The use of Botox for the correction of facial wrinkles

Few have heard of Botox today. This word has already managed to become a household name, denoting specific radical procedures that allow you to correct certain cosmetic facial flaws. And almost all the residents of large and medium-sized cities of Russia, at least sometimes in contact with the beauty industry, have probably heard more than once the proposal to make Botox for the face in order to remove wrinkles and overall smoothing of the skin.

At the same time, it is quite rightly considered that Botox is more effective than many other, more traditional cosmetic procedures. For which he, in fact, earned his fame, and for which people, often far from cosmetology, are ready to pay a considerable price for him. But how safe is it, are there any undesirable side effects when using it?

Next, we will deal with these issues and find out when and to whom it will really be useful for Botox injections for the face, what clients of cosmetic clinics say about such injections in the reviews and how this procedure should be carried out in accordance with the rules. Now let’s clarify that in most cases, when searching for information about Botox, people mean by this word not so much a specific drug, but botulinum toxin preparations and botulinum therapy in general. Therefore, the rest of the article will be about botulinum therapy as a technique for the correction of facial cosmetic defects, and Botox itself will be discussed in the context of the description of this particular cosmetological method.

 

What is botulinum therapy and how does Botox work?

The term Botox most often refers to various botulinum toxin preparations, as well as the very procedure for introducing these drugs into the muscles to obtain a pronounced cosmetological effect.

In the narrow and most precise sense of the term, Botox is one of the most famous and popular botulinum toxin preparations in the world for medical and cosmetic applications. It was developed and put on the market among the first similar tools. Its developer, Allergan Company, correctly used all the features and quickly made Botox a brand that is recognizable and “classic”, with which all other drugs are compared today.

In this regard, it is correct to say "make Botox injections for the face," and not just "make Botox."

Botulinum toxin itself is a very strong neurotropic poison, one of the strongest in the world. Once in muscle tissue, it migrates in them towards the nerves, since its molecule is able to attach only to the surface of nerve cells. With this migration, the molecules of this substance sooner or later come into contact with nerve synapses, through which impulses from the brain are transmitted to the muscles and lead to their contractions. Here, botulinum toxin breaks the chain of signals that ensure the interaction of the brain with muscles, and leads to the fact that the muscles can not contract either with arbitrary attempts by a person to do this, or with their involuntary contraction.

Actually, this is how botulinum toxin acts in case of fatal poisoning of the body. In large quantities, it leads to disruption of the diaphragm and heart muscle and to death from respiratory failure.

In cosmetological use, very small amounts of toxin are used that are harmless to the body, and it is introduced locally into the target muscles.Due to microscopic dosages, the drug cannot cause poisoning, but if correctly administered, it gives the desired cosmetic effect.

In general, the field of medical use of botulinum toxin is quite wide. With its help, they treat various nervous disorders, disorders of the nervous regulation of certain muscles. For example, injections of it are used for cerebral palsy and, in some cases, for urinary incontinence, botulinum toxin preparations are quite effective for migraines and excessive sweating. Even for purely cosmetic purposes, it is used to correct certain conditions of the skin and muscles on almost the entire body - from the legs to the decollete zone.

However, in the largest quantities, injections of Botox and other analog drugs are carried out precisely in the muscles of the face. Here, these procedures make it possible to immobilize target facial muscles, the constant or frequent reduction of which leads to the appearance of wrinkles. After injections, these muscles no longer contract, as a result of which wrinkles do not appear on the skin covering them. If these wrinkles were already formed and noticeable even with a relaxed underlying muscle, then after botulinum therapy their severity weakens until the skin is completely smoothed.

For example, in the photo on the left - the patient's forehead before the introduction of botulinum toxin, and on the right - a week after:

This effect occurs on average 3-5 days after injection and lasts for 6-12 months. These terms largely depend on the sensitivity of the patient himself, on the correct administration of the toxin, on compliance with the rules of rehabilitation and on the drug that was used during the procedure. In some cases, the drug may not work at all, but sometimes it, on the contrary, gives an excessive effect, leading to undesirable consequences.

Obviously, Botox does not make sense to prick in those parts of the face in which there are no muscles - in the wings of the nose, lips, nose.

On a note

After the introduction of Botox, it is impossible to remove from the tissues or remove from the face. If after the procedure undesirable consequences and defects appear, they either pass through some time on their own or are corrected by additional methods.

