In any face-to-face encounter, words alone don't tell the whole story. More often, our facial expressions send a stronger message. If you've found that frown lines, forehead creases or other facial expression lines are preventing you from looking as good as you feel, cosmetic denervation with Botulinum toxin (Botox) injections and Dermal filler may be a good option for you.
Botulinum toxin is a purified therapeutic agent that removes lines and creases in the upper part of the face by inactivating specific muscles that pull on the skin. It works to eliminate the face's dynamic wrinkles - those wrinkles that are caused not by ageing or sun exposure, but by years of facial movements, such as laughing, smiling or frowning. Treatment with Botox in the affected areas, causes the underlying muscles to relax, giving the skin a smoother, more refreshed appearance.
Dermal fillers are materials that help to reduce the appearance of facial wrinkles, lines, folds and indented scars. Also known as soft-tissue fillers, dermal fillers are injected into the skin under wrinkles and lines caused by ageing, smoking and exposure to the sun. They are often used to soften irregularities caused by acne scars or skin damage. Dermal fillers often offer a relatively painless, fast and inexpensive option. For these reasons, dermal fillers have become popular in recent years.
The effects of dermal filling may last from several months to years, depending on the product used and the condition of the skin. Effects are not permanent. The procedure may need to be repeated in the future if you want to maintain the dermal filler effect. While a dermal filler can have a positive effect on facial lines and wrinkles, results may be short-lived or may not meet your expectations for a variety of reasons.
Botox (botulinum toxin) injections are not similar to Dermal Fillers. Although Botulinum toxin or Botox is injected to reduce the appearance of wrinkles, it works in a different way by relaxing the muscles that surround wrinkles. It may be used in conjunction with dermal fillers to improve results.
How does it work to reduce facial lines?
Facial lines are caused by repeated use of the facial muscles of expression e.g. squinting and frowning. By reducing the amount of facial muscle movement the lines can be softened.
Injections are given into the muscles, temporarily putting them to sleep' for a period of three to six months. The freezing of the muscle is always temporary and is sometimes called 'The Hibernation Period' as the muscle 'hibernates' for a short period. The aim of the treatment is to break the habit of frowning or squinting and so reduce the appearance of the lines and also reduce the development of further facial lines.
After your treatment, it will take 2-3 days for the effects to start to be seen reaching its maximum effect at 7-10 days. The treatment may last from to 3-6 months, on average 4 months. With ongoing treatment, the effects may last longer.
Occasionally you may require a top-up injection at two weeks if the muscle is not fully asleep. It is always better to inject a conservative amount of the Botulinum toxin (Botox Azzalure, Dysport) and add more if required. The Botulinum toxin will make it difficult to frown and squint and therefore reduce facial lines However if you try very hard you will be able to move the muscles a little. This does not mean the treatment has not worked.
Is wrinkle relaxing injections( Botox) treatment right for me?
Botox is most commonly used to treat adults 30 and older. However, patients of any age can benefit from treatment.
You may be a good candidate for cosmetic Botox injections if you have any of the following conditions:
- Frown lines (vertical wrinkles between the eyebrows)
- Forehead creases (horizontal forehead lines)
- "Crow's feet" near the eyes
- Platysmal bands, which appear in the neck as thick bands or "cords"
Other uses for Botox
In addition to its cosmetic use, Botox has a long record of safe and effective use in treating other conditions, such as:
- Eyelid spasm or eye muscle spasm that can cause crossed eyes
- Facial muscle imbalance
- Spasms of the neck muscles
- Spastic muscles in patients with cerebral palsy
- Newer research has found that Botox may also provide some relief for:
- - migraine headaches
- - excessive sweating of the palms or underarms
Botox has a 20-year record of safe and effective use. However, you should be aware that cosmetic denervation is an "off label" use for Botox. This means that the Food and Drug Administration has not yet reviewed and approved Botox for its expanded use in the correction of wrinkles, even though it is widely and safely used for this purpose
Where can wrinkle relaxing (Botox) injections be given?
Eyes - to reduce crow's feet
Forehead and brow - to reduce frown lines
Mouth - to reduce the fine vertical lines on the upper lip or to treat down turned mouths
Neck - to treat lines and lift the jowl line.
Are there any side effects?
The side effects are minimal and all are temporary. The injections may sting very slightly but they are not painful. Other side effects are minimal redness and swelling at the injection sites that usually disappears after an hour or so. There is also a small risk of bruising at the injections sites. You may experience a transient headache and numbness at the treatment sites.
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 2-3 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 doctors.
After several treatments, very rarely some patients become resistant to the drug and it no longer works effectively
Who cannot have muscle relaxing injections Botox/Dermal Filler?
It is not recommended for anyone who is pregnant or breastfeeding or who suffers from a neuromuscular disorder. You should make your doctor aware of any medication you are taking including Gingko Biloba and St John's Wort.