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Q.1) Am I a Candidate for this procedure?

Botulinum toxin is a purified substance that’s derived from a bacterium called Clostridium botulinum. There are various forms used to different treatment purposes. The cosmetic form of botulinum toxin is a popular injectable that temporarily reduces or eliminates facial fine lines and wrinkles. Injections of botulinum toxin block the nerve signals to the muscle in which it is injected. Without such a signal, the muscle is not able to contract. The end result is diminished unwanted facial wrinkles or appearance.

It is a product that is designed to treat Dynamic wrinkles, that is those wrinkles which develop on your face when you contract your facial muscles, for example when you smile, when you grimace, when you are angry and when you laugh. Examples of dynamic wrinkles include frown lines between the brows, crow’s feet near the eyes, neck bands and creases in your forehead.

On the other hand, Static wrinkles are the wrinkles that are on your face even at rest, regardless of the facial expression you make. These are caused by lost facial volume as well as other deficiencies in your skin. So if you have dynamic wrinkles that are affecting the way you feel about your appearance, you meet the first criteria to be a candidate for Botulinum toxin treatment.

The second criteria is the age range – Botulinum toxin works best for individuals between 18 and 65 years of age. If you are under 18, it is very unlikely that you have already developed dynamic wrinkles that require the use of this product. If you have, there is probably an underlying condition that needs to be observed by your qualified plastic surgeon.

Botulinum toxin can therefore be used to

• Smooth crow’s feet wrinkling near the eyes

• Reduce or smoothen forehead furrows

• Eliminate the frown lines between the eyebrows

• Soften lip lines and bunny lines

• Diminish vertical neck bands

• Improve the appearance of skin dimpling of the chin

• Lift the corners of the mouth

• Soften a square jawline if it is due to thick jaw muscles

• Correct a gummy smile

Q.2) General information about the Procedure?

The procedure involves tiny multiple injections at the site of the treatment. In this treatment, a fresh vial of the product is mixed with sterile saline, the area is numbed with local anaesthetic cream or a momentary ice pack and then it is injected precisely into multiple pre-marked points in the offending muscle. A very thin needle is used to inject small amounts of botulinum toxin, known as units, into specific muscles. By carefully choosing spots in specific muscles, your healthcare provider weakens ONLY the wrinkle-producing muscles, preserving your natural facial expressions.

Botulinum toxin treatment injections usually take less than 15 minutes. The number of injections you need will depend on your facial features and the extent of your wrinkles. Crow’s feet, for example, usually require two to three injection spots. Furrows above your brow can take five or more.

Injections of botulinum toxin may seem to be a simple procedure to you but it is actually a precise and well understood science that only an experienced healthcare professional should perform. There are 43 fine muscles in your face and it’s absolutely vital that the person who performs botulinum toxin injections completely knows the anatomy, fully understands the overactivity of specific muscles in your individual case and is therefore able to pinpoint the correct spots to optimize your treatment.

Q.3) What kind of result I can expect?

To get the most out of Botulinum toxin, it is important to understand exactly what the product can do for you before you have the procedure performed. BOTOX will not give you a complete make-over or make you look decades younger. It will minimize the appearance of local dynamic wrinkles in the area treated, for a period of 4-6 months. It is a simple matter to repeat the treatment, if you wish, when the wrinkles reappear.

You are likely to see the early results of your treatment by 48 hours and full result at the end of 1 week. Your qualified plastic surgeon may call you back for a follow-up between 4-7 days to assess the result. You may sometimes require a minor top-up dose to fully accentuate the result. The treated area will appear smoother and look more refreshed. After your first treatment, you may feel a slight ‘tight’ sensation or a feeling of ‘heaviness’, which will subside in 1-2 weeks.

Q.4) What can go wrong and how is it remedied?

When done by a qualified person, there are no usually side effects and this is a very safe procedure. However, since this is after all an invasive injectable treatment, there can be some minor side effects.

You may sometimes experience minor pain, redness, bruising or swelling at the sites of injections for some time. There may be some nausea. Temporary facial weakness or drooping may be seen. Rare complications include allergic reactions, shortness of breath and headache or flu-like symptoms. It is very very unlikely that the toxin might spread beyond the treatment area, causing botulism-like signs and symptoms such as breathing problems, trouble swallowing, muscle weakness and slurred speech.

However, these side effects are almost always limited. In most cases, they can be completely prevented if you have your treatment done by a skilled professional with sound anatomical knowledge.

Q.5) Common Post Op. Do’s and Dont’s

You may resume basic normal activities immediately. Your doctor may ask you to frown repeatedly for about one hour immediately following the treatment. This will help the treatment to be more effective by increasing the uptake by the targeted muscle groups. After this time, try to avoid extreme facial expressions for the next 12 hours. It is a good idea to keep upright for the first 4 hours to prevent diffusion of the injected toxin beyond the targeted area.

You will be instructed to avoid rubbing or massaging the treated area and avoid make-up if possible. In case of any bruising at the injection site, you can gently apply light make-up immediately after treatment but with a light dabbing motion, not a rubbing or spreading motion.

There should be restriction on any exercise or strenuous activity for the next 12 hrs. You will be asked to avoid sleeping on your face the first night. It would be wise to avoid alcohol consumption for 24hrs.

It is preferable to avoid any beauty treatments on your face e.g. facials, facial massage for 2 weeks since this may cause the injected solution to spread to nearby muscles. Exposure to strong sunlight, very cold temperatures and saunas for the next 2 weeks should be avoided if possible.

The most important note of caution: Do not rub or massage the treated areas after the wrinkle treatment because it can cause the botulinum toxin to migrate to another area of your face. If this happens, you could have temporary facial weakness or drooping.