Botox

Botox Myths and Facts

The most commonly used product in the field of medical aesthetics is Botox. It has a 20-year history and high patient satisfaction.

Botulinum, known since the 19th century, is used not only in the field of aesthetics but also for medical treatment in the treatment of various diseases, and satisfactory results are obtained.

Botox goes through reliable and high-tech steps in the production process. If applied repeatedly and regularly, long-term effectiveness can be achieved. Although the effect of Botox applied for the first time varies from person to person, it lasts an average of 4-6 months, while it can go up to 6-8 after the next session and 8-10 months after the next. In other words, the effect of each application lasts longer than the previous one.

With Botox, patients can now achieve natural results. An expressionless and mimic-free face is not preferred as in the past. Therefore, the amount of Botox applied has been revised compared to the past. In this way, wrinkles and lines are reduced while mimics are preserved.

Performing Botox application in the years when lines first start to form gives more effective results. In this way, precautions are taken before the lines settle and deepen. A kind of protective treatment is performed. Today, men as well as women have Botox. Because, Botox applications can now be performed without being visible from the outside and without spoiling the patient’s natural appearance.

Botox has many indications such as overactive bladder, excessive sweating, migraine, strabismus in addition to medical facial aesthetics. It also shows its effectiveness in these therapeutic areas other than medical facial aesthetics. The World Health Organization has approved Botox treatment for severe migraine. In addition, the use of Botox has been approved for excessive sweating in the armpits, hands and feet. Very effective results are obtained with Botox in both migraine and excessive sweating.

According to research, approximately 58.6 million people are interested in non-surgical aesthetic treatments. However, only 9% of these people can take action for injectable facial applications. In terms of aesthetic treatments that women follow with interest, stories spread by word of mouth on many issues such as the application method, application duration, and safety of the application for non-surgical aesthetic procedures can sometimes contain unrealistic information and cause anxiety.

What is Skin Aging?

The most important clinical feature of skin aging is wrinkles. Volume loss and natural skin thinning are seen in the skin over time due to the decrease in collagen, hyaluronic acid and elastin. This dermal atrophy process is accelerated by external factors such as sun exposure and smoking. In addition, hyperdynamic, i.e. frequently used facial muscles contribute to the formation of visible lines and wrinkles. Initially, lines and wrinkles are seen during active facial expressions such as anger and laughter. These are known as dynamic lines. After a certain period of time, these lines turn into static, i.e. permanent lines that are also seen at rest.

Botox Usage Areas

Mechanism of Action

Botox is a protein obtained from the Clostridium botulinum bacteria. The target is to suppress the release of acetylcholine at the junction of the nerve-muscle junction when a small amount of botulinum toxin is injected into the muscles, resulting in the interruption of chemical transmission and smoothing of skin wrinkles in the treated area.

Basic and Advanced Applications

Basic

The best response and least side effects are seen with Botox in the upper part of the face, in areas with hyperdynamic, i.e. very mobile muscles (frown lines, crow’s feet and horizontal forehead lines).

Advanced

The application of Botox treatment in the lower part of the face is known as advanced application. This area is quite active and in addition to facial expression, the lower facial muscles play an important role in chewing and speaking. Since the muscles treated in the lower face require more practical application skills, the toxin should be applied in low doses and partial functionality should be left in the muscles.

Patient Selection

The best responses to Botox treatment are obtained in patients with dynamic wrinkles and no or minimal static (established) wrinkles. Therefore, it is recommended to start Botox in the early 30s, before wrinkles set in.

In patients with static (not deepened) wrinkles, the response develops slowly and the best response is obtained after two or three consecutive treatments due to the cumulative effect. Deep static (established) lines may not respond to botulinum toxin treatment alone. For the best results in these patients, a combination with treatments such as fillers or skin rejuvenation should be performed.

Products

The FDA has approved two botulinum toxin serotype A products for the glabellar region muscles. These products are onabotulinum toxinA (OBTX) (Botox Allergan, Inc, Irvine, CA) and abobotulinum toxinA (Dysport Medicis Pharmaceutical Company, Scottsdale, AZ).

