WRINKLE TREATMENT WITH BOTULINUM TOXIN TYPE A ALSO KNOWN AS BOTOX® FOR AESTHETICS AND ANTI-AGEING
A sterile, vacuum-dried form of purified botulinum toxin type A, produced by the bacterium Clostridium botulinum is widely used in aesthetic medicine to treat lines and wrinkles. Neurotoxic effects of botulinum toxin have been used for the treatment of various medical disorders (e.g. in children and adults with cerebral paralysis) since 1980. There are 7 types of Botulinum toxins produced by different strains of Clostridium botulinum. Each stereotype has different properties and actions. At present, only Botulinum toxin type A is the most studied and approved by FDA (Food and Drug Administration of USA).
Facial ageing manifests in changes of skin texture, the appearance of dynamic and/or static lines and wrinkles, loss of volume, and skeletal remodeling (bone ageing).
In Aesthetic Medicine Botulinum toxin A is used to treat the following conditions:
- Facial dynamic lines/wrinkles, in particular wrinkles between the eyebrows (frown lines), around the eyes (Crow’s feet), horizontal lines on the forehead, wrinkles on the jaw line, lips (peri–oral wrinkles), and lines on the nose (bunny lines).
- Gingival smile (gummy smile)
- To improve horizontal lines on the neck (platisma band) – “the Nefertiti neck treatment’
- Bruxism –Hypertrophic Masseter (in this condition an over active jowl muscle causes grinding of the teeth)
- Hyperhidrosis – Excessive sweating.
HOW DOES BOTULINUM TOXIN A WORK?
Botulinum toxin blocks the action of the acetylcholine neurotransmitter. Acetylcholine stimulates striated as well as smooth muscles and the secretion of glands such as sweat glands.
After Botulinum toxin A has been injected it diffuses into the muscle until it selectively and irreversibly binds to it and blocks the action of acetylcholine. The action of the drug slowly decreases over time and the inactive nerve regenerates its function again.
Botulinum Toxin A has a cosmetic effect only if injected into particular muscles. Topical applications of the toxin are insufficient and therefore, the claims stating that Botulinum toxin containing creams have a similar effect are questionable.
Expression lines (e.g. frown lines) may give one tired, cross and/or unhappy look. Botulinum toxin A treatment relaxes muscles and thus takes away an undesirable facial expression. The appearance of lines and wrinkles is smoother and overall the face looks more rejuvenated. The degree of improvement depends mostly on the initial depth/severity of the lines/wrinkles.
ABOUT BOTULINUM TOXIN A TREATMENT
A typical Botulinum toxin A treatment visit takes usually 30 min. Initially, the treatment areas are discussed with the doctor, a detailed medical history is taken and an informed consent form is signed. The client is asked to pull certain facial expressions in order to assess activity and the strength of the muscles and based on that the doctor will calculate the individual dose of Botulinum toxin A. Small amounts of Botulinum toxin Aare injected in the localised muscles at several sites using fine sterile needles. The procedure is well tolerated by most patients, however; in order to make it more comfortable a topical anaesthetic cream may be used. The injectable minute amounts of Botulinum toxin A are non-toxic to the body as a whole and have an effect only on the muscles that were treated. Botulinum toxin A injections result in the relaxation of the over-active muscles, as described above.
In order to reduce the possible risk of bruising and bleeding it is advisable to avoid the consumption of alcohol, non-steroidal anti-inflammatory drugs for pain and aspirin for 5 to 7 days prior to Botulinum toxin A treatment.
On you first visit you will need to provide your Doctor with a full medical history.
During the first 4 hours after Botulinum toxin A treatment the patients must not lie down or do strenuous exercise. The consumption of alcohol and application of make-up must be avoided for the next 12 hours.
It is important not to rub or massage the treated areas for the first 24 hours after injections and to avoid direct sun exposure, UV light, freezing temperatures and saunas for the next 2 weeks.
Botulinum toxin A is recommended to both male and female clients. There is no restriction to its use based on the colour of the skin. As a prevention strategy to forming dynamic wrinkles, the use of Botulinum toxin A may be appropriate in younger individuals (from early twenties).
DOES BOTULINUM TOXIN A HAVE AN IMMEDIATE EFFECT?
Usually, it takes from 72 hours to 14 days to see the results of Botulinum toxin A treatment. Two weeks after the treatment we offer a check-up consultation and if necessary, an additional dose will be administrated by the Doctor to reach the perfect result (free of charge).
The moderate or deep wrinkles will look smoother as a result of the treatment; however, often to further improve the appearance of those wrinkles an additional treatment with dermal fillers of laser might be required. Your aesthetics doctor will advise you on the best course of treatment to suit your needs.
It is important to notice that Botulinum toxin A significantly rejuvenates and improves the overall look of the face by eliminating the” tired look” and undesirable facial expressions associated with negative/angry emotions (e.g. frowning).
HOW OFTEN DO I NEED TO DO BOTULINUM TOXIN A ?
The wrinkle smoothing effect of Botulinum toxin A usually lasts 12 – 16 weeks. The intensity of muscle movement gradually reverts to normal. Ideally the repeat treatment should be done before the effect of Botulinum toxin A fully wears off.
With the long term use of Botulinum toxin A the interval between the treatments can be extended to 6 months or even longer.
The moderate or deep wrinkles will look smoother as a result of the treatment; however, often to further improve the appearance of those wrinkles an additional treatment with dermal fillers of laser might be required.
WHAT ARE THE SIDE EFFECTS OF BOTULINUM TOXIN A ?
As all the other medicines, Botulinum toxin A can cause some side effects, which clients are advised on before the procedure.
Most common side effects such as mild pain, redness or mild swelling (little bumps) are related to the injections and they usually resolve within few hours. In some cases a mild bruising is possible at the sites of injections.
Another temporary side effect of Botulinum toxin A may be the dropping of the upper eyelid caused by a spread of the injected Botulinum toxin A into the nearby muscles.
An asymmetry in the level of the eyebrows is possible, but it is usually corrected by the doctor during the scheduled follow–up treatment.
There is a very small risk of an allergic reaction to Botulinum toxin A.
Botulinum toxin A is contraindicated in the following conditions:
- Pregnancy and breast feeding
- Known allergy to Botulinum toxin A
- Current infection at the sites of injection
- Some medical conditions, such as Myasthenia Gravis or Eaton Lambert syndrome.