Botox for the whole face

I am glad to welcome you again, my dear readers. Who doesn't dream of prolonging their youth? How you don’t want wrinkles to appear on your face. Unfortunately, this process is inevitable. But thank God, nowadays there are a lot of options for preserving youth. And one of them is Botox for the face, of course there are different reviews about this procedure. I can’t say that everything is super positive. So let's look at the pros and cons together.

What is Botox and how does it work?

It was discovered by American scientists in the 19th century. At that time, they were looking for the cause of botulism (an infection of the nervous system). As you understand, the substance was not initially studied for use in cosmetology. The word comes from the American botox, so it is correct to pronounce botox, not botex.

This is an A-type neurotoxin, its basis is a protein produced by the microorganism Clostridium botulinum

It is the causative agent of such a dangerous disease as botulism. At the beginning of the 20th century, scientists were able to isolate a toxin from this microbe. In animal testing, the toxin was noted to relieve muscle spasms and squints. When the toxin entered the muscles, it blocked their contraction. Simply put, it caused muscle paralysis.

In 1978, clinical trials of drugs based on this toxin began. Ten years later, the American company Allergan began producing drugs with Botox. They were used to treat strabismus and blepharospasm.

Scientists noticed that in patients receiving injections, facial wrinkles were smoothed out. It has been proven that the drug is absolutely safe in therapeutic doses. And for more than 30 years it has been successfully used in cosmetology.

Dysport is also used in cosmetology for these purposes. In essence, this is the same Botox, the only difference is the concentration of the toxin. There is less of it in Dysport and this drug is produced by the French company Ipsen.

Toxin injections are administered to areas of increased muscle tone. Botox is administered subcutaneously, intradermally and intramuscularly. The doctor decides exactly how to inject and in which area. Of course, many are interested in when Botox begins to work after injection. Visible changes occur within 3-4 days. The maximum result from the introduction of the toxin appears after 2-3 weeks.

ARTICLES ON THE TOPIC:

Reviews about the procedure, as well as before and after photos

In order to understand how effective this rejuvenation method is, I collected reviews. And for a visual example, I have prepared a photo for you. Honestly, some of the photos are truly amazing. It feels like the person is 10 years younger 🙂

Lily: I constantly wrinkle my forehead and frown. As a result, glabellar and horizontal wrinkles appeared. I was injected with Botex in these places - my forehead is smooth, the effect is simply super! Hyaluronic acid can fill deep folds. But for facial expressions, Botox is still the answer.

Aster: Recently I was injected for facial wrinkles on the forehead, around the eyes and in the area of ​​the bridge of the nose. There are no problems with facial expressions, but wrinkles do not appear. I liked it and will make it again.

Daisy: I was terribly afraid of these injections! Honestly... I almost fainted right at the doctor, I even sniffed ammonia. If you are afraid, calm down. the injection is similar to a mosquito bite. But it's worth it. I now have a very smooth forehead. I can wince, but no wrinkles form. Hurray, that's what I wanted))

Camilla: It is enough for me to inject myself once a year. I use it in the summer because I often wince in the sun. The effect lasts for a long time, maybe because I’m still 30 years old... I don’t think I’m old..))

Marina: I also injected it in the forehead area, the effect lasted for 6 months. Then all the wrinkles returned, it didn’t get any worse. just the way it was

Olesya: I was advised to inject Dysport between the eyebrows. I didn’t notice much difference with Botox. Now I can’t wrinkle my eyebrows and forehead. I really hope that the muscles will get used to not wrinkle when the effect of the drug wears off.

Margot: I was given injections into the forehead and eye area. I was delighted. somehow my whole face looked younger. They were afraid that it would be worse later, I don’t know... the action went away, everything returned as it was. The only drawback is that the effect lasted a little more than six months... although it was probably my own fault, I drank alcohol and a lot of water... The difference before and after is very noticeable, despite my 33 years. I will continue to inject

Where is Botox injected and how much does the injection cost?

Now let’s talk about where the toxin can be injected and what its effectiveness is, especially after 40 years. Typically, injections are administered into the forehead, eyebrows, nasolabial folds, lips, and under the eyes. You can also use the toxin to lift the tip of your nose and eyebrows.

Before the procedure, the amount of toxin is measured in units. How many units of Botox do you need? For each zone the number of units is different. It also depends on the condition of the skin and wrinkles, so the dosage is selected individually. I will give the average values.

(average)

4500-6000 rubles The transition zone between the nose and the upper lip is 2-4 units. Allows you to slightly raise the tip of the nose. 600-1600 rubles

Calculate the approximate cost of injections based on the price of 300-400 rubles per unit of toxin. Dysport is approximately half the price.

You can find these procedures at a good discount on Biglion and Groupon. I recommend looking at the options on these sites first. So it’s better to ask the price, and read the reviews of those who have already tried it.

Is Botox harmful for the face?

Now let's figure out why Botox is harmful to the face. Negative consequences usually occur when the drug is used incorrectly. It is very important to correctly calculate the dose and location for introducing the toxin. Professionalism depends on the cosmetologist, his experience and understanding of which points to inject. The most harmless complications are bruising, swelling and redness at the sites of botulinum toxin injection.

