Botulinum Toxin/Neuromodulation

What is Botulinum Toxin Injection?

Ageing, genetics, sun damage, poor hydration, smoking and other lifestyle factors all contribute to the development of facial wrinkles/rhytids that makes us look older than we are, or older than we wish to appear. With repetitive movement of the facial muscles, wrinkles start to set in. Neuromodulation is essentially an office-based treatment of anti-wrinkle injections with Botulinum toxin (Botox, Dysport, Xeomin). Anti-wrinkle injections work well to relax the muscles of facial expression and smooth out wrinkles in the forehead, frown lines between the eyes, and smile lines at the outer corner of the eyes. This is achieved through paralysing the muscles with the use of small doses of the Botox drug.

Botulinum toxin is a purified protein produced through a strictly controlled process. Botulinum neurotoxin injections block specific chemical signals from the facial nerves that would normally cause muscles to contract, thus preventing the movement that leads to lines and wrinkles. Over time, using Botulinum toxin injections will also help slow down the development of new lines, since the contraction of facial muscles is temporarily stopped for approximately 3- 4 months.

Botulinum neurotoxin injections have been one of the most popular and effective anti-wrinkle treatments for more than 20 years. The procedure must be done under a skilled and properly certified doctor's care that specialises in the condition and has prior experience with injecting the treatments.

Fast Facts:

Length of procedure: 10- 20minutes
Type of anaesthesia: Numbing cream applied before (if required).
Length of hospital stay: Office treatment
What to expect post-treatment: Can return to work or social activities immediately after. Minor bruising may occur at injection sites.
Recovery time: Some activities should be limited in the first 24 hours (e.g. vigorous exercise or facial massage), but all normal activity is permitted after 24 hours.
Results: Results are seen within 5 - 7 days and last 2- 6 months (usually 3- 4 months for most people).

Who might benefit from Botulinum Toxin Injection?

Anyone who has wrinkles or lines in the upper third of their face that bother them or are visible at rest. Dynamic wrinkles are lines that form when you are actively moving your facial muscles (e.g. smiling, frowning or raising your eyebrows). Static wrinkles are deep lines that have set in over the years are always visible, even when you are not actively smiling, frowning or raising your brow. Many people complain that this makes them look old, angry or unhappy.

There is no ‘right age’ to start botulinum neurotoxin injections, and starting earlier and maintaining your botulinum neurotoxin treatments may help prevent deep static lines from forming. You should not have botulinum toxin injections if:

  • You have an allergy or history of a reaction to the constituents of Botox or Dysport.
  • You have Myasthenia Gravis, Eaton Lambert Syndrome or a similar condition.
  • You are pregnant or breastfeeding.
  • You are taking certain medications such as penicillamine, aminoglycoside antibiotics, calcium channel blockers, quinine.

What does Botulinum Toxin Injection involve?

At your first visit for neuromodulation, Dr do Vale will usually perform a full skincare consultation. She will discuss and answer any questions you may have regarding Botulinum toxin injections, all options available to you, and the expected benefits and results so that together you can come to a personalised decision about your non-surgical facial rejuvenation. Dr do Vale will assess the number of injections needed and the dosage of units, depending on several factors, including the size of the area being treated. The Botox or Dysport cosmetic procedure generally takes ten minutes to complete.

The procedure involves injecting tiny amounts of Botulinum toxin into the forehead, the glabella (the area between the eyebrows), and crow's feet (smile lines at the outer eye), using a very thin, tiny needle. Most people find the procedure easy to tolerate because the needle is so small, however, some individuals prefer to have their skin numbed prior to the botox injections which may be accomplished by a topical numbing cream or numbing medications injected into the skin. If required, Dr do Vale typically uses a topical numbing cream which needs to be applied for 20- 30 minutes beforehand to effectively numb the skin.

Botulinum toxin is usually used to effectively treat upper face wrinkles:

  • Frown lines of the glabella (the area between the eyebrows)
  • Forehead lines
  • Smile lines (crow’s feet) at the outer edge of the eyes
  • Bunny lines on the nose
  • Subtle non-surgical brow lift

In the lower face botulinum toxin is used less often, but is effective for certain indications:

  • Dimpling of the chin
  • Gummy smile
  • Platysma bands in the neck.

Botulinum toxin formulas work by temporarily blocking nerve signals and thereby temporarily paralysing the target muscle and preventing contractions, which improves the appearance of visible lines and wrinkles. Over time, using Botulinum toxin injections will also help slow down the development of new lines, since the contraction of facial muscles is temporarily stopped for approximately 3- 4 months.

Recovery after Botulinum Toxin Injection:

The tiny botox injection marks are usually not visible soon after the treatment. Patients are able to return to work or their regular schedule immediately after the botox procedure. To avoid complications, it is advisable to:

  • Avoid rubbing or massaging the treated areas for 4 -6 hours following botulinum toxin injection.
  • Avoid vigorous exercise, straining, heavy lifting for the rest of the day.
  • Do not lie down or sleep for 6 hours following botox injection.
  • Do not wear headbands, hats or helmets that might compress the treated area for 24 hours.
  • Avoid other facial treatments for the first 24 hours, such as facials, micro-needling, microdermabrasion, or chemical peels, steaming or saunas.

Results are visible within 5 to 7 days and usually last for approximately 3-4 months. Patients report few side effects and those reported are mild and cause no disruption to their daily life. Side effects may include bruising at the botox injection sites (most common), or a temporary headache. In 1- 5% of patients, drooping of the eyelid can occur- fortunately, it will recover spontaneously within 3- 4 weeks. When the procedure is done correctly, under a plastic surgeon's care, a patient's best aesthetic results can be achieved.

For more information on Botulinum toxin request a consultation with Dr do Vale below or call 0109003999.