Botulinum toxin

Author: Dr. Oreste Di Mattei Di Matteo


What is botulinum toxin
? Botulinum toxin is a drug extracted from the bacteria Clostridium whose main action is to paralyse the muscles. The presentation is in powder form. The doctor reconstitutes the botulinum toxin with a saline solution and injects it using a small syringe. It is used in other areas of medicine where muscle relaxation (for muscle spasms) is required.

Why use botulinum toxin?
In a cosmetic context, if correctly indicated and applied in moderation, it can bring satisfactory and completely natural results.
Both men and women can make use of botulinum toxin.

Is there an age limit before you can start applying botulinum toxin?
There is no ideal age to start applying botulinum toxin.
There are people who use it early on because they tend to have prominent expression lines when they smile or talk.
A combination of factors leads to the formation of wrinkles.
It starts with expression lines, but with time they can become permanently visible wrinkles.
Those with lots of expression wrinkles benefit more from early applications of botulinum toxin.
Early, when? In general, from the age of 30. Each case should be evaluated individually.

Does botulinum toxin prevent ageing?
The application of botulinum toxin does not prevent ageing. It avoids, prevents and reduces the appearance of wrinkles on the areas where it is applied (such as the forehead, between the eyes, crow's feet, etc.). Wrinkles are just one element of ageing and botulinum toxin alone does not solve all problems.

On which areas can botulinum toxin be applied?
The most common areas, and for the best results, are:

  • crow's feet
  • forehead (forehead and between eyebrows)

Less common are:

  • the chin
  • neck
  • mouth
  • nose
  • drooping nasal tip
  • wrinkles around the mouth
  • lower eyelids
  • wrinkles on the cheeks

Is there a risk of having an unnatural appearance after the application of botulinum toxin?
Most of the time, it is a combination of treatments that exaggerates the results of botulinum toxin.

When applied by trained and experienced dermatologists who remain updated in the field, it is hard for botulinum toxin to give unnatural results. With this technique you can select the muscle you want to hit, so it is essential that the doctor is experienced.

How does botulinum toxin act on the forehead?
When the eyebrows droop due to ageing and gravity, botulinum toxin can help reduce this sagging, but not all patients can improve their eyebrows by applying botulinum toxin.
When applied to specific points, there may be a few millimeters of eyebrow lift. This effect is subtle, as it should be, but brings more harmony to the face. The result is very natural.

How long does the effect of botulinum toxin last?
The average duration is 4 to 6 months. After 3 months, the muscle ceases to be completely paralysed and very gradually begins to contract. The results do not vanish overnight. Little by little the effect of botulinum toxin is reduced and the muscle resumes its activity. In some people, the effect can last for even longer than 6 months.
Muscle contraction progresses by about 20% per month, by the fourth month you may already see a 60% reduction in the effect of botulinum toxin, on average.

Can botulinum toxin and hyaluronic acid be used together? That wouldn’t be a problem. In fact, it is also recommended. Botulinum toxin can prolong the effects of hyaluronic acid, since due to muscle paralysis, the filler reduces the risk of:

  • migration
  • being absorbed

Both treatments are used for a complete facial rejuvenation.

What are the risks with botulinum toxin? What can go wrong?
There is much less risk when in expert hands. The most unpleasant side effect is muscle weakness of the eyelid (ptosis). This side effect is most often related to:

  • the differences that exist from one individual to the next
  • a lack of professional preparation.

This side effect is extremely rare.

The chance of producing inactivating antibodies can be an unwanted side effect when performing high-dose treatments at short intervals (less than three months apart). 

How long does it take to see the effects of botulinum toxin?
The day after the application, you may notice:

  • Muscle spasms
  • skin tightness

The final effect is visible after 2 weeks.

Is undergoing botulinum toxin treatment worth it?
It depends on the expectations. If expectations are realistic and not miracles, then maybe it can be worth it.
This is a treatment:

    • with successful results
    • which slows down the formation of new wrinkles
  • which reduces those that are already present

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