After the expiration of the drug, the eliminated cosmetic defects (in particular, wrinkles) are restored. That is, if you stop injecting Botox regularly, there will be no dangerous consequences, but the effect of previous procedures will disappear.

These procedures are equally effective for both women and men. But for obvious reasons, it is women who order the lion's share of injections for aesthetic purposes.

Feedback

“My beautician told me that Dysport is an analogue of Botox, only more diluted. That is, Botox is more powerful, but not always good. There are times that Botox’s face is distorted, or his forehead “fell”, like a primitive man. In these cases, Dysport is just useful, because it is softer, or something. And the technology of their introduction is the same, only Dysport is taken a little more. "

Maryana, Moscow

Botox itself, in a number of tools for such procedures, is considered a kind of standard, against which the advantages and disadvantages of analog drugs are evaluated.

At the same time, botulinum toxin is not omnipotent. Its capabilities when injected into the face are limited only by the elimination of dynamic wrinkles, but it will not help in cases where wrinkles are caused by:

• Age-related thinning of the skin, especially pronounced after 40 years;
• Reducing the amount of fluid in the skin and underlying tissues;
• Violation of the structure of the intercellular matrix of the skin (usually this is the result of many reasons - age, balance of production and breakdown of hyaluronic acid, skin supply with nutrients);
• Decrease in the tone of individual muscles while maintaining the tone of antagonists, the denervation of which is unacceptable.

Moreover, in some cases, with the help of Botox receive other effects that are not associated with the elimination of wrinkles.

 

What exactly can be improved in the appearance of a person with the help of a tool

Most often, Botox injections are done to eliminate the most noticeable wrinkles on the face. In particular, with proper use, it can be used to get rid of:

• Horizontal frontal wrinkles;
• One or more wrinkles in the epiglottis (usually the most noticeable and the first to appear);
• “Goose feet” - small wrinkles in the corners of the eyes;
• Fine wrinkles under the eyes;
• "Rabbit wrinkles" appearing on the nose between the eyes when lifting the upper lip (usually with an expression of disgust on the face);
• “Nasolong” - if not completely (normally even children have them), then to the extent that these wrinkles deepen with age;
• "Puppet Lines" descending from the corners of the lips;
• Labial folds;
• Radial wrinkles above the upper lip.

Botulinum toxin in combination with the use of fillers can eliminate these wrinkles at almost any stage.

In addition, botulinum toxin is also used to obtain other effects:

• Limited correction of the shape of the nose - here it is used in addition to other methods, since the activity of the facial muscles has little effect on the shape of the nose. In some cases, it is possible to raise the tip of the nose if its omission is due to the involuntary extension of the upper lip or when it becomes a habit to try to portray the lips as a duck. However, with the natural position of the nose, raising it with Botox will not work. Similarly, with Botox it is impossible to achieve a reduction in the nose and serious plasty of it;
• Treatment of the “gummy smile”, when with a normal smile the patient’s upper gum is exposed;
• Raising eyebrows and changing their shape;
• Elimination of hypertrophy of the masticatory muscle and the effect of the "heavy" lower jaw associated with it;
• Correction of the oval of the face - here also the main effect is achieved due to complex therapy, in which, depending on the place of introduction of the toxin, either a "lift" or, on the contrary, an increase in volume is performed;
• Correction of defects in the position of the lips - constantly raised upper (ajar mouth) or lower ("evil face") lips;
• Prevention of the formation of scars and scars at the site of wounds or surgical incisions.

On the other hand, it is impossible to use Botox and its analogues to obtain an effect that is not related to muscle activity. For example, botulinum therapy does not allow to narrow the nose, eliminate “bags” under the eyes or age spots on the skin, and achieve the effect of fullness of the skin.

Today, more and more botulinum therapy is carried out for complex cosmetic treatment, when one patient needs to eliminate many different undesirable facial features.

In addition, in addition to purely cosmetic purposes, Botox and its analogues can be used to treat certain diseases that manifest as a violation of the facial muscles.

 

Possibilities of using the drug for the treatment of facial pathologies

Given the specifics of the action of botulinum toxin, it is often used to treat those diseases that are caused by unwanted involuntary contractions of the facial muscles.

The most common of these pathologies is blepharospasm, in which the eyelids close due to the tension of the circular muscle of the eye. Botulinum therapy can eliminate this effect, but only if the doctor is highly professional: when injecting, you need to accurately calculate the dosage of the drug so that it relaxes the muscle, but does not completely inactivate it. Otherwise, the opposite effect can be obtained: the muscle will not contract at all and the eye will not close.

