Botox is the abbreviated term for botulinum toxin A, a liquid injectable used to treat lines between the eyebrows, on the forehead and around the sides of the eyes. Many dermatologists believe Botox should not be used to treat frown or smile lines for the simple reason that it is a neurotoxin, which effectively paralyzes muscles. This can present a problem when speaking or eating, for example, so an off-target Botox injection is really not worth the risk.
Unlike fillers, which simply fill in lines, Botox actually reduces the cause of dynamic facial lines – the repeated contractions of the underlying facial muscles. Botox blocks the signal from the brain to the muscle (to frown, for example) at the neuromuscular junction site. This effect can last between three and eight months. However, there is increasing evidence that Botox treatments are cumulative. In other words, treating dynamic lines with a series of Botox injections may help retrain the muscles used in facial expression. As a result, the treatment is both corrective and preventative.
Botox works like this: the inactive muscles paralyzed by Botox become atrophied and weakened, so are less able to act. Subsequently, the lines produced by these muscular actions become less apparent. Botox is injected using an electromyography (EMG) instrument connected to the delivery needle, an instrument that ensures the accurate delivery of Botox to specific areas. Pre-treatment with a topical anaesthetic cream will render the injection essentially pain-free. Occasionally mild bruising may result in the area.
Complications that can arise from Botox injections are mainly tied up with the skill of the physician – a droopy eye or unnaturally frozen eyes and forehead are not uncommon. Injections need to be well distributed to avoid creating facial disharmonies. Among cosmetic surgeons, Botox treatment is seen as an art form, so choose a surgeon who knows a Picasso when they see it.