WHAT IS BOTULINUM TOXIN (BOTOX)? It is the toxin produced by the bacterium Clostridium botulinum. The substance, initially used by Ophthalmology and Neurology to treat muscular deviations a few years ago, started to be used in Dermatology to correct dynamic wrinkles, with excellent results. It became known by the commercial name Botox.
HOW DOES BOTOX WORK? This toxin has the effect of paralyzing the musculature. The drug binds to neuromuscular receptors, preventing the transmission of impulses from the neuron toward the muscle. Thus, its contraction does not happen, relaxing the musculature. Therefore, there is no formation of dynamic wrinkles, as when we frown or in “crow’s feet” wrinkles. This also has a preventive effect, as it delays the appearance of static wrinkles.
BUT WHAT ARE DYNAMIC AND STATIC WRINKLES? Dynamic wrinkles, or expression wrinkles, are those caused by the muscle contraction of facial mimicry, which leads, over time, to the formation of creases in the skin (static wrinkles).
WHAT ARE YOUR INDICATIONS? For aesthetic purposes, it is used to treat expression lines and facial lines and treat hyperhidrosis (excessive sweating). Today, it has also been used to treat migraine, bruxism, the definition of the contour of the jaw, and other changes.
WHERE CAN IT BE USED? The main places on the face where it can be used are the frontal region (forehead), the glabella (between the eyebrows), and the peri-orbital region (“crow’s feet”). Still, it can also be used in the lower third of the face (wrinkles around the mouth and chin) and on the neck.
HOW IS THE PROCEDURE PERFORMED? Botox such as face-lift botox (การ ฉีด โบ ท็ อก ซ์ ลิ ฟ หน้า which is the term in Thai) is applied through small injections in the areas to be treated. In more sensitive patients, we can use topical anesthetics or ice to relieve the sensation, but in most people, the pain is very mild, like pinching a hair, for example.
DOES BOTULIN TOXIN TREATMENT LEAVE A PERSON WITHOUT EXPRESSION? When the procedure is carried out without exaggeration, treating the muscle groups that produce the most wrinkles, the person’s expression is not affected. It is worth remembering that not all people form “crow’s feet” when smiling, which does not mean that their smile is inexpressive.
DOES IT HURRY TO APPLY? Because it is injected with a very fine needle, most patients report that the stinging sensation is perfectly bearable. Some don’t even feel it. More sensitive people can use an anesthetic cream applied 30 minutes before the procedure to alleviate the discomfort.
HOW LONG DOES THE EFFECT OCCUR? The effect begins to be observed in the first 72 hours and gradually increases in the 10 to 15 days following application when it stabilizes.
HOW LONG DOES THE EFFECT LAST? It lasts around 4-6 months when Botox is applied to the face and 9 months to 1 year when Botox is applied for hyperhidrosis.
DOES IT HAVE SIDE EFFECTS? Allergic reactions to botulinum toxin are not known, but transient side effects such as headache after the procedure or eyelid ptosis (lowering of the upper eyelid) may occur. Another possible side effect is the formation of a small ecchymosis (purple spot) at the injection site.
What does “PREVENTIVE BOTOX” mean? When we apply the toxin to a younger patient, the skin is still intact, without “definitive” wrinkles due to deep lesions in the dermis. The intention is to avoid folds in the same places that generate deep creases. But the application is not only preventive. She is also therapeutic.