Other pathologies eliminated with the help of botulinum toxin preparations are:

• Hemifacial spasm that develops with the contraction of individual large facial muscles and usually leads to a noticeable curvature of the face;
• Hyperkinesis, including persistent nervous tics, not resolved by sedatives;
• Violations of the symmetry of the lips caused by paresis or, conversely, hyperactivity of the masticatory muscles.

All of them no longer belong to cosmetic problems and require first of all a thorough diagnosis, identification of the primary causes, and only then treatment with botulinum toxin.

 

Is it safe and what are the risks

Despite the fact that the active ingredient of botulinum therapy is a very strong poisonous substance (the strongest organic poison in the world), due to microscopic doses and local administration, it does not have a toxic effect on the body. He cannot kill like poison.

At the same time, due to its antigenic activity, cosmetic botulinum toxin can cause severe allergies. This is very rare, but over the course of several decades of using botulinum toxin, more than 30 cases of patient death from anaphylaxis have been reported. Basically, because of this risk, Botox can be injected only in a clinic where a doctor has a set of tools at hand for emergency relief of hypersensitivity symptoms.

Less dangerous, but significant negative consequences of using Botox include:

• Facial disturbances associated with the fact that the muscles into which botulinum toxin is injected do not contract and do not participate in the expression of emotions. As a rule, after botulinum therapy with any, even a very small amount of the drug administered, an attentive interlocutor will understand that the person was injected, because his general facial expressions become unnatural to some extent with certain emotions. With the most undesirable outcome (usually with an unprofessional procedure and the cosmetologist’s mistakes), the effect of a “wax face” occurs, when most of the muscles do not contract at all and the face does not change expression. With a successful manipulation, you can notice some mismatch of a person’s facial expressions with a normal, “live” muscle contraction, although the signs of the procedure are not clearly unambiguous;
• Disturbances of facial symmetry due to uncompensated contraction of antagonist muscles. For this reason, after Botox injection, ptosis (drooping eyelids), excessive raising of eyebrows (“Mephistopheles eyebrows”), strabismus may occur;
  

  A side effect after using the drug may be drooping of the eyelids (ptosis).

• Inactivation of the circular muscle with the inability to close the eye;
• Dysphagia, in which a person cannot swallow;
• Violation of the masticatory muscles and associated dysfunction;
• Swelling on the face at the injection site;
• Headache for several days after injections;
• Flu-like syndrome.

Some of these effects depend only on the patient's response to the drug (for example, respiratory syndrome or migraine). The main part of the side effects associated with various medical errors.

Obviously, you cannot inject Botox yourself. Successful and safe injections require a deep understanding of the anatomy of the face, the biochemistry of the drug’s interaction with the tissues, and the physiology of the body itself. It is also necessary to take into account the individual features of the facial expressions of a particular patient, the type of his face and the specifics of his facial muscles.

 

Compatibility of botulinum therapy with some other cosmetic procedures

Botulinum therapy is compatible with most other cosmetic methods and products, provided that the requirements for preparation for injection and rehabilitation after them are met.

So, after Botox injections, you can’t massage and warm your face for several days, apply various cosmetics, apply microcurrents, conduct intensive therapy of the facial skin - all these actions can lead to an unpredictable change in the activity of botulinum toxin.

For example, a facial massage or warming up in a solarium can lead to the release of botulinum toxin from the intended area of ​​action and immobilization of those muscles, the effect on which may be undesirable. That is, procedures that violate the rules of botulinum therapy can lead to negative side effects.

At the same time, many cosmetic problems can be solved only by applying a set of measures, in particular, with the parallel use of botulinum therapy, skin revitalization, and the use of fillers. For example, in the treatment of age-related wrinkles, only the Botox-hyaluronic acid complex allows reliable skin repair and elimination of typical gerontological defects.

In such cases, a comprehensive program is developed, the schedule of which takes into account the time during which after Botox it is unacceptable to carry out certain procedures. With such a comprehensive program, botulinum therapy can be combined with a thread face lift, skin cleansing, various physiotherapeutic procedures (microcurrents, masks), biorevitalization. In each case, the doctor will decide in what sequence and for how long to conduct courses of certain procedures.

 

Botulinum toxin preparations: which is better to choose to eliminate facial wrinkles

Today, there are more than 10 botulinum toxin preparations on the market, and every year more and more new products from various manufacturers appear.

