Botox

Aging differs from person to person, but sooner or later everyone will develop wrinkles. A well-executed Botox treatment looks beautiful and natural.

BOTOX

Aging differs from person to person, but sooner or later everyone will develop wrinkles. Wrinkles are the results of aging of skin and of movement of facial muscles. Sun exposure and smoking are important aggravating factors in aging and wrinkle formation of the skin. Protection of the sun and not smoking will not prevent aging, but will prevent acceleration. Wrinkles of the frown area, forehead and crow feet are the result of contraction of the underlying muscles. After every facial movement creases will be visible in the skin. In young people these creases will recover due to sufficient elasticity in the skin. Over the years the first facial lines will become visible and in the years thereafter they will develop into wrinkles. By selectively paralyzing facial muscles with Botox many of these wrinkles will soften or sometimes disappear. If you start at an early age (after 18) and regularly undergo a Botox treatment you can prevent these wrinkles from developing. Since the nineties Botox has been used extensively for cosmetic purposes. This treatment became immediately popular amongst top models whom required to remain without wrinkles. Nowadays many people chose to have Botox treatments.

DETAILS OF THE TREATMENT

WHAT IS BOTOX?

Botox is a brand name for botulinum toxin A, which was the first brand that was approved for cosmetic purposes. In the meantime, many different brands produce botulinum toxin A. Botulinum toxin A is a protein produced by the bacteria Clostridium Botulinum. This protein blocks the transmission of electrical impulse of the nerve to the muscle, resulting in temporary paralysis of the muscle. It also blocks the transmission between nerves and sweat glands. For many years botulinum toxin A has been used for medical and cosmetic purposes. Botox therefore is not a filler but blocks muscle activity and glands.

Besides the use of treating wrinkles of the face there are many indications for the use of Botox such as e.g. spasticity of muscle of the arms, hands and neck. Botox can also be useful in the treatment of spastic bladder, spasms of muscles around the eyes and squint eyes or migraine (see Migraine). Even for depression a positive effect has been measured after the use of Botox treatments for facial wrinkles. After injecting Botox under the skin in the axilla a significant reduction of sweating is to be expected for 4 to 6 months. Also teeth grinding can be reduced by weakening the masticatory muscles. The most popular cosmetic use of Botox is the treatment of frown, forehead and crowfeet wrinkles. Trough selectively paralyzing specific muscles in the face improvements can be made in the position and shape of the eyebrow, the bunny lines, the ‘gummy smile”, the corner of the mouth, dimples in the chin and bands in the neck.

During your first consultation your wishes and the different options to realize these wishes will be discussed. It is important to have realistic expectations of the treatment. Therefore during your consultation it will be explained what is possible and what is not possible to achieve with a Botox treatment.

Botox is selectively injected subcutaneously in muscles with a thin needle. The exact location of the injection will be analyzed accurately beforehand and marked. Although the injections will be sensitive, in general they are not experienced as painful and an anesthetic is not required. An effective way to ease the discomfort of the injections is to cool the skin just prior to injecting. A treatment with Botox is quick and, in most cases, lasts 5 minutes. When it is your very first Botox treatment it may be wise to start off conservative and assess the effect after a week. If necessary additional Botox injections can then be given.

Botox is a “lunch break” treatment. At the injection sites some swelling and redness will appear that will subside within 30 minutes. You will be able to continue immediately with your daily activities. It is very important not to apply any pressure on the injection sites and not to lie down in the next 4 hours. It is also not advisable to do any sports that day or go to the sauna to prevent spreading the Botox by sweeping sweat from your forehead. The injected Botox will take some time for its effect to come into action. If the treated muscles are contracted often, like frowning allot if the frown muscles have been treated, the effect of the Botox will kick in quicker. The next day the effect will become noticeable but the total effect of Botox will be visible after one week. The wrinkles will become more superficial and the balance of forces on the surrounding structures will change. In this way the position and shape of the eyebrow can be manipulated by paralyzing selective muscles. The effect of Botox will last 3 to 4 months after which the muscles will recover completely. When Botox is continuously repeated for many years, the muscles will not be able to recuperate and the effect of Botox will become more lasting. After one week you are invited to evaluate the result should you feel the aimed result has not been achieved. Any touch-up injections are included in the primary treatment. It is of importance that you achieve the maximum result and that you are content with the treatment.

The use of Botox is effective in the hands of an experience doctor and can produce attractive and natural results. Some people want more Botox than is necessary. When they fully understand the esthetic effect and specifically aim for this then it is their personal choice. It is therefore most important that during the first consultation the areas to be treated, the dosages and the effects thereof are clearly discussed. In some instances it may be wise to start conservatively, review its effect after a week and add Botox if desired.

The injections with thin needles normally will give some localized redness and swelling that will subside within 30 minutes. A small bruise can develop if a small vessel at the injection site is pierced. This does not occur often and if it does a cold compress will contain it. Make-up can be applied until the bruise is resolved after a couple of days. When the eyebrows are already positioned low one must be cautious treating forehead wrinkles. In this situation the treatment of a horizontal wrinkle above the eyebrow can result in a droopy eyebrow. Very deep wrinkles, e.g. frown wrinkles, will still be present after treatment because the skin in the wrinkle has become thinner due to years of frowning. This can be treated best by using a filler (see Fillers) after a Botox treatment. As a precaution pregnant women will not be treated with Botox. About 1% to 2% of people have antibodies against botulinum toxin and Botox will therefore have little or no effect.

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