Contraindications (Conditions That Should Not Be Done)

Pregnancy or breastfeeding

Active infection in the treatment area (e.g. herpes simplex, pustular acne, cellulitis)

Hypertrophic or keloidal scar tissue

Bleeding disorder (thrombocytopenia, anticoagulant use)

Impaired wound healing (due to immunosuppression)

Skin atrophy

Active dermatosis (psoriasis, eczema) in the treatment area

Sensitivity or allergy to botulinum toxin components

Milk allergy with ababotulinum toxinA products

Large muscle weakness in the treatment area (polio, Bell palsy)

Neuromuscular diseases

Inability to actively contract the muscle in the treatment area before treatment

Having had eye or eye surgery in the last 6 months (LASIK, blepharoplasty)

Drugs that inhibit neuromuscular transmission and enhance botulinum toxin effects

Uncontrolled systemic situations

People who need perfect facial expression (actors, artists)

Advantages

Technically simple method with short treatment time

Safe and effective, especially in the upper face area

High patient satisfaction

Disadvantages

Short-term effect compared to other cosmetic procedures, despite cumulative effect with repeated applications

Results and Follow-up

Partial loss of muscle function occurs 2-3 days after Botox treatment, and maximum loss occurs 1-2 weeks later. The effects are most evident in the treatment of dynamic lines. Static lines respond more slowly and better results can be achieved with several consecutive treatments or with concomitant minimally invasive aesthetic interventions (dermal fillers) and reshaping procedures.
If the desired loss of muscle function has not been achieved, correction can be made 2 weeks after the procedure. The botulinum toxin touch-up dose varies according to the residual muscle function in the target muscle.
The results of Botox treatment are not immediately visible in the lower part of the face, while more dramatic changes are observed in the upper part of the face. Minimal or greater functional changes can be seen in the mouth for the desired aesthetic effect on the lower face.
Muscle function in the affected area returns after 4-6 months, depending on the applied dose, the area of ​​application and the patient’s physiology. It is recommended to perform the next application before the facial lines return to their former state when the muscles in the treated area begin to contract again.

Botulinum Toxin Treatment in Multiple Face Areas

Botoxin treatment applied to the upper third of the face can be safely and easily combined with treatment of the lower face in a single visit.

Let’s look at the myths about Botox applications together in order to reach real information and make the right decisions,

Indications for Botox (Circumstances Approved)

Botox was approved by the FDA as a temporary treatment for adults between the ages of 18-65 with moderate to severe dynamic glabellar (inter-brow area) frown lines (2002).
Botox was approved by the FDA for the temporary treatment of primary axillary hyperhidrosis (excessive sweating) (2004)
Other FDA-approved indications: blepharospasm (involuntary blinking of the eye) (1989), strabismus (1989), cranial nerve VII disorders (1989), cervical dystonia (2000), upper extremity spasticity (2010), chronic migraine prophylaxis (2010).
Other cosmetic uses: Reducing wrinkles on the upper and lower face, neck and chest, face lifting and correcting facial asymmetries.

1- Is Botox snake venom?

No. Botox is a drug. It is a natural, purified protein-based drug produced from a specific bacteria.

2- Is Botox safe?

Yes. Botox is a drug approved by the Ministry of Health in Turkey and in more than 70 countries around the world, with over 2000 scientific studies. It has been used for 20 years. Millions of people safely prefer these applications every year.

3- How long does the effect of Botox last?

The effect of BOTOX may vary from patient to patient and depending on the dose applied, the average effect period is 4-6 months. The effect of the drug begins to appear 2-3 days after the injection and is fully apparent in 1-2 weeks.

4- Does its effectiveness decrease as Botox is repeated?

Although the possibility of developing antibodies against Botox is theoretically possible, no antibody development against Botox that reduces its clinical effectiveness has been detected in facial aesthetic applications so far.

5- Does the effect not last as long as before because there have been changes in the production process of Botox?

There has been no change in the production process of Botox. High-tech production has been carried out with the same standards and in accordance with the criteria of the FDA and the European Medicines Agency for many years.

