What is it and how does it work?
Botulinum toxin is a substance that temporarily reduces the signal travelling from the nerve ending to the muscle. The contractile strength of the muscle it is applied to falls for a certain period.
The expression lines on the face are formed by the repeated contraction of the underlying muscles over the years. When the activity of the muscle is reduced, the deepening of these lines stops and the existing lines soften to a degree.
The effect is not permanent. The nerve endings re-establish their connections in time and the muscle returns to its former strength.
When is it used?
- Expression lines. Forehead lines, the vertical lines between the eyebrows, the lines around the eyes.
- Excessive sweating (hyperhidrosis). In sweating of the armpits, palms and soles that affects daily life.
- Teeth clenching and enlargement of the jaw muscle. In jaw pain due to night-time clenching and in prominence of the masseter muscle.
- Symmetry after facial palsy. In balancing the excessive movement on the unaffected side.
- Chronic migraine. With neurological assessment and an appropriate diagnosis, according to established protocols.
Some of these headings are aesthetic indications and some are medical ones; the distinction becomes clear at the examination.
Who is it not suitable for?
Pregnancy and breastfeeding, diseases affecting the neuromuscular junction, active infection at the site of application, known allergy to the components of the substance and the use of certain medicines are circumstances that prevent the procedure or postpone it. All the medicines you use and all your existing illnesses need to be shared.
The procedure
The procedure is carried out with fine-tipped needles and within minutes. In most people no anaesthesia is needed; a topical numbing cream may be used if wished.
The dose and the points of application are determined individually. The strength of the facial muscles and the way they work differ in everyone; no standard scheme is applied.
Onset and duration of the effect
- The effect usually begins within 3-7 days.
- The result settles fully within about 2 weeks; assessment is not made before this time.
- In most people the effect lasts 3-6 months; it varies with the area, the dose and the person’s muscle structure.
After the procedure
You return to daily life the same day. For the first few hours it is advised not to rub the treated area, not to lie down for several hours, and to avoid heavy exercise, hot showers and the sauna that day.
Risks
The headings that need to be discussed: temporary redness and bruising at the needle sites, headache, a sense of asymmetry in the first days after the procedure, temporary drooping of the eyelid or the eyebrow.
These effects are temporary and disappear as the effect of the substance wears off. Their frequency varies with the area treated, the dose and the experience of the person carrying out the procedure.
Realistic expectations
- Botulinum toxin is effective on the lines produced by the muscle. It does not on its own remove the static lines that are due to skin quality, sun damage and loss of volume.
- It does not move sagging tissue back into place; it is not a substitute for a lifting operation.
- The loss of facial expression is not a desired result; preserving natural expression is a matter of the choice of dose and points.
Assessment
Before the procedure the way the facial muscles work and the expectation are assessed together. In some people the soundest advice is a different method, or no procedure at all.
You are welcome to book an appointment for an assessment.