of Botox, returning to their old appearances creates a wrong thought in patients.

 

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. Botox application is not appropriate in the presence of eye surgery or periocular surgery within 6 months.

 

For which cosmetic purposes is Botox not used?

Botox applications should not be confused with other medical aesthetic procedures such as PRP, mesotherapy and filler applications. Considering the principle of action of botulinum toxin, its effect is completely different from the other applications mentioned. The volume effect provided by the fillers is not expected in Botox application. Botox application will provide some brightness to the skin as it corrects the wrinkles, but it does not have an obvious effect on skin brightness as PRP and mesotherapy applications used for this purpose. Botox application treats wrinkles, but does not offer a permanent solution as in lifting operations such as face lift, neck lift, temple lift, eyebrow lift.

Summary

Botulinum toxin (Botox) injections are simple and effective applications that are frequently used in the treatment of facial wrinkles. Regular Botox applications for cosmetic purposes delay aging. Number of injections and dose per muscle varies depending on the place of use, the person, and the need. The duration of the botulinum toxin application varies according to the previous applications, the treated area and individual factors. Please do not compare the application with other applications and yourself with other people. Unfortunately, overdose is irreversible. Instead, I prefer to have the effect I want with the least possible dose, and I do my applications accordingly. Small wrinkles may remain due to individual factors, minimal asymmetries may occur, or the desired effect may not be fully achieved due to low doses. Have no doubt that we will handle all the situations 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.

 

Sources