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Botulinum Toxin A (Btx)

(Synopsis) - For a more comprehensive overview see here

 

What is Btx Toxin and how does it correct wrinkles?

The so-called "dynamic" wrinkles; wrinkles caused by facial expressions, such as crow's feet, glabella or frown lines, and forehead lines were recently the source of much consternation for patients and doctors because they were difficult to treat -  even with surgery. Also, these wrinkles do not respond well to laser resurfacing or dermal fillers.

Currently, botulinum toxin type A, commonly known as Botox, is the most commonly injectable used in the management of these wrinkles. A tiny amount of Btx when injected into tense facial muscles inhibits contraction of the targeted muscle, causing it to relax. With less muscle movement, wrinkles on the overlying skin begin to soften.

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What Drugs Do You Use?

Only FDA Approved drugs with approval for cosmetic use are used at LK Aesthetics

  1. Botox® (Vistabel), 
  2. Xeomin®(Bocouture),
  3. Dysport®(Azzalure)

For a more detailed description of the drugs and their differences see our recent blog Is there More Than One Toxin? Also, Check out our fact sheets on the three different drugs in the LK Library.

What exactly is it used for?

Despite the fact that cosmetic injections of Botox, Dysport, or Xeomin in any site other than the glabella or crow's feet constitute an off-label indication in the United States, the scope of botox applications in cosmetic surgery is increasing every year.  Botox, Dysport, or Xeomin are commonly used to correct the following:

  • Frown lines
  • Crow's Feet
  • Forehead Lines
  • Bunny Lines
  • Corners of the Mouth
  • Brow Lift or Brow Balance
  • Smokers' Lines
  • Jawline Reduction and Facial Slimming
  • Teeth Grinding
  • Gummy Smile
  • Wrinkled and Dimpled Chin
  • Neck Bands
  • Nasal Flare
  • Excessive Sweating

For a more detailed description of these treatment areas, continue here...

How does it work?

It works by reversibly targeting the small muscles of the face and damping down their contraction, thus softening lines and wrinkles. Btx Toxin also works in a similar way on sweat glands to stop the production of sweat.

When will it start working and how long does it last?

Patients usually notice the clinical effect 1-3 days following injections, and the effect is maximal by 1-2 weeks. The clinical results can vary depending on the skill of the practitioner, the nature, dose and concentration of the product, the frequency of the injections, the nature of the injected muscle, as well as the quality of the skin. For instance, a higher dose for a particular area might be needed if the interval between treatments is much longer than recommended.

The benefits of Toxin treatments typically last 3-6 months. Younger patients may experience longer lasting benefits due to the better quality of their skin. Treatments can be repeated as the effects of the treatments wear off.

Deeper wrinkles may require 1 to 2 additional sequential sessions before the best results are seen. In select cases, it may be necessary for the patient to have additional procedures, such filler injections, for optimal results. It is not immediately reversible but always gradually wears off.

Is everyone suitable for Toxin treatment?

There are some groups of people who should not have Toxin treatment. These include:

  • Pregnant women,
  • Women who are currently breastfeeding and
  • Anyone with a neuromuscular disorder such as MS, myasthenia gravis or Eaton Lambert syndrome.
  • People on certain medication may not be suitable for treatment.

Dr. Kelleher will take a full medical and drug history from you as part of your assessment appointment to ensure that treatment is both safe and suitable for you. See our fact sheets in the LK Library for more detail.

What to expect during injection sessions?

  • You will be asked to remove any makeup. This will help Dr. Kelleher identify and avoid the veins at injection sites that are prone to bruising, like the crow's feet area.
  • You will be placed in a sitting position.
  • The areas to be treated will be cleansed and topical ice applied to help shrink the blood vessels and desensitize the skin.
  • Just before the injections, Dr. Kelleher will ask you to repeatedly contract and relax your problematic muscles.
  • Dr. Kelleher will then assess the thickness and quality of your skin, the thickness and size of the underlying muscles, and determine the most appropriate dose and point suitable for the injections.
  • Finally, Dr. Kelleher injects the targeted muscles with the finest possible needle, thus minimizing discomfort and bruising.
  • In the unlikely event that skin bleeding occurs, you will be asked to apply manual point pressure. This helps minimize the extent of bruising.
  • Makeup may be applied as soon as the bleeding stops.

Does Toxin treatment hurt?

The treatment consists of a small number of tiny injections, given with a minimum of discomfort, which cause relaxation of the targeted muscles. There may be a small amount of swelling and redness afterwards but this generally settles very quickly.

Is Toxin treatment safe?

Yes, as long as you are medically suitable it is extremely safe.

The most common side effects of Toxin used in cosmetic surgery are temporary soreness or mild bruising around the injection sites.  Applying ice to the injection sites before and after treatment may decrease the pain and the risk of swelling and bruising. Some people may experience a slight headache that lasts for several hours after treatment.

 See the Patient Information Leaflets in the LK Library for detailed information.

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What is the After Care Like?

For most practical purposes Toxin injections are considered lunchtime procedures, so people can return to normal activities immediately after the treatment.

See the LK Aesthetics Toxin After Care Sheet

I don't want a frozen face!

Toxin has had a bad reputation in the past for producing the 'frozen face' look. This is very much down to the "workman" not the "tools". Dr. Kelleher is very keen to avoid this unnatural look and does so by not over-treating and so maintaining some natural looking movement while softening lines. It should not be obvious to people that you have had treatment – only that you look rested and fresh.