This chemical has been used by neurologists and ophthalmologists for years, for the treatment of eye squint and nervous twitching.
It acts by temporarily putting muscles to sleep. For this reason, the method has been called the “Hibernation Method” of treating facial lines.
Lines can be softened, or erased by filler injection, chemical peels, laser resurfacing, and even face-lifting. These methods treat the effect of repeated usage of facial muscles, but not the CAUSE. Botulinum Toxin works by temporarily (over months) immobilizing the overactive facial muscles, and hence breaks the habit of frowning.
The facial lines will simply disappear following Botulinum Toxin injections.
WHICH MUSCLES CAN BE IMMOBILISED ON THE FACE?
• The forehead consists of 3 main muscles (the powerful corrugator, the frontalis, and the procerus). These muscles give forehead frowns, and the anxious look.
• Naso-labial lines can be relaxed, although other methods are needed to eradicate these.
• Angle of the mouth. The depressor muscles are more active than the elevator muscles and give a “jowl” or downturned appearance
• The chin may display a “cobblestone” appearance that can only be treated by Botulinum Toxin injections.
HOW IS THE PROCEDURE DONE?
The Botulinum Toxin, diluted into a small syringe, is injected using a very fine needle into the belly of the muscle.
You are asked to bring out your frown, and then the lines may be marked on your skin.
The skin may be numbed with Emla anaesthetic cream, or icepacks. However the pain of the fine injection is very mild, and it is better not to affect the lines in any way.
Makeup does not need to be removed, as this may enhance the lines that we wish to soften.
Usually the effect of the injection takes about 4-5 days to become noticeable, and becomes most marked by about a week.
WHAT DO I DO AFTER THE TREATMENT?
You can carry on your normal activities, EXCEPT do not massage the area, or have a facial, for four days. This is to prevent migration of the chemical.
ARE THERE ANY SIDE EFFECTS?
• The Botulinum Toxin works only locally, and does not spread to any other part of the body.
• Rarely, no beneficial effects occur, because some patients have antibodies to the Botulinum Toxin
• A “heaviness” may be noticed in the forehead because suddenly the muscle has no tone. This may last hours or even up to 2 weeks
• Occasionally the Botulinum Toxin may spread locally and the eyebrow may droop. This may take 2 to 3 weeks to recover. Rarely, the eyelid may droop (ptosis) and recovery may take up to three months.
• Oedema (swelling) may occur locally due to decreased muscle movement. Massage is the best way to control this problem.
HOW MANY TREATMENTS DO I NEED?
This will depend upon your age, and the depth of your lines. If the facial muscle is more overactive, it will be harder to break the habit.
A young person will require only one or two injections, and an older person may require upto 6 of them.
Injections need to be performed initially with a gap of about three months between. However with subsequent injections, this gap can be lengthened
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