Botulinum toxin is most commonly known for treating lines and wrinkles. It’s reassuring to also know that doctors have been using botulinum toxin injections in medical practice – to treat muscle spasticity and facial spasms in adults and children – for decades.
How does botulinum toxin work?
Facial lines are caused by repeated use of the facial muscles for expression, for example raising the eyebrows, frowning and smiling. By reducing the amount of facial muscle movement, the lines can be softened.
When botulinum toxin is injected, it’s able to block the communication from nerves that tell the muscles to move. The effect is always temporary as nerves grow nerve endings that enable muscles to regain their movement after three to six months.
The main areas of the face that are treated include the frown lines (glabella complex of muscles), forehead wrinkles (frontalis muscles) and the crow’s feet (orbicularis oculi muscles), which are wrinkles around the corners of the eyes.
Botulinum toxin injections can also be used to treat jaw clenching and teeth grinding, excessive sweating, hyperactive muscles in the lower face and to smooth the neck (platysma muscle).
Who is suitable for treatment?
Botulinum toxin is suitable for most people, apart from those who are pregnant, breastfeeding or suffer from a neuromuscular disorder.
You should make your practitioner aware of any medication you are taking including Gingko Biloba, aspirin and other blood thinners like ibuprofen, fish oils (omega3) and St John’s Wort. A consultation with a medical professional is essential before going ahead with treatment.
What results are expected from botulinum toxin?
Results will depend on what you’ve had treated. Botulinum toxin injections can be used to reduce:
- Wrinkles around the eyes (crow’s feet)
- Frown lines on the forehead and brow
- Amount of upper gum shown when smiling
- Vertical wrinkles of the upper lip (smoker’s/lipstick lines)
- Downturned smile – it relaxes the muscle that pulls the corner of the mouth, therefore reducing a sad appearance
- Chin dimpling – relaxes the strength of the mentalis (chin) muscle, which reduces the dimpling of the chin and horizontal line between the chin and the lower lip
They can also treat:
- Bruxism (teeth grinding) and provide a narrower jawline
- Neck lines and lift the jowl line
- Excessive sweating
Results are usually noticeable seven to 12 days after the injections, reaching their maximum effect 28 days later. They will usually last three to six months. With ongoing treatments, the effects of botulinum toxin treatment may last longer as the muscle will become weaker and smaller.
Occasionally you might require an adjustment treatment at two weeks if the muscle is not adequately relaxed. It is always better for the practitioner to inject a conservative amount of botulinum toxin and add more if required.
The botulinum toxin will make it difficult to frown and squint, however if you try very hard you will be able to move the muscles a little as it’s important to retain normal facial expression.
Does the procedure hurt?
As with any injection, botulinum toxin treatment can sting. Your practitioner can cool or numb the area prior to the procedure to make it more comfortable.
Are there any risks associated with botulinum toxin?
It’s normal to experience slight redness and swelling after treatment. There is also a very small risk of bleeding, bruising or infection at the injection sites. You may experience transient headaches.
There is a very small risk of eyelid drooping (ptosis) and slight puffiness following treatment. In the unlikely event that this occurs, it is always temporary and usually settles after two to three weeks. The incidence of ptosis is about 2% but always ask your practitioner what problems they have had with treatments as this will differ between them.
After several treatments, very rarely, some patients become resistant to botulinum toxin and it no longer works effectively.