Botulinum Toxin (Botox)
Botulinum toxin, also known as botulinum toxin, has long been known as a potent neurotoxin and is the most toxic biological toxin to date. In 1979, the medical community first used it as a drug for clinical treatment, initially in ophthalmology. The principle is that it acts on the human nervous system, inhibiting the release of neurotransmitters, which leads to the paralysis of muscles and cessation of muscle spasms. In 1986, a Canadian ophthalmologist named Dr. Jean Carruthers discovered its effect in reducing eye wrinkles, sparking the “Botox revolution” in the beauty industry. Since then, botulinum toxin has been widely used in cosmetic procedures. When used for cosmetic wrinkle treatment, its concentration is diluted to very low levels.
Botulinum toxin can be classified into eight different serotypes based on its toxicity and antigenicity: A, B, Ca, Cb, D, E, F, and G. The botulinum toxin available in the market is primarily Type A and Type B. The Type A botulinum toxin is the purified protein commonly used for wrinkle removal.
Mechanism of Action for Wrinkle Removal: Botulinum toxin is an exotoxin produced by the Clostridium botulinum bacteria. It works by targeting acetylcholine receptors, blocking the release of acetylcholine, which reduces the activity of the target muscles and makes the face appear more youthful.
Botulinum toxin is injected into the muscle layer to reduce muscle contraction and help relax facial muscles. It can block the nerve cells that cause muscle contractions, smoothing facial lines and preventing new wrinkles from forming. It is a fast-acting, safe, and minimally invasive treatment method.
Treatment Duration and Results:
The treatment takes about ten minutes. The effects begin to take place within 2-3 days, with noticeable improvements around the 7th day, and the ideal results appear in about a month. After the treatment, there are no visible scars on the face, and it does not affect daily work or life.
Mechanism of Action for Facial Slimming Using Botulinum Toxin:
Botulinum toxin works by blocking the SNAP-25 protein in the nerve cells. This prevents nerve impulses from reaching the muscles, causing the muscles to relax and reducing their tension. This helps relax over-contracted and tense muscles, paralyzing excessively developed muscles. By paralyzing the muscles, the muscle fibers cannot contract, leading to a reduction in the size of overdeveloped muscles. Importantly, this process does not damage the excitability or conductivity of the nerves and muscles. This phenomenon is medically referred to as “chemical denervation.”
Botulinum toxin is particularly suitable for patients with well-developed masseter muscles. However, it is not suitable for improving facial shape issues caused by factors such as excess fat or broad bone structure.
Types of Wrinkles:
Static Wrinkles: These are wrinkles that appear on the skin’s surface even when the face is at rest, such as forehead lines and nasolabial folds that remain visible even without facial expressions.
Dynamic Wrinkles: These are expression lines that appear when making facial expressions, such as the lines between the eyebrows when frowning or crow’s feet at the corners of the eyes when laughing. Over time, dynamic wrinkles can become permanent and turn into static wrinkles.
Botulinum toxin is more effective for treating dynamic wrinkles. If you wish to achieve comprehensive improvement across the entire face, it is recommended to combine botulinum toxin with hyaluronic acid treatment. This combination provides more prominent results compared to using a single treatment method.
Treatment Management:
Botulinum toxin for cosmetic use should be stored at a temperature of 2-8°C and mixed with 2.5 milliliters of 0.9% saline solution. The dosage for injections varies depending on the treatment area, such as between the eyebrows, forehead wrinkles, crow’s feet, etc.
Treatment Scope:
Removal of forehead lines, frown lines, and other expression wrinkles, as well as dynamic neck wrinkles.
Face slimming: If the masseter muscles on both sides of the cheeks are overly developed, it can affect the appearance of the face. Injecting botulinum toxin in this area can shrink the chewing muscles, making the face appear slimmer and smaller.
Axillary odor: Injecting botulinum toxin into the armpits acts on the nerve endings, causing the sweat glands in the armpit to shrink, reducing sweat secretion and treating axillary odor.
Slimming shoulders: Injecting botulinum toxin into the shoulder muscles can improve shoulder lines and enhance one’s overall appearance.
Correcting gummy smiles: Botulinum toxin can improve the condition of showing too much gum when smiling.