For the most part, these tools are complete analogues of each other, many of them either do not differ in composition at all, or the differences are in the set of auxiliary components. At the same time, even preparations of identical composition are produced using slightly different technologies, which affects the purity, antigenic activity of a particular agent, and therefore its effectiveness and, to a greater extent, its safety.

However, some drugs have a pronounced specificity. Consider the main products on the market:

• Botox from the US-Irish company Allergan. It is considered a classic drug with which almost all clinics work and from which experts repel, conducting a comparative assessment of other drugs. Consists of type A botulinum toxin in combination with a hemagglutinating protein. The latter provides high tropism to the nervous tissue, but at the same time it can provoke allergic reactions. The product also includes a stabilizer (human albumin) and sodium chloride. Its analogues in composition are Relatox, Botulax and some other means;
  

  Botox is a time-tested and patient Allergan drug.

• Dysport, generally similar in composition to Botox, but containing albumin and lactose as additional components. The ratio of the effectiveness of Botox and Dysport is estimated at about 1: 1.25, that is, one unit of Botox will be as effective as 1.25 units of Dysport. If the amounts of injectable drugs are selected in accordance with these proportions, the rate of onset of the effect and its duration are identical. Even with this ratio, the cost of Disport is slightly lower than Botox;
• Xeomin is a drug whose active ingredient is type A botulinum toxin, purified from complexing proteins.Its effectiveness is similar to that of Botox. It is assumed that due to the lack of auxiliary proteins, Xeomin should be much less likely to cause allergies, but in fact, differences in the immunogenicity of the drugs over the years of their use were not found;
• Mioblock is the only type B botulinum toxin drug used today. It is used to a greater extent in neurology and pediatrics than in cosmetology, and its main area of ​​application is injection to patients in whom the type A botulinum toxin does not appear.

For each drug, their own breeding tables have been developed, depending on the form of the product (lyophilisate or solution) and the solvent itself.

Choosing a drug from the whole variety is the task of a cosmetologist, although many patients often try to choose a tool themselves to save money. This is not entirely justified: the opinion of a specialist is more important than saving. If the procedures have already been done once and gave the desired result, it is undesirable to subsequently change the remedy.

Feedback

“Both Botox and Dysport were pricked to me. There is no difference at all. It all depends on the doctor, a good doctor will give the desired result, regardless of which drug. But doctors already have their own preferences. Here you do not need to choose a remedy. You need to choose a doctor. I found a good one, I trust him completely. What he injects will be. The main thing is that without consequences and with a good effect. Plus, he takes into account my features (I have a very complex face, strong muscles, ptosis), even recommends what time of the year it is better to do, how to combine with cycles ... "

Oksana, Moscow

Also today, there are drugs such as Mesobotox, which are not injected into the muscles, but into the subcutaneous tissue, which reduces the complexity and pain of the procedures. However, their effectiveness is much less than Botox injections.

Moreover, studies show that to some extent the effect of botulinum toxin is manifested even if it is applied simply to the surface of the skin at the site of wrinkles. This is because, despite the large size of the toxin molecule, it can be absorbed by the skin and transported to the target muscles.

At the same time, today it is not shown how reliable the result of the external use of botulinum toxin preparations is, and therefore these products are not used in commercial cosmetology. This, however, does not prevent enterprising manufacturers from producing various serums and creams with a very small amount of neurotoxin in their composition, giving them names with the word “Botox” and successfully selling them under the guise of drugs that can be used independently at home.

Finally, some businessmen from the beauty industry go even further and produce products for external use on the basis of any components, but without botulinum toxin (due to the high cost and complexity of its production). In the description of the drug, they without any reason indicate that the drug gives "an effect similar to Botox, but without injection."

An example of such a remedy is the so-called BioBotox cream, which does not contain botulinum toxin, but contains fly agaric extract, collagen, vitamins A and D, caffeine and amaranth oil. On sale, the product is positioned as a natural analogue of Botox, which is quite simple to apply on the skin to obtain a similar result. However, there is no actual evidence of such a effectiveness of BioBotox.

 

Botox injections, preparation for them and the rehabilitation period after the procedures

Botulinum toxin injections themselves are simple procedures for a well-trained cosmetologist.The main difficulty in their implementation is precisely the choice of places for administering the drug, studying the face anatomy of a particular patient and the specifics of his facial expressions, leading, in fact, to the appearance of wrinkles. The extent to which the procedure is effective and safe will depend on how correctly the injection sites and the amount of substance for each injection are determined.

