First things first…. What is it?
Well, it is a toxin, Botulinum toxin more accurately, and is a protein made by a bacterium that stops the release of neurotransmitters. “Botox” is a name brand but belongs to an entire group of neuromodulators, which disrupts the signals from your brain to your muscles causing localized muscle paralysis. The effects are temporary and last usually a few months as the body repairs communications to the affected muscles.
Cosmetically neuromodulators are used to treat and prevent rhytides, which is that fancy word for wrinkles. Facial wrinkles are caused when skin loses elasticity and can no longer “bounce back” from repetitive movement of the muscles of the face. Literally the saying is correct, “if you keep making that face you will be stuck like that”. Here is where neuromodulators such as Botox come into play. The idea is that if you can no longer move the muscles of your face your wrinkles will improve or resolve. This is a semi permanent treatment however as the effects are temporary and last only a few months depending on how your body reacts to treatment.
The process…
Neuromodulators are prescription only so you will need to see a plastic surgeon that will give you a consultation on if treatment is right for you. The process involves injection with a very small needle into the muscles of the face that are being treated. Some providers will offer numbing with topical gel or with ice packs before treatment as well. Because such a small needle is used the pain is very minimal with some feeling no pain at all during the procedure.
Immediately after injection there can be a small amount of minimal bleeding, redness, and possibly a small raised area at the injection site. This typically lasts minutes to hours after the procedure and is not very noticeable. Rarely some can have minimal bruising at the injection sites. Neuromodulators take several days to a week for the effects to start to be seen and can take even longer for wrinkled skin to even out. Some deep wrinkles might improve but may be permanent when the skin cannot, “bounce back.”
The risks…
There is always risk of infection or allergic reaction for injectables but this is very rare. The biggest risk would be asymmetry, where muscles on one side of the face are not paralyzed as well as on the other side. If you have droopy eyelids neuromodulators may make this worse. Your provider should evaluate you for this. If the person injecting the neuromodulators does not know facial anatomy, incorrect muscles can be injected which can in some instances cause inability to open one eye. It is always recommended to find a provider that is properly trained in cosmetic injections to protect yourself against these outcomes.
Recap:
- Neuromodulators such as Botox are safe and effectively treat facial wrinkles
- Treatment is temporary and will need to be repeated for continued effects
- It is very important to get a provider trained in injecting neuromodulators
Additional Reading:
Botulinum toxin: mechanisms of action