Botulinum Toxin ( B o t o x ) Information
What is Botulinum toxin?
Our facial expressions change as we contract or relax our muscles. This is caused by the brain sending a signal to our muscles via our nerve endings. Botulinum toxin is a naturally occurring protein produced by the bacterium Clostridium botulinum. When a highly diluted dose of Botulinum toxin is injected by a fine needle into a specific muscle it blocks the signal from the nerve to the muscle, inhibiting the movement of that muscle. This inhibition is not permanent and requires maintenance treatments to sustain the result.
After treatment the skin in and around the area will look more smooth and the appearance of wrinkles and frown lines will be reduced. The rest of your face will not be affected, and you will still be able to laugh, smile and frown but with less wrinkling of the skin in the areas treated.
What areas can be treated?
As well as treatment of frown lines, forehead creases, crows feet and wrinkles, Botox is useful for the treatment of platysmal bands (‘turkey neck’) as well as hyperhidrosis (excessive sweating).
What happens during the treatment?
You will discuss your expectations of the outcome of treatment and whether this is the best treatment for you. Dr Mahadi will take a medical history to make sure Botulinum toxin is suitable for you. Before and after photographs may be taken with your face relaxed, smiling and frowning to show how successful your treatment has been.
Prior to injection, you will be asked to sign a consent form. The area to be treated will be cleaned with an antiseptic wipe. Then, using a very fine needle and disposable syringe, small amounts of Botulinum toxin will be injected into several points in the area being treated. A cool pack may be applied to the area to reduce redness and swelling.
Most patients find that the injections cause only a little discomfort or sting, as the needles used are very fine and the treatment is very quick. A few patients do, however, prefer to have a cream called EMLA applied half an hour or so prior to the treatment to help numb the skin.
What should I expect after the treatment?
Successful therapy is indicated by muscle weakness that begins between 48 and 72 hours after treatment, and peaking at 7 to 14 days. Minor reactions may include brief pain or a mild headache. The affected area may look a little red for up to 6 hours after treatment. After 6 hours, makeup may be applied. (Mineral make up may be applied straight away).
Bruising may occur, but can be minimised by avoiding Aspirin, Ibuprofen and other anti-inflammatory medications within 5 days of treatment, avoiding excessive alcohol intake, avoiding strenuous exercise and air travel for 2 days.
Repeat procedures
Depending on the area treated, the dose used and how well each individual responds to the
injections, each treatment usually lasts between 3 to 4 months. You will normally expect to require maintenance injections approximately 3 – 4 times per year to retain the required effect and over time you may be able to reduce the number of treatments as the muscles retrain and cease contracting in the previous manner.
What are the contraindications to having treatment?
Generally, Botulinum toxin injections are not recommended if you are pregnant and/or breast feeding or have an active neuromuscular condition such as Multiple Sclerosis, Myasthenia Gravis, and Bell’s Palsy. If you are taking medications such as penicillamine, aminoglyocide antibiotics and calcium blockers then you should not have Botulinum toxin. Please discuss with Dr Mahadi any medications that you take and any allergies that you have.
What are the potential side effects?
In 20 years of clinical use there have been no known long-term harmful effects. As previously mentioned, temporary swelling and bruising are to be expected. A mild weakness or paralysis of the upper eyelid (ptosis) or brow may occur in patients and will disappear over a period of 2 – 10 weeks. Eye drops may help to speed up recovery. A more common side effect is paralysis of the muscles in the outer edge of the eyebrow. This elevates so changes shape. A small amount of Botulinum toxin injected above the raised area of the eyebrow will bring the eyebrow back down.
