Botulinum toxin, produced by the bacterium 'Clostridium botulinum' used to be best known as the substance that caused the illness 'botulism'. In 1992 a form of the toxin, known as Botulinum Toxin A, was described as being of use in the cosmetic setting. Since then, it has become the most commonly performed cosmetic procedure in the USA.
Botulinum Toxin A has been packaged by a number of different companies and is sold under many names. The most commonly known brand name is 'Botox'.
How does Botox work?
Botox, like other brands of Botulinum toxin A, acts on certain nerve endings and blocks their action. Muscles need the nerves to make them work, so if Botox is injected near a muscle then the nerve gets blocked and the muscle in turn becomes weaker.
Facial wrinkles develop due to the action of underlying facial muscles. Botox blocks the nerves, the muscles work less, and the wrinkles can improve!
Does Botox work instantly?
The full effects will generally not be noticeable for about 3-4 days.
How long does Botox last?
Generally, the effects of Botox will last for 3-6 months, although on close examination some effects may still be visible at 7 months. Regular repeat injections of Botox can lead to longer and longer durations of action.
What else can Botox be used for?
Botulinum toxin, as Botox or other names, is often used by doctors for more than just wrinkles - it can for example also be used to reduce excess sweating and ease muscle spasms. It can be extremely effective in these scenarios, and continues to be used more and more commonly.
How is Botox given?
Tiny amounts of Botox are carefully injected into required areas. This may involve just a few injections, or can be many depending on how much is needed. The needles used are very fine, and are usually relatively painless.
The areas that have been injected with Botox may appear slightly red at first, which is quite normal. You should not massage or rub the area straight after injection, as this can cause the Botox to spread to unwanted areas.
Will Botox improve all my wrinkles?
Not necessarily. Botox is very good at improving early wrinkles and can produce a youthful appearance; some wrinkles, though, are not suited to Botox and may instead require fillers, a brow lift or a face lift to regain a smooth, youthful look.
A quick test is to gently pull on either side of your wrinkle. If it disappears, then Botox may be suitable. If the wrinkle remains, then it may not help.
Doesn't Botox give an expressionless face?
When used carefully and in moderation, Botox can give a very subtle result, whereby you will look more youthful without it being too obvious that anything has been done.
Large areas of facial muscle being affected, however, can result in a 'mask-like', expressionless look. Whilst this is not dangerous and will wear off in a few months, it does make it more obvious that something has been done. The ability for a specialist to produce a natural result with Botox will often rest on their experience, although can be a difficult judgement even in the best hands.
What are the risks of Botox injection?
Unwanted effects - as mentioned previously, too much Botox can result in loss of facial expression. Whilst this is essentially the underlying way that wrinkles are treated, a 'mask-like' appearance can result from large areas of muscle being affected. Very rarely, the main facial nerve can be affected, which will give drooping of the eyelid and mouth on the affected side. This will wear off after a few months as the Botox toxin weakens.
Recurrence of wrinkles - this is not a risk as such, as much as a natural course. As the Botox toxin wears off the wrinkles may return and repeated procedures may be necessary.
Bruising - it is relatively common to experience minor bruising at the injection sites, which should settle after a few days
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Any procedure involving skin incision can also result in unfavourable scarring, wound infection, or bleeding. This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.
The information provided is as a guide only and you should discuss matters fully with your specialist before deciding if this is the right procedure for you. Please also read our disclaimer