BOTULINUM TOXIN INJECTION

Facial lines are caused by the repeated use of the facial muscles in a particular manner.  Facial lines form wherever we frown, squint or smile.  Some people have a distinctive facial habit – raising eyebrows, using one side of the face more than the other and they will in time see a set of facial lines appear which reflect this individual habit.

Botulinum toxin injections is a preventative treatment to help reduce the appearance of wrinkles on the forehead, between the brows and around the eyes. When you smile or frown, this is a result of a nerve signal from your brain to your muscles causing them to move.  Botulinum toxin is a purified protein that blocks this signal from brain to the nerve endings.  Injections are given to temporarily put the muscles to sleep for a period of three to six months, although the results can last longer with repeated treatments.  This freezing of the muscle is always temporary and can never be permanent so Botulinum toxin is sometimes called “The Hibernation Treatment” as the muscle “hibernates” for a few months.  The aim is to break the habit of frowning and educate the patient in his or her facial movement so that one “forgets” how to frown.  Usually patients have several of these injections over a year or two until the frowning habit is broken.

The positive benefits of botox injections are that while the muscle is temporarily immobilized, the frown line is not being created or reinforced.  Most patients notice that their existing frown lines do soften because the forehead is completely relaxed.  Some people have a markedly lopsided face due to an overactive muscle on one side.  This botox treatment can be used to weaken an overactive muscle thereby balancing the face.

The botox treatment takes approximately 15 minutes.  The surgeon will clean your skin and then small amounts of botulinum toxin will be injected into the area to be treated.  He will ask you to frown, this is so he can see the exact pattern of the forehead and frown movements in the individual patient.  The injections are slightly uncomfortable.  Afterwards you may have some tiny red marks where the needle was inserted, these may last up to 24 hours.  The effect of the botox gradually takes effect over a week to ten days.  After two weeks the muscle will be completely “asleep”.

Very occasionally you may require more than the usual injection amount; if the muscle does not go to sleep you may have to have a top up injection.  Also patients who have well-exercised and developed frown muscles (more common in men) may need a second injection.  It is better to inject a conservative amount of the substance and add more if required.

It must be emphasized that the injection is intended to make it difficult to frown, we all frown subconsciously, this treatment prevents inadvertent frowning.

The substance that is injected is Botulinum toxin.  The substance cannot cause any permanent damage or travel inside the body because it attaches itself to the muscle and cannot migrate from there.  The injection technique that is used ensures that the substance cannot pass into the bloodstream.

Although Botulinum toxin has been used cosmetically since 1987 it is at present not licensed for cosmetic use in the UK and is administered at the surgeons discretion.

There is a very small risk of eyelid or eyebrow droop, slight puffiness and occasional bruising following the injections.  In the unlikely event that this occurs, it is always temporary, and may be treated with eye drops for a short period of time.

In some older patients because of the poor tone of their muscle they may feel heaviness over the eyebrows.  This lasts 2-3 weeks.  Usually in older patients a lower dose is injected to prevent this happening.

After treatment, please avoid micro dermabrasion, electrolysis, laser treatment and any electrical beauty procedures for up to one week after the injections.  In the first four hours after your procedure do not shampoo your hair, have a scalp massage or any facial treatment and avoid wearing anything tight around your head.  When cleansing the face do not apply pressure and avoid leaning forward or lying on the treated area.  Please do not take vitamin E or alcohol and avoid strenuous exercise and yoga.