Slimming calves: Botulinum toxin injected into the calf muscles can reduce muscle bulk and improve the shape of the calves, making the legs appear more aesthetically pleasing.
Advantages of Botulinum Toxin for Wrinkle Removal:
No surgery or incisions required: The injected substance is absorbed by the body, resulting in minimal trauma, reduced pain, and a quick recovery.
No recovery period: No need for rest, and it won’t interfere with work or daily activities.
Precise wrinkle removal: Multiple subcutaneous injections are administered on the face, quickly and accurately eliminating wrinkles, leaving the skin smooth and elastic.
Fast results: Noticeable effects typically appear within about a week.
Short injection time: Treatment can usually be completed in just ten minutes.
Disadvantages of Botulinum Toxin for Wrinkle Removal:
Relatively short duration: The effects typically last 4-8 months, requiring regular repeat injections.
Possible side effects: As the treatment is injected, it may occasionally damage capillaries, leading to bruising or other temporary side effects, which will disappear after some time.
Temporary muscle weakness: Some cases may experience temporary muscle weakness, and in rare cases, facial asymmetry may occur.
Duration of Effect:
The duration of the treatment’s effects varies from person to person, typically lasting 4-8 months. You can continue treatment as needed based on the results. Once the effect wears off, wrinkles will return to their pre-treatment state without worsening.
Precautions:
Choose a reputable institution: Select an experienced microplastic surgeon, and carefully consider the brand and type of injectable used.
Be mindful of the dosage: Pay attention to the correct amount of botulinum toxin used.
Ensure the source of botulinum toxin is reliable: Counterfeit products pose significant risks and can jeopardize your health.
Botulinum toxin injection carries certain risks: The procedure should only be performed by a professionally trained and experienced microplastic surgeon.
Risk Factors:
Improper botulinum toxin dilution ratio: This can lead to suboptimal treatment results.
Too frequent injections: While botulinum toxin can be used multiple times, there should be about a six-month gap between treatments to avoid potential side effects.
Incorrect injection sites: For facial slimming injections, it is essential to accurately target three or four points on each side of the face. Incorrect placement can lead to undesirable outcomes and even risks.
Excessive injection dosage: Over-injecting botulinum toxin may cause facial stiffness, affecting natural expressions.
Injection too shallow: For facial slimming, the botulinum toxin must be injected into the masseter muscle to achieve muscle atrophy. Misplacement or insufficient knowledge of facial anatomy can result in ineffective or undesirable outcomes.
Unsuitable Groups:
The principle of botulinum toxin is to paralyze muscles to eliminate wrinkles, which can sometimes lead to various adverse reactions. The following groups should avoid botulinum toxin for cosmetic purposes:
Individuals with a history of neurological disorders
People with allergies
Pregnant or breastfeeding women
Patients with major diseases such as multiple sclerosis
Those who have recently taken aminoglycoside antibiotics (such as gentamicin) may experience enhanced effects, which could lead to side effects.
Individuals with heart disease, liver disease, or other internal organ conditions should not undergo botulinum toxin treatments.
Risks and Side Effects:
Botulinum toxin is not a perfect drug, and improper use or individual health conditions may result in side effects. Therefore, it is important to inform your doctor about your health status before the procedure to avoid potential risks.
Common side effects: Headache, respiratory infections, nausea, etc.
Muscle relaxation or swallowing difficulties: For those taking muscle relaxants, this could occur.
Allergic reactions: It is advised not to use pain relievers or antipyretics and aminoglycoside antibiotics (e.g., gentamicin) within a week after the injection to prevent allergic reactions.
Symptoms similar to a cold: Such as fever and body aches. This may indicate a more serious issue, especially if an excessive dosage was administered. It is important to seek medical attention immediately if these symptoms occur.
Post-Treatment Care for Botulinum Toxin:
Avoid stimulating foods and alcohol for one week after the treatment.
Avoid eating foods that are difficult to chew immediately after the injection.
Do not lie down for a few hours after the treatment.
Do not wash your face or apply makeup within 24 hours of the treatment.
Avoid touching the treated area, facial massages, or exposure to high-temperature environments after the injection.
Develop good chewing habits and avoid chewing only on one side of the mouth. Poor chewing habits can lead to asymmetry on the treated side of the face.
Avoid intense physical activity within 24 hours of the treatment.