BOTOX – Botulinum Toxin

What is botulinum toxin?

One of the fastest and safest remedies to eliminate or smooth wrinkles and expression lines is the treatment with Botox® injection, also known as botulinum toxin. Although it may be the best known, Botox® is only one type of neurotoxin on the market. It is one of the most performed treatments in aesthetic medicine due to its pleasant results and easy application. It also offers a very natural result that adapts to the needs of each patient.

The cosmetic use of botulinum toxin consists of an injectable treatment that temporarily eliminates or reduces expression lines, wrinkles and facial furrows. The most commonly treated areas are expression lines on the mouth and lips, wrinkles on the forehead and between the eyebrows, and crow’s feet near the eyes.

Botulinum toxin is a purified substance derived from a strain of bacteria. Botulinum toxin injections block the nerve signals of the muscle into which it is injected, which without this nerve signal cannot contract. The end result is the elimination or reduction of wrinkles by smoothing the unwanted facial appearance. The most common types of botulinum toxin injections include Botox®, Dysport® and Xeomin®. They all come from the same strain of bacteria (clostridium botulinum), and therefore work in essentially the same way, obtaining the same results.

Main uses of botulinum toxin – BOTOX

  • Eliminate or reduce crow’s feet.
  • Eliminate or reduce furrows in the forehead and between the eyebrows.
  • Eliminate or reduce expression lines, lines around the lips and at the corners of the mouth.
  • Diminish neck wrinkles.
  • Improve the appearance of the chin.
  • Raise the corners of the mouth.
  • Smoothing the square jaw.
  • Correct the droopy smile.
  • Smooth the appearance of deep expression wrinkles.
  • Prevent the formation of wrinkles and expression lines.
  • To give symmetry to both sides of the face, correcting eyebrow asymmetries.
  • Solve axillary, palmar and plantar hyperhidrosis (armpits, hands and feet).
  • Correct tics.

Cases in which botulinum toxin injection is recommended


Currently, botulinum toxin treatment is the star treatment in aesthetic medicine, due to its optimal results, its easy application and the natural and rejuvenating effects it provides. Smiling, frowning, squinting and even chewing; basically any facial movement can lead to one of the most common signs of aging: wrinkles. They can make the person appear tired or even angry when they are not. Sometimes, if the patient gesticulates a lot, these symptoms may appear earlier than expected. In these cases it can also be applied preventively, in smaller quantities to achieve the desired result if the patient requires it.

It is recommended for use as apreventive method from the age of 30 to avoid the appearance of wrinkles or facial folds. Although currently there has been an increase in patients younger than this age due to the appearance of premature wrinkles caused by excessive sun exposure.

It is used as a corrective method when wrinkles are more evident. In the case of these patients the lines are more likely to be etched in the skin, so this treatment is ideal for reducing or smoothing them. Once the wrinkle is formed, it will remain there, like a crease that bears witness to the skin’s memory. What is achieved with this treatment is to blur it to the point that it is not noticeable to the naked eye or, if it is very deep, to transform it into a much softer and less visible line.

When there is a loss of volume in the face it can be remedied with the help of Botox®, achieving a smooth skin. By deeply relaxing the muscles, not only are the wrinkles formed by the action of repeated muscle contraction on the skin unnoticeable, but also, for the duration of the action of the medication, the muscle does not contract again and, therefore, the appearance of unsightly furrows in this area is prevented.

It is important to set reasonable expectations. With this treatment not all wrinkles on the face will disappear, but only those that appear as a result of expressions, the so-called expression lines or wrinkles. It improves the appearance of these wrinkles by relaxing the muscles, but does not eliminate what we call static wrinkles, which are those that are seen at rest when looking in the mirror. Botulinum toxin can be combined with other cosmetic skin procedures, such as chemical peels, laser treatments, dermal fillers or microdermabrasion, to further enhance your results. This combination of therapies may even help prevent the formation of new lines and wrinkles.

Risks and side effects of botulinum toxin injection

After botulinum toxin injection, normal activities can be resumed immediately. Although it is a very quick, simple and painless treatment, which is performed in the office and after which you can live a completely normal life, as a general precaution, patients should rest after the application of botulinum toxin.

Heavy exercise should be avoided for one or two days after application and laser or intense pulsed light treatments should be avoided for up to 4 weeks. Do not perform facial massages until 4 hours after application. The consumption of alcoholic beverages or the use of saunas or humid areas on the day of application is not recommended.

Botox® is a treatment that can be performed at any time of the year.

Although generally safe, side effects and complications of botulinum toxin may include:

  • Bruising and pain at the injection site.
  • Flu-like symptoms.
  • Headache.
  • Nausea.
  • Reddening of the treated area.
  • Temporary facial weakness or drooping.

Botox® injection procedure

Botulinum toxin injection may give the impression of being a simple procedure, as it consists of a few injections, but in reality it is both an art and a science. It is important to remember that Botox® treatment must be performed by a qualified medical professional, such as a physician specializing in aesthetic medicine or a plastic surgeon. There are 43 muscles in the face and it is vital that the person performing botulinum toxin injections knows the correct points to optimize the treatment.

First, after taking a medical history and explaining the informed consent, the doctor will inform the patient about everything he/she needs to know about the treatment. He will answer your questions and together you will evaluate the points to be addressed to ensure a successful outcome. In addition, some photos will be taken beforehand for later evaluation. The following will be applied anesthetic cream to make the treatment painless.

A very fine needle is used to inject small amounts of botulinum toxin into specific muscles. The medical professional weakens only the muscles that produce wrinkles, preserving your natural facial expressions. After the infiltration, the patient will remain on ice for a few minutes to avoid the possibility of hematoma or reddening of the skin. In this way, the person can return to normal life immediately. After 10 days, the effect will be reviewed at a follow-up appointment and, if necessary, a touch-up will be made at any point that needs to be perfected.

The number of injections needed in each area will depend on the facial features and the extent of wrinkles. Crow’s feet, for example, usually require two or three injections. For forehead furrows, five or more may be needed.

Botulinum toxin treatment results

Botox® takes three to five days to become noticeable, and the full effect is evident after two weeks. With the application of this product, the muscle that causes the wrinkles we want to correct to form is relaxed. This prevents them from deepening and becoming more evident over time.

While the toxin is taking effect, we do not mark these wrinkles, thus preventing the facial aging process from progressing. Once the effect has worn off, the patient will progressively recover full muscle elasticity, gradually returning to its previous state.

This treatment does not compromise its continuous application since it can be infiltrated only once, improving the patient’s appearance at a specific moment, such as an important event or a specific season, if the patient does not wish to maintain it. If the patient wishes to maintain the results, the treatment should be applied every 7-10 months.

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