Botulinum toxin is a neurotoxin obtained from bacteria that has multiple medical uses. It works by blocking nerve signals in the muscles into which it is injected. This results in temporary paralysis and relaxation of the muscle. Larger amounts may be deadly, but tiny, regulated amounts of botulinum toxin have been used safely for decades to treat a variety of conditions, including muscle spasms, twitching and excessive sweating (hyperhidrosis).
In the realm of aesthetics, targeted relaxation of selective facial and neck muscles results in softening and reduction of certain wrinkles. Minimizing the appearance of lines and wrinkles caused by facial expression helps to bring about a more youthful appearance. Commonly treated areas include the forehead, around the eyes, and around the lips. The results are generally more subtle and less dramatic than those achievable through surgical procedures, such as a facelift. There are different formulations of botulinum toxin that are commercially available, such as Botox and Dysport.
Botulinum toxin injection only works for wrinkles that are caused by muscle movement (dynamic wrinkles). It is not effective for fine lines and wrinkles that are present when your face is at rest (static wrinkles). The results after treatment are also not permanent. Most people find that the muscle relaxation lasts for 3 to 4 months. Repeated treatments will be necessary for continued wrinkle-reducing effect.
Botulinum toxin injection is not recommended for women who are pregnant or breastfeeding. Allergy to cow’s milk protein is also a contraindication as the formulations may contain trace amounts of cow’s milk protein. You should also discuss any pre-existing health conditions or medications with your plastic surgeon as some of these may increase the risk of botulinum toxin injection.
The ProcedureBotulinum toxin injection is routinely performed in an office-based setting. Which muscle needs to be injected depends on the area(s) of concern that you have. Several injections are usually required to treat one muscle. Several areas can be treated in one session.
The injections may sting, but are generally well-tolerated as a very fine needle is used. A topical anaesthetic cream may be applied first to minimize the discomfort during the procedure. If the procedure goes smoothly, you will be able to go home soon afterwards. There is minimal downtime, and you can resume your normal activities the next day.
After the ProcedureRedness, swelling, pain and bruising are relatively common side effects afterwards. These usually settle within a week. You are advised to avoid physical exertion or rubbing the treated area for 24 hours, as these can encourage spread of the toxin to surrounding muscles resulting in unintended weakness. The injection usually begins to work 1 to 3 days after treatment. The results of each treatment are temporary and you will need to return for a repeat injection about 3 to 4 months later.
Understanding the RisksMillions of people undergo Botulinum toxin injection every year without complication. The toxins are manufactured in very strict and controlled environments so that they won’t cause botulism. As with all procedures however, there may be side effects, which include: • Prolonged swelling and bruising• Allergy – hives, rashes, itching• Inadvertent weakness or paralysis of nearby muscles which can result in droopy eyelids (ptosis), drooping of the brow, difficulty with speech or swallowing• Flu-like symptoms
The treatment may also fail to work due to antibodies in your body that fight and neutralise toxin. This happens in less than 1 percent of people who have had repeated Botox treatments.
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