What is botox cosmetic?
The appropriate use of Botox requires an understanding of the art of facial aesthetics and the science of this unique molecule. No two patients are exactly the same,and patients commonly present with baseline asymmetries. Cookbook approaches should be avoided. The mechanism of action of botox cosmetic is to decrease muscular activity by inhibiting the release of acetylcholine, which is necessary for neuromuscular transmission.
To practice the art of facial aesthetic , botox cosmetic , knowledge of the facial musculature is essential. This includes the thickness and pattern of muscle ﬁbers as well as differences in the sex and race of the patient. Men, in general, require higher doses per treatment area. Thin muscles, such as the platysma, require much lower doses than larger muscles, such as the corrugators. Patients should be evaluated for brow and lid ptosis at baseline. Asians and elderly patients may present with brow or lid ptosis at baseline, and the treatment patterns and doses of Botox utilized should minimize the chance of exacerbating such underlying conditions. A lower eyelid snap test should be performed to reveal any underlying weakness of eye-lid closure and, if present, treatment periorbitally should only proceed with caution, keeping this baseline state in mind.
botox cosmetic is FDA approved for use in the glabellar area; however, it has now been used in multiple areas.
In botox cosmatic for treating the glabella, botox is utilized to weaken muscles such as the bilateral corrugators, depressor supercilii, and the central procerus, which is responsible, in large part, for the glabellar lines . Often two injections are given per corrugator (which will also treat the modestly important depressor supercilii), with one or two injections in the procerus. It has also been suggested that botox treatment of the glabella region results in a slight brow lift by weakening the central frontalis effect of brow elevation and thus proportionately increasing the frontalis effect of lateral brow elevation. A more advanced technique , in which botox is used to weaken the lateral lid depressor muscles, thereby achieving a lateral
To avoid lowering the brow, the forehead, being the primary brow elevator, is most commonly treated in conjunction with the glabellar area, which is composed of primary brow depressors. When treating the forehead for the ﬁrst time, many physicians will reserve treatment of the forehead area for a two-week follow-up visit after glabellar treatment and utilize a relatively low dose to reduce the possibility of lowering the brow too much. Men particularly have lower set brows, and aggressive treatment of the forehead should be done with caution as lowering of the
brow can be an unwanted result
Treatment of crow’s feet will results in partial paralysis of the lateralorbicularis oculi. Treatment of the nasalis, to decrease the presence of bunny lines , the depressor anguli oris, to release the downward pull on the corners of the mouth the chin, to reduce dimpling ; the masseter, to reduce masseter hypertrophy and help restore mandibular angles ; and the platysma, to reduce neck rhytids, are shown. In summary, although the FDA-approved use of botox cosmetic is 20 units for the treatment of glabellar lines, there are many new and interesting uses of botox for the treatment of many different facial lines. These uses have been described by astute clinicians, and such advanced techniques allow for facial contouring and the treatment of a variety of rhytids. A proper understanding of anatomy, the individual patient’s baseline state, and careful consideration of treatment goals are critical for optimal outcomes
Risks of botox cosmetic are very minor . The main risks consist of headache, pain, and flu-like illness. In rare cases, there may be a drooping lid or eyebrow area. It is important for the cosmetic surgeon to assess the patient’s lids before injecting because the patient may not be a good candidate if he or she has an extremely droopy lid to begin with or one that is held up by constantly arching the lids. Ptosis (a severe drooping of the eyelid) can happen in up to 5% of patients but is very rare if the cosmetic surgeon does this procedure often (In this author’s practice, it occurs in less than 0.01%). These complications are typically very minor occurrences and resolve with time.
Recently, there have been concerns about retrograde botulinum toxin transmission, meaning that the toxin could travel back to the central nervous system, causing long-term damage. Studies done in Italy by Flavia Antonucci have been mainly on a raw form of the toxin and not any of the commercially available preparations. Additionally, these studies have been performed on animals (rats, mainly) and with the injection of the toxin to one area and in a concentration of nearly 150 times greater than normal injections for cosmetic indications, which are spread over multiple sites.
Still, there have been enough concerns that the FDA instituted a REMS (Risk Evaluation and Mitigation Strategy) requirement for all botulinum toxin preparations that specifically addresses the issues of distant spread of the toxin and the risk of problems, leading to death, from swallowing or breathing issues in certain patients who may be susceptible after botulinum toxin treatment. All products, including Dysport, Myobloc, Xeomin, and Botox, are monitored via this strategy. This is specifically aimed at a certain population of patients receiving more than the usual doses of botulinum toxin and not aimed at the casual user of Botox, per se.
Please click on the following clip to watch botox video procedure
Botox injection aftercare
Try to exercise your treated muscles for the 1st hour after your Botox treatment (e.g facial gestures like frowning, raising your eyebrows and squinting). This will work the injection into your muscles. Although this may help Botox procedure outcome, it will not impact on your treatment adversely if you forget to.
Do not have a facial, nor rub or massage the treated areas for 24 hours after your treatment.
Do not lie down or do strenuous exercise for 3 hours after treatment. Also, avoid any exposure to a sauna, hot tub or tanning for 4 hours.
Please be aware that some patients experience a mild headache after the Botox treatment. if this happens you take Paracetamol as needed.
Do not take Aspirin, Ibuprofen or other anti-inflammatories or alcoholic beverages as this may increase bruising.
Any tiny bumps or marks will go away within a few hours after your Botox treatment. There is a small risk of bruising. If this does occur, it will only be temporary and can easily be covered with makeup.
Botox takes 3 to 5 days to begin to work. The botox cosmetic treatment can take up to 2 weeks to reach the completed results.
Anti-wrinkle injections are a temporary procedure and at first, you may find that your treatment results will last approximately 3 or 4 months. If you maintain your treatment appointments with the frequency recommended, the duration of each treatment result may last longer than 4 months.
botox creams contain age fighting ingredients, but Botox itself is not yet available in a cream form. However,after first botox injection applying botox cream may increase botox effects and duration of action and may work as botox alternative
botox cosmetic and pregnancy
According to Allergan company ,if you’ve used Botox and just found out you are pregnant, it’s unlikely there’s any risk to your baby. Studies have shown that when Botox is injected into facial muscles, the small amount used is not expected to circulate throughout your body. Therefore it wouldn’t get to your baby, however checking b- HCG before botox injection ,for rulling out positive cases is essential, because botox effects on pregnancy has not been studied .
If you’re pregnant and are considering Botox injections, though, due to the lack of data, it is recommended waiting until after you deliver your baby to receive the treatment.The Botox won’t hurt the baby, but you probably won’t need it during pregnancy. Being pregnant causes your body to retain water, which usually puffs up your face and fills in all the little character lines and crow’s feet around your eyes. So being pregnant may be all the
cosmetic therapy you need.
botox cosmetic and breastfeeding
Botox cosmetic in patients who are breast feeding may cause some problems for nursing mothers . Although Botox stays in the muscle and does not migrate to the breast, there’s just no research proving this because we don’t ever run tests on pregnant women, breast feeding women, etc. so it’s definitiveness cannot be ultimately shown. There is no need to be concerned for your baby’s safety or your milk; however, it is not generally advised to do any types of injectables on women who are nursing.