What is Botulinum Toxin (Botox)?
Botulinum toxin type A (BTA) is a toxin produced by Clostridium botulinum, a gram-positive anaerobic bacterium. It acts by binding specific nerve- endings responsible for muscle movements, thus causing a blocking effect on the muscles. Recovery occurs through the growth of new nerve-endings, thus re-innervate the muscles. The new growth will take between 2 to 6 months.
What are the indications?
In plastic surgery it is used mainly for cosmetic reasons. Treatment with BTA can relax the muscles that cause expression lines, thereby preventing wrinkles from forming and improving the appearance of existing wrinkles caused by facial expressions. It can be used mainly for the frown lines, crow’s feet, forehead wrinkles and skin bands on the neck. Injecting around the mouth and under the eyes is less common, as it can cause dropping of the lower eyelid and deform the mouth.
BTA can be used successfully in patients with hyperhidrosis(excessive sweating) in the underarm and palms. It can also be helpful in some patients suffering from migraine. Other medical specialties use it for the treatment of some movement disorders (dystonias), spasticity and other disorders of the muscles.
How safe is it?
In high dosages it can be lethal mainly due to paralysation of the breathing muscles but the quantities used for medical reasons are very low, making BTA a very safe substance.
What are the risks and site effects?
Minor side effects include allergic reactions, rash, itching, headache and at the injection site pain, redness, swelling, or tenderness. Severe allergic reactions requiring medical treatment are very rare.
Botox injections can cause unintended side effects to functionally-important muscle fibers, either from improper placement of injections, from localized distribution, or overdose. Eyelid drooping, lip weakness, eyebrow malposition and difficulties in swallowing are some of the rare site effects. Normal function will return in 2-3 months when the new nerve-endings will re-innervated the affected muscles.
Where can you get BTA?
Injectable treatments are medical procedures that require appropriate training and sound judgment in order to help protect patient safety. Make sure that the doctor is credentialed. Don't choose a provider based only on the price and avoid discounts that seem extreme. It’s possible that you are receiving a very diluted form of BTA or perhaps something that is not even real BTA at all. Ask always of what you are being injected with.
A credentialed doctor should have the time to explain you all the benefits and risks during the consultation as every medical procedure has inherent risks and benefits. He should take a medical history, answer all your questions and document in your file all the steps of the procedure. It is recommended by medical societies that all medical procedures should be performed in an appropriate medical facility and not in shopping malls, private homes, office parties, group social gatherings or hair salons and spa.
Overall BTA injected by professionals and well educated physicians in appropriate medical facilities is a very safe treatment to remove wrinkles and rejuvenate the face.