Botox wrinkle treatment is an aesthetic medicine procedure to combat mimic wrinkles. The so-called botulinum toxin (Botox for short) is a natural bacterial toxin produced by Clostridium botulinum. Botox is neurotoxic and inhibits the release of the neurotransmitter acetylcholine (a neurotransmitter is a messenger that transmits electrical information from one nerve cell to another). It is the neurotransmitter of the nerve cells responsible for supplying the muscles. This effect leads to paralysis of the muscles by blocking the nerve impulses. Botulinum toxin has been used as an approved drug in medicine since 1989, initially in neurology and ophthalmology. In aesthetic medicine it was first used in Canada, in 2002 in the USA and in 2006 in Germany. Wrinkle therapy with botulinum toxin type A (BTX-A) primarily serves cosmetic purposes and thus the well-being of the patient. However, it is gaining importance in symmetry restoration of faces after reconstructive surgery (restoration of injured or disfigured regions of the face). Botox injections can also help in the therapy of persistent (permanent) hypertrophic scars (scars that have grown a lot) or in the treatment of painful scars.
Indications (areas of use)
- Glabellar region (glabellar wrinkles, “frown lines”).
- Lifting the eyebrows
- Periorbital wrinkles (“crow’s feet“) – wrinkles on the sides of the eyes.
- Lateral eye lift
- Lower eyelid wrinkles
- Forehead region (“thinker’s crease”) – forehead wrinkles
- Lifting the tip of the nose
- Nose wrinkles
- Marionette wrinkles (“drooping corners of the mouth”)
- Upper lip wrinkles
- Lateral cheek-chin wrinkles (“hamster cheeks”)
- Chin wrinkles
- Platysma wrinkles (“turkey neck”)
- Décolleté folds
Contraindications
- Neuromuscular diseases such as myasthenia gravis, Eaton-Lambert syndrome, or amyotrophic lateral sclerosis (ALS).
- Inflammation at the injection sites
- Proven hypersensitivity to any of the ingredients.
- Pregnancy and lactation
- Children under 12 years
Note: Caution should be exercised in patients taking medications that interfere with neuromuscular function. This applies, for example, to cholinesterase inhibitors or calcium channel blockers.
Before treatment
Before starting wrinkle treatment, a comprehensive educational and counseling discussion should take place between the physician and the patient. The content of the discussion should include the goals, expectations, and options for treatment, as well as side effects (e.g., allergic reactions) and risks. Anticoagulants (anticoagulant drugs such as acetylsalicylic acid/ASS) should be discontinued as far as possible to reduce the risk of hematomas (bruises). Immediately before treatment, disinfect the skin of the areas to be treated.
The procedure
Mimic wrinkles are caused by the mechanical friction between the facial mimic muscles and the skin. The facial musculature (unlike the rest of the skeletal musculature) is not held in place against the skin by a fascia (component of connective tissue). This anatomical peculiarity makes it possible for the movements of the mimic muscle groups to show up on the skin and become visible as facial expressions (e.g. emotions). However, the permanent deformation causes a change or degeneration of the skin. In addition, excessive exposure to the sun and lack of nutrition accelerate the formation of wrinkles. Treatment with Botox starts at the facial muscles and takes place with the patient in a semi-sitting or sitting position. Targeted intracutaneous injections of Botox at intervals of about 1 cm paralyze the muscles in question and stop the mechanically induced production of wrinkles. At the same time, facial expressions may be impaired due to the paralysis of the facial muscles (“mask-like facial expression”). As a rule, the Botox used is botulinum toxin-A (BTX-A), which is available in Germany as Azzalure, Bocouture or Vistabel. The first effect occurs after 24 to 48 hours, the maximum effect is usually achieved after three to ten days and lasts about 3-5 months. Studies show that after regular injections at intervals of about four months over a period of 20 months, the duration of effect increases.The effect then lasts up to six months. The treatment can be repeated as often as desired, as studies have shown that there are no clustered side effects.
After treatment
Following wrinkle treatment, the treated areas should be cooled to prevent or avoid swelling or redness. The patient should not massage the affected regions directly, otherwise the successful course of treatment will be jeopardized. Further notes
- If deep hypertonic and hyperkinetic frown lines are also present, they can be additionally softened by intradermal injections (“into the skin”) with hyaluronic acid. See this under “Hyaluronic acid wrinkle injection“.
Benefits
Botox wrinkle treatment is a very effective procedure to eliminate annoying blemishes that can reduce self-confidence. It requires little effort and is very versatile, but should be performed by an experienced physician. Botox wrinkle treatment positively affects your aesthetic appearance and thus increases your well-being.
