Botox
What is Botox?
A bacterium called Clostridia Botulinum produces a neurotoxin that affects the movement of muscles by blocking the nerve receptors in the muscle. Historically, improper canning of food would allow this bacteria to grow. An unfortunate person who ate the contaminated canned goods would become paralyzed from this neurotoxin within the Clostridia Botulinum and would perish from “Botulism.”
Today, with modern science and Research and Development by Pharmaceutical companies, this bacteria is grown in the laboratory, and the neurotoxin can be isolated as a drug medication. Used in very small and precise amounts, multiple medical uses for this neurotoxin are used today.
There are a number of companies that produce this neurotoxin from the Clostridia Botulinum bacterium commercially. The most common trade name is “Botox.”
Where is Botox used?
The most common use is in the face to decrease facial wrinkles in certain areas by temporarily paralyzing the muscle that produces the unwanted wrinkles.
Other uses include:
treatment for migraine headaches
excess sweating in the axilla: (arm pits) hyper-hydrosis
muscle spastic conditions
Where can it be used in the Face?
There are at least 42 facial muscles on each side of the face that are responsible for facial movement, both in response to emotional and non-emotional stimulation. Some of these muscles over time, and a lifetime of repeated use, produce wrinkling creases in the skin. We do not see these permanent etched creases in the face of a child. We regard the child’s face as youthful. By removing these etched-in lines, the face takes on a more youthful appearance like the child’s face.
Common areas where ‘Botox” is used in the face include:
Forehead and brow to decrease the horizontal furrowed lines
Glabella (area between the eyebrow above the nose) which produces the glabellar folds and a stern troubled look (angry brows)
Outside part of the eyelid area: “the laugh lines” when you close your eyes tightly
Nose: the horizontal crease at the top of the nose and the oblique crease on either side of the nose (bunny creases) produced when you smile hard or smell something bad and turn up your nose.
Lips: Upper lip to turn it up slightly; the lower lip to decrease the marionette and bitterness lines at the corner of the mouth.
Chin: to the transverse curved crease in the lower chin/lip area
Neck: to decrease the neck cords that develop with aging
How is the Botox injected and how long does it last?
The Botox comes refrigerated. A specific amount of non-preserved saline is injected into the vial of Botox to produce a solution. There are a measured number of units in the solution. A specific number of units are then injected into the muscles that are to be treated to reduce or eliminate the wrinkled area by paralyzing the muscle that produces the wrinkle.
To achieve the desired effect, the correct number of units must be injected into the muscle to produce paralysis. If paralysis does not occur, an inadequate number of units were used and the wrinkle will remain.
The full effect of the paralysis of the muscle takes up to 7 days following the Botox injection and the effect of the muscle paralysis and decreased wrinkling typically lasts 3 – 6 months. This varies from patient to patient.
Are there risks with Botox injection?
Botox injection is very operator dependant. An experienced medically trained practioner is advisable.
Dr. Giuffre has a highly trained Registered Nurse that treats patients with temporary filler and Botox in his surgical suite under supervision.
Please see www.pclsc.ca
An inadequate number of units or units placed incorrectly will not achieve the desired effect.
If the upper brow is over injected or injected too close to the upper eyelid, an eyelid ptosis (drooping upper eyelid) can occur until the effect of the Botox on the muscle that opens the eyelid disappears.
Headache may be experienced after Botox injection
There is a maximum dose that should not be exceeded. A massive overdose could have the same effect systemic effect as “Botulism.”
Can Botox be used in conjunction with other temporary injectables?
The engine that drives the crease formation in the face is the repeated use of a facial muscle. When this muscle is paralyzed with Botox, the crease may soften but may not completely disappear.
Either at the same time or at 1 week post injection of Botox, further blunting or elimination of the crease may be done using temporary fillers which fills out and camouflage the crease.
Temporary Fillers
What are temporary fillers?
This is a product that is injected into facial wrinkles to blunt or camouflage the wrinkle and gives a more youthful appearance to the face. It can also be used to increase volume in certain areas of the face to give the appearance of a fuller more youthful face.
Please refer to FAQ section on “temporary and permanent fillers (Restylane & Juvéderm).”
*There are many options for injectables. Both medical and non medical practitioners are using injectables. Please ensure that the correct material is being injected by trained medical personnel who are affiliated with a physician experienced in the use and risk of injectables.