Botox: I’m not angry …it’s just my wrinkles! What can I do?
“I’m not an aging gracefully type. But I do believe in aging with grace”. Danielle Steele.
I think I have to agree with Danielle. But to each his own. Some people cringe at the discussion of doing any “work” on your self by injecting of any sort. My take on that is, if you don’t agree with it, then don’t do it.
Some people have muscles so well developed on their face, people constantly ask them what is wrong. It is just that they repeatedly make that facial expression, and now it is etched in whether they make the expression or not.
This week we will deal with botulinum toxin, which was branded ever so successfully by Botox, but there are other brands – Dysport and Xeomin, which do the same thing. The subtle changes to the botulinum molecule gives additional benefits. The injection of all these products use purified botulinum which reduces wrinkles and can also reduce excessive sweating.
Deep wrinkles are really secondary to muscles which have become strong by using them over the years. When we go to the gym, if we want muscles to get big, we use the muscles that we want to get bigger to strengthen them and make them larger. The same effect occurs in the face. So when we worry, or get angry or smile exuberantly, these are the facial equivalent of going to the gym. Over the years, the muscles increase in size and the lines that the muscles make remain. The lines get deeper the more that we use them. These are nice in biceps and triceps, but not too nice in your face. Botulinum works by weakening selected facial muscles so that they cannot pull on the overlying skin, thereby reducing wrinkles. So the deeper wrinkles are not a skin issue as much as it is a muscle issue.
Botulinum is most commonly used for wrinkles on the upper half of the face, mainly the forehead, and wrinkles around the eyes)
When a smile shows too much teeth, we can use it in this instance as well.
Images of study subjects before, at left and after receiving Botox. Aesthetic Surgery Journal.
We may also use it for the neck – the “turkey neck”
Botox is also indicated for migraines and for excessive sweating, that is not controlled by other medications.
There is no chance of allergic reaction, and there is minimal swelling or bruising from the procedure. It has gotten a bad rap because of people trying to get it cheaply by using veterinarain equivalents, or from other coutries where it may be tainted.
“Are the injections painful?”
No. Most patients describe it feeling like a mosquito bite or “like squeezing a pimple.”
“What is recovery like after Botulinum injections?”
Typically there is minimal to no bruising or swelling . The instructions I give to patients are to stay upright for about 4 hours so it stays where it should. The major concern being the eyelid. No gym, no lying flat on the face to sleep that night, no facials or manipulation of that area, no caps, or bandanas.
“How long will the results last?”
Most patients can expect 3 months from a procedure on the face. For excessive sweating, this will last a year. In some people, it may last longer and in others shorter depending on their metabolism. Anecdotally, some of my patients have noticed that when they are at the gym more, it lasts for a shorter period of time.
“What unintended results could I get from the botulinum?”
There is a slight (2 – 5 %) chance of mild eyelid droop with each Botox treatment performed on the forehead region. Medication can be prescribed to treat this condition, although it resolves on it’s own within 4 to 6 weeks without treatment.
“Does botulinum work 100% of the time?”
In some individuals the botulinum does not always “take” on the first attempt which means you may need repeated treatments to achieve the desired results. Some individuals also have very strong muscles and may require a greater dosage.