6- Is Botox application painful?

Before this application, the application area is numbed with local anesthetic cream, so the injection is quite painless.

7- What should be considered after Botox application?

After the application, there may be temporary sensitivity, swelling or bruising on your skin, but this does not prevent you from returning to your social life. Make-up should not be worn for 12 hours, and hot environments such as direct sunlight, Turkish bath, sauna, solarium, steam bath, hot shower should be avoided for 2 weeks.

8- Is it true that facial expressions disappear when Botox is applied?

No, this is not true. This is an application carried out under the supervision of the physician and upon the request of the patient. With the applied dose and area selection, it is possible to both eliminate wrinkles and use facial expressions.

9- Will my wrinkles get worse if I do not continue Botox applications?

No. Your wrinkles will gradually return to their pre-treatment state.

10- Are Botox and dermal fillers used for the same purpose?

BOTOX is used for dynamic wrinkles, dermal fillers for static (established) wrinkles and facial shaping. Their mechanisms of action and application areas are different. A patient may need both Botox and dermal filler applications. Dermal fillers consist of hyaluronic acid, a natural substance.

11- Is Botox used on lips?

No. BOTOX is used for dynamic wrinkles. Dermal fillers are used to plump lips.

12- Is it possible to eliminate wrinkles at the same level with creams instead of Botox injections?

No, this is not possible. Botox is a treatment that is injected into the muscle by a doctor and effectively eliminates dynamic wrinkles. Creams, on the other hand, fulfill the functions of nourishing the skin, moisturizing, protecting it from the sun and eliminating very light superficial wrinkles.

13- Where is Botox applied?

This application can be performed by a licensed and experienced medical doctor. It is not legal for people who are not medical doctors to perform this injection.

What is Botox?

Botox is a botulinum substance secreted from a bacterium that is applied to eliminate wrinkles that are left on our skin by factors such as aging, direct sun exposure, stress, and improper skin care. Botox is entered into the muscle where the wrinkled area is located, allowing the muscle there to contract less, thus reducing wrinkles. Its effect lasts 4 to 6 months. If the person comes to the second session when the effect of Botox starts to lose, the effect of Botox increases to 6 to 8 months. Botox is used for forehead, crow’s feet, eyebrow, chin wrinkles, chin, as well as for therapeutic jaw/teeth clenching and teeth grinding, hand, foot, armpit sweating and for migraine treatment.

What is Migraine Botox?

Today, the cosmetic Botox application used to be used for treatment. This method is applied to people whose migraine does not go away with medication and it is aimed to relieve migraine pain. At the same time, the quality of life increases, sleep patterns are established and the happiness hormone is secreted. Migraine Botox, whose effectiveness has been scientifically proven; is applied intensively using a Botox tube. It starts from the nape of the neck and is applied to many muscles in the head, the temporal region and the forehead.

What is Masseter Botox?

It is a botox that is applied to people with a wide jawline and face for aesthetic purposes to make the jawline more prominent and to make the face thinner. Masseter is the name given to the chewing muscle. In addition to making the jawline more prominent and making the face thinner, masseter botox applied for teeth grinding and clenching is quite effective. Shortly after having masseter botox applied; both your jaw will have a straighter shape and your facial line will be thinner, and teeth grinding will be minimized. A doctor’s check-up is performed after 15 days. The effect of botox varies between 4 and 6 months. If you apply the procedure again between 4 and 6 months, the duration of masseter botox will be extended and it will be durable up to 1 year in time. Its effect is felt more after 2 to 3 applications.

Botox for Sweating

For various reasons, almost everyone has a sweating problem. However, in some people, sweating is well above normal. This is where botox comes into play. Excessive sweating can cause discomfort. The sweating problem, which is most commonly seen in the armpits, hands and feet, can be reduced with Botox. Results are obtained in the first session. Its effect varies between 4 and 6 months. Before the procedure, the person is anesthetized with a numbing cream. In this procedure, which takes approximately 20 minutes, results begin to be obtained from the first session. No serious side effects are expected.

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