Injections are carried out in one session. Its duration is approximately 30-40 minutes, sometimes more. Before the procedure, the patient signs a consent to botulinum therapy, after which the procedure takes place in the following sequence:

• The doctor asks the patient to depict certain facial expressions, which allows him to determine the muscles and individual fibers, the contractions of which cause the appearance of wrinkles, as well as evaluate the interaction of these muscles with agonists and antagonists;
  

  During the botulinum treatment procedure, the specialist offers the client to depict various emotions on her face in order to understand where to inject the drug.

• The number of injections and the drug is selected;
• The agent is restored to obtain a solution for intramuscular injection, is typed into a syringe;
• Anesthetic is treated at the injection site of botulinum toxin;
• The doctor gently squeezes the injected muscle with his fingers, inserts a needle into it to a depth of several millimeters, and slowly squeezes the piston of the syringe and squeezes the drug;
• After the introduction of the drug, the needle is removed from the muscle and skin, the doctor can rub the injection site a little with a finger;
• The injections are repeated for all planned places.

As a rule, with a correctly performed procedure, the patient does not experience pain. Even if the pain appears, it is relatively mild, often similar to itching.

The photo shows the injection sites an hour after the injection:

The very next day, these red dots will not remain.

In one session, no more than 20-25 injections can be made with the introduction of up to 200 Botox units, but more often 5-10 injections with the amount of the drug up to 80 units are made during the procedure. A larger number (if necessary) is preferably distributed over a larger number of sessions.

Immediately after the procedure, the patient can resume his usual activity. However, after the introduction of Botox, some actions are prohibited, such as:

• Facial massage, rubbing it, applying cosmetics, other cosmetic procedures - within 3 days;
• Washing with hot water, taking a hot bath, sunbathing in the sun or in a solarium - for 2-3 days;
• The adoption of a horizontal position of the body - for several hours;
• The use of certain drugs (a list of them must be agreed with the beautician);
• Physical exercise.

The cosmetologist himself after the procedure reports what the patient can do and what is undesirable. If any questions arise after the injections, it is advisable to coordinate them by phone.

Similarly, it is better to prepare for the procedure in advance, having previously phoned the doctor.

In any case, Botox injections in the face are contraindicated in pregnant women, people with acute respiratory viral infections in the acute period, as well as taking certain medications. (muscle stimulants or muscle relaxants, individual antibiotics), with an allergy to botulinum toxin and in the presence of inflammation at the sites of the alleged administration of the drug. The responsibility for compliance with these contraindications lies with the doctor, so he carefully interviews the patient in advance about the presence of such factors.

 

About injection prices and some important nuances

Botulinum toxin preparations can be bought at some pharmacies or in online stores at prices from 6,000 rubles per bottle with a volume of 50 units and from 8,500 rubles per bottle with a capacity of 100 units. In the future, more affordable analogues may appear.

It is important to understand here that the cost of the work of a specialist cosmetologist significantly exceeds the price of the drug itself. It’s pointless to buy Botox on your own (it still needs to be entered correctly), and in the clinics they don’t inject the product brought by the patient. Yes, and they can buy botulinum toxin in cosmetology centers at lower prices due to wholesale deliveries and contracts with suppliers.

So, botulinum toxin injections are now offered at about the following prices:

• Botox - from 300 rubles per unit of drug administered;
• Dysport - from 160 rubles per unit (remember that the Dysport unit is 1.25 times less effective than the Botox unit);
• Kseomin - from 300 rubles per unit;
• Relatox (a drug of Russian production) - from 230 rubles per unit.

In Moscow and St. Petersburg, the cost of procedures may slightly differ from prices in the regions, but this difference is not significant.

Here, as in the question of choosing a drug, you need to focus primarily on the opinion of the doctor. Based on his experience, he can predict the result from the use of a particular tool and recommend not what is more expensive or cheaper, but what is more suitable for a particular patient.

In addition, it is important to remember that the doctor’s knowledge of the patient’s history and the results of previous procedures may be more important than high professionalism. Therefore, it is necessary to change clinics for injections very carefully and only with full confidence in the correctness of this step. And even more so, it is not recommended to run from doctor to doctor in pursuit of savings. Nevertheless, we are talking here about beauty and health, and saving in these matters is not always reasonable.

 

Botulinum Therapy

 

Useful video about the procedure of botulinum therapy with comments and explanations of a specialist