BOTULINUM TOXIN TYPE A – ANTI-WRINKLE INJECTIONS
Botulinum Toxin Type A is a prescription only medication (POM), that has a temporary effect of relaxation on the muscles. In cosmetic medicine it can be used to prevent and/or reduce fine lines and wrinkles on the frown lines, forehead and around the eyes. It can also be used to reduce excessive sweating in the arm pits, palms of hands, feet and forehead. It can be used to prevent teeth grinding which in turn results in facial slimming and reducing pain in the jaw. Botulinum Toxin Type A is a very effective treatment for migraines also.
Botox (the preferred medicine we use in clinic) works by blocking the nerve impulses that cause our muscles to move. Our nerves do not touch, they sit very closely together and between them is a fluid filled space. In this fluid filled space is a molecule called Snap-25. It’s the job of Snap-25 to carry the signal from one nerve to another, like a relay. Botox binds to Snap-25 and prevents it from receiving and sending that signal. This begins to happen around 5 days post treatment. In time our body slowly repairs Snap-25 allowing it to rebuild that chemical bridge. It is at this point that we may start to notice movement on the top of the skin, as movement gradually returns to our muscles.
Most people notice this movement returning around week 8 as the chemical bridge begins to repair. For the majority of patients, Botox lasts around 12 weeks. Although, this does vary between individuals and from treatment to treatment, it is important to know that Botox does not paralyse the muscle fully for 12 weeks. The movement reduces and then returns on a very gradual incline and decline. The aim of the treatment is to reduce the muscle movement enough so that the skin is not buckling in the same place repeatedly, this is what causes wrinkles to develop. By allowing the surface skin to rest, the new skin cells can replenish and smooth over fine lines without being disrupted by the muscle movement below. Even though movement may gradually return before week 12 in some people, the strength of the movement is reduced and in some cases the location of the movement also, this is still very beneficial to the quality of the skin on top.
Following an in-depth consultation, the areas to be treated on the face will be thoroughly cleaned and botulinum toxin will be injected into the muscles of the area being treated using a very fine needle and following an aseptic technique.
You'll need injections in different places, depending on the area being treated. You'll be asked to move the muscles in your face to help find the best place for the injections.
The procedure will take around 5-10 minutes to complete. You will not see a change straight away. It takes about 4/5 days to start working, and around 14/21 days to see the full effects.
POTENTIAL RISKS, SIDE EFFECTS AND CONTRAINDICATIONS
The risks of botulinum toxin injections are small if it's done correctly by a suitably qualified practitioner. After treatment you may have:
- A headache and flu-like symptoms for the first 24 hours.
- Bruising, swelling and redness on the skin at the injection sites.
- A frozen look – you might not be able to move the muscles in your face if too much Botox is injected.
- Temporary weakness and droopiness in your face – for example, your eyelids or eyebrows may droop if the Botox moves into these areas.
Very rarely, serious problems such as blurred or double vision can happen if the area around the eyes is treated or breathing difficulties if the neck area is treated.
In certain circumstances, Botox injections are not recommended if:
- You have a skin infection
- You're unwell in any way
- You have a neuromuscular condition like myasthenia gravis
- You're taking certain medicines
- You're pregnant or breastfeeding
After your treatment the botulinum toxin is present in the muscle for 48 hours. In this time, it is very important to carefully follow this after care advice. Failure to adhere to this advice will affect the efficacy, longevity and end result of your treatment.
Do Not Touch - Avoid facials, brow treatments, rubbing your head etc for 48 hours post treatment. The medicine has been carefully placed into the perfect part of your muscle to get you the best results possible. Placing pressure on that muscle could displace the Botox and affect a neighbouring part of the muscle. This would again increase the likelihood of side effects such as Ptosis. It is acceptable to shower and clean your face, ensuring you do not rub the area too vigorously and pat it dry gently with a clean towel.
Stay Cool (24 hours) - We know that as a protein Botox is not happy in high temperatures. It arrives to us in a cold box and is kept in a temperature-controlled fridge until the moment it is administered by your practitioner. For this reason, hot baths, showers, sun beds, exercise (however gentle), hot tubs, saunas should all be avoided for the first 48 hours post treatment. There is also evidence to suggest that as the activities that make us warm open our vessels to increase blood flow through our muscles, this can wash the Botox away before its’ had the chance to do its job effectively.
Avoid Alcohol (24hours) - Alcohol dilates blood vessels and increases blood flow through the muscles. Drinking alcohol within the 24 hours post treatment can have a negative effect on your overall result.
Stay Upright (4 hours) - Botox is a liquid and will follow the path that gravity takes it. Laying down directly after your treatment could increase the risk of displacing the medicine which can increase the risk of side effects such as Ptosis (droopy eye, heavy brow etc)
Keep it Clean – Your injection sites are vulnerable to infection for the initial 24 hours post treatment. It is important that in this time you avoid touching the area as much as possible. If you must touch the areas of injection, please ensure you do so with clean hands.
Sometimes a review may be needed but this isn’t a routine part of the treatment. It will have been explained to you about what to expect when the toxin starts to take effect, the time it takes to reach peak effect, the process of asymmetry which may occur during the activation period and subsequently settle, and what to look for which may mean that you need to come and see you for a review.
Please get in touch with us any time if you have any further questions or concerns that are not answered on this leaflet. Out of clinic hours, please call and leave a voicemail on the mobile number provided. One of our on call staff will get in contact with you as soon as they can.
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