BOTOX®
(MUSCLE DENERVATION BOTULINUM TOXIN)
BOTOX® is a registered trademark of Allergan, Inc.
Introduction
Botulinum toxin (BOTOX®) is extracted from bacteria cultured (grown) in the laboratory. It relaxes muscle (prevents it contracting) by blocking transmission of the nerve impulse to the muscle. The effect lasts for three to four months in general. It is now thought to be the commonest cosmetic procedure performed.
Mode of action
Dynamic facial wrinkles and unsightly lines of facial expression result from over activity of the underlying facial muscles. By preventing these muscles from contracting, the cause of the wrinkle is eliminated and in time the wrinkle becomes less prominent (ironed out) and can even disappear completely. It must be stressed that lines caused by ageing and sun damage will not respond to BOTOX®.
This method of treating facial wrinkles is known as the hibernation treatment because the muscle goes to sleep or is in hibernation.
Common treatment sites
- BOTOX® is used to treat the following areas of lines & wrinkles on the face.
- Horizontal forehead lines & wrinkles
- Vertical lines & folds between the eyebrows (glabellar lines)
- Crows feet (outer margins of the eyelids) and horizontal lines in the lower eyelids.
- Turkey neck and horizontal neck lines.
Technique
The injections take only a few minutes to administer. The appropriate muscles are injected at strategic points on the face and forehead using a very fine needle. Ice packs can be applied afterwards to reduce swelling.
Duration of action
This varies from patient to patient. In general the effects from the initial injections should last from three to four months. Having regular injections as soon as the muscles regain their activity will cause them to gradually shrink in size. The result is that the intervals between injections become longer.
Postoperative events
Redness over the injection sites can last for a few hours. Occasionally an area of bruising can develop if an underlying vein has been accidentally punctured.
Generalised reactions can occasionally occur. These include nausea, fatigue, flu like symptoms, headaches, skin rashes (very rare).
Drooping of upper eyelid . This can sometimes occur temporarily if the injected toxin migrates through the surrounding tissues to affect the muscle which elevates the eyelid.
Drooping of the eyebrow : Can occasionally occur temporarily if the forehead muscle becomes too weak after injection and droops.
Drooping of the lower eyelid : Can occasionally occur after injecting the crow's feet area.
Asymmetry of facial expression can occur but this is only temporary.
Resistance : Can occasionally develop whereby a patient no longer responds to the effect of injected BOTOX®.
Allergic reactions : Can rarely occur.
Other uses of BOTOX®
Excessive Sweating (Hyperhydrosis)
Excessive sweating or hyperhydrosis occurs in about 1% of the population and is thought to be of genetic origin. It is caused by over activity of one type of sweat gland (the eccrine gland). These glands are found throughout the body but are concentrated on the palms of the hands, soles of the feet and in the armpits.
When injected into the skin of the armpit, BOTOX® blocks the action of the nerves that supply the sweat glands thereby preventing them from producing sweat. The effect lasts from four to seven months.
Migraine:
BOTOX® has shown to be successful in treating some patients who suffer from regular attacks of migraine. The mechanism of action is unclear and research is ongoing.
Contraindications to BOTOX® injections
BOTOX® injections are contraindicated in the following circumstances:
- Known allergy to BOTOX® or previous problems with BOTOX®.
- Pregnancy & breast-feeding.
- Known muscle diseases or taking drugs used to relax muscles.
