Botulinum toxin therapy for facial wrinkles and lines is an injection treatment to reduce facial expression lines. Botulinum toxin has been used for many years and is licensed for treatment of spasticity and various facial tics and spasms. It is being increasingly used in medicine for treatment for tension headaches, migraine and whiplash injuries to the neck, and is now licensed for the treatment of excessive axiliary sweating, hiperhidrosis.
Botulinum toxin relaxes specific facial muscles that cause unwanted lines, for example, the deep creases between the eyes, crows feet and forehead lines.
How does Botox® work?
Botox® prevents nerve impulses arriving at the muscle to cause contraction. The muscle is therefore temporary paralysed, but this effect is completely reversible in time and the muscle itself is not damaged.
A number of injections will be required, and these generally cause only temporary discomfort. The effect will develop gradually over 3-5 days but can take up to 2 weeks to get maximal results. The final effect will depend on various factors including the initial magnitude for the lines, the size of the underlying muscles and the amount of botox used to achieve the required result. The effect will last between 2-7 months, the average being 4-5 months.
How is the treatment administered?
Botox® is injected using a disposable syringe with a very fine needle; minute amounts of botox muscle relaxant are injected very precisely into several locations on the face, which are determined by carefully examining the movements of the muscle of your face. The pain associated with the injections is minimal and can any potential discomfort and be minimised by using a topical anaesthetic prior to treatment if required. The injection procedure takes around fifteen minute and the results are a youthful refreshing look with a normal facial expression.
Baby Botox®
Baby botox is a term which is used for either a smaller dose or a more dilute mix of botox. This is mainly used by clients as a preventative rather than a reactive treatment to prevent facial lines and wrinkles forming. Usually used by the younger client to maintain and prolong wrinkle free facial features.
Are there any risks?
Side effects for this treatment are rare and usually mild, however you need to be aware of the following:
· Immediately post treatment there will be some mild swelling and redness, and this usually settles within a few hours. As with any injection therapy, there is always a risk of infection, but this is very uncommon.
· Bruising at the injection site may occur, and can be exacerbated by Warfarin and Aspirin treatment. Occasionally a temporary drooping of the eye lid can or eye brow can occur, but this usually resolves in a few weeks.
· An eyebrow lift may occur, but can be corrected by a small additional injection of botox. The relaxation of the forehead muscles may rarely increase the risk of sleep ine development, but this may be resolved by treatment with dermal filler.
· Some experience a mild headache but tension headaches are usually improved.
· Rarely a transient numbness may occur in the treated area, and extremely rare side effect is generalised weakness and fatigue.
· For reasons that are not understood, some patients may by resistant to the effects of botox®, and for these treatment may not be as effective or long lasting.
· If you are prone to cold sores, treatment may precipitate a break out.
Contra-indications
You should not undergo the treatment if you are pregnant or breastfeeding. Certain medications, allergies and medical conditions are contra-indicated to the treatment, but these will be covered in your medical questionnaire prior to treatment.
Botox® injections pre treatment instructions
Avoid aspirin and non-steroid anti-inflammatory drugs (e.g Ibuprofen) for 10 days prior to treatment as these may increase chances of bleeding or bruising.
Try to avoid or reduce alcohol intake for one week prior to treatment for the same reasons listed above.
What are Fillers?
These products contain hyaluraonic acid in the form of clear gel which is used to smooth wrinkles and folds or to add contour. Hyaluronic acid is occurs naturally in all living organisms and is identical in all species and tissue types.
How does the product work?
In the skin, hyaluronic acid binds water and creates volume. These products are long-lasting because the initial volume is maintained through the degradation process by replacement with water, the less concentrated the product becomes, the more water it is able to bind, so the volume is maintained until the product is completely degraded.
How is the treatment administered?
Depending on the area to be treated, a number of injections will be required. Some of the most popular areas to be treated are the naso-labial folds from the nose to the mouth, the lines at the corners of the mouth and the lips. All areas require an advanced injection technique which can be uncomfortable therefore a topical anaesthetic cream is recommended before each treatment which is applied by the practitioner.
Are there any special precautions?
You should not consider treatment if you are pregnant or breast feeding. It should not be used near areas of skin affected by dermatitis or infection, and treatment should not be used in conjunction with laser or chemical peels.
Are there any risks?
There will usually be some swelling and redness, and occasionally bruising especially when anaesthetic has been injected. Occasionally there may be itching, pain, discolouration, or tenderness at the injection site. Resolution is typically spontaneous in one to two days. As with all injected treatments, there is a risk of infection, but this is unusual. If you are prone to cold sores, treatment may precipitate an eruption. Hyper-sensitivity reactions have been reported in one in two thousand treatments and consist of swelling at the injection site. Rarely acne form papules may develop. Theses problems are usually self limiting and settle within two weeks. There is potential risk that the product can be injected into a blood vessel, causing a blockage and subsequent tissue damage, or damage to the facial nerves. These are theoretical risks which have not yet been reported with these products. Occasionally a temporary palpable lumpiness may be noted in some patients.