Other side effects may include:

1. headache;
2. pain in the injection area;
3. waxy face (complete lack of facial expressions);
4. penetration of botulinum toxin into neighboring muscles;
5. nausea, double vision;
6. Quincke's edema;
7. flu symptoms;
8. drooping eyelid or eyebrow.

Doctors often keep silent about the dangers of the drug. Of course, such complications occur extremely rarely. Basically, harm to health occurs due to the incompetence of the doctor. Or this may be due to the body’s individual reaction to the drug. Unfortunately, it is impossible to predict this in advance.

The consequences of Botox - reviews

Of course, in addition to favorable assessments after the procedure, there are also negative consequences. In order to study this procedure from all sides, I collected negative results from injections.

Oksana: Unfortunately, I had a negative experience... I was injected with botulinum toxin in the forehead area. This is terrible... instead of smooth skin, I got drooping eyelids and eyebrows. I found another clinic, thank God they fixed everything. It turned out that the first time they injected me with the toxin in the wrong place. The moral is simple - look for a good specialist!

Lusi: My facial expression has changed... my look has become different, as if you were always walking around in surprise. Thank God the effect of the injection wore off and facial expressions were restored. I definitely won’t be getting any more injections.

Valyushka: I’m having trouble with these beauty injections... I wanted to get rid of the “crow’s feet” on the outer corners of my eyes. The specialist I went to was experienced and did everything correctly. The result was that after two days the bags under the eyes disappeared on the third day. And three weeks later I had Quincke’s edema ((I was admitted to the hospital, the immunologist told me that it was an individual intolerance.. that’s it..

Snezhana: I’m not allergic, but my experience with Botox is extraordinary. A couple of hours after the injections, I was taken away in an ambulance with Quincke's edema. no more injections((

Alenka: I was given injections in the bridge of my nose and eyebrows, it only lasts 4 months. Then it’s all over again, to be honest, it’s terrible to have to have injections three times a year. I completely abandoned this idea.

What not to do after the procedure - restrictions

In order to achieve maximum effect and the result to be visible for a long time, after injections it is necessary to observe some restrictions. In the first 4 hours after the procedure, it is necessary to maintain a strictly vertical position. You should not lower your head, this is important for the muscles. After all, after the injection of botulinum toxin, they relax and must take the correct position.

Under no circumstances should you touch the injection sites, massage them, or apply creams. It is important not to introduce infection to the injection sites. All sports are prohibited for at least 48 hours. Even measured fitness yoga and other types of physical activity are prohibited. The muscles should be at rest.

For at least 7 days, and preferably 10-14, any thermal procedures are prohibited. At this time you will have to forget about the solarium, sauna and even drying your hair with a hairdryer. The thing is that heat accelerates the removal of the drug from the body.

Swelling also nullifies the effect of Botox. For the first two weeks, try not to eat salty foods, smoked foods, or drink a lot of liquids.

As for alcohol, it is also prohibited for at least 14 days. Please take this limitation very seriously. Alcohol dilates blood vessels, in this situation botulinum toxin can be easily absorbed into the blood. This is a potentially dangerous situation for the body. Then you shouldn’t be surprised that you have complications. This also applies to blood thinners.

Botox - contraindications

Since botulinum toxin is essentially a poison, it naturally has a number of contraindications. Before listing them, I want to warn you against injections at home. Even an experienced doctor can miss the dose and injection site. What can we say about amateurs?

Trust your face only to an experienced specialist. Restoring facial expressions or, God forbid, treating angioedema will be more expensive. In what cases are Botox injections strictly contraindicated:

1. chronic diseases of the lungs, liver and kidneys;
2. hernia of the upper or lower eyelid;
3. drooping upper eyelid;
4. neuromuscular diseases of an autoimmune nature;
5. severe myopia;
6. poor blood clotting;
7. oncology;
8. predisposition to the formation of keloid and hypertrophic scars;
9. individual intolerance to the components of the drug.

When planning, as well as in the early stages of pregnancy, it is better to avoid injections. Botox during pregnancy can negatively affect the fetus. This is confirmed by more than 40 recorded cases around the world. It is also worth holding off on injections during lactation. In Europe, a study of the toxin was conducted on pregnant rats. There was a negative effect on the fetus; many animals were born with pathologies of muscles and bones. Many pregnant females experienced miscarriages.

A temporary contraindication to beauty injections is fever. Exacerbation of chronic diseases, any infectious diseases, herpes. Recent facial surgery, menstruation period. Taking antibiotics, anticoagulants and anti-inflammatory drugs is also a temporary contraindication.

Well, we figured out why botulinum toxin is harmful. And also after what time you can expect maximum effect. Whether or not to resort to this method of rejuvenation is up to you to decide. If it makes you happy and gives you confidence, it's worth a try.

Yes, in addition to the facial procedure, there is also Botox for hair and Botox for eyelashes. And today I say goodbye to you, but new interesting topics await us ahead. So don't forget to subscribe for updates. Bye everyone!

Expression wrinkles make themselves felt after the age of 25, and over the years their severity becomes more pronounced. To solve this problem, women resort to various cosmetic products and procedures.

A more radical technique is botulinum therapy.

How harmful is Botox for the face, what effect can be expected, what are the indications and contraindications for use, consequences - let's look at all these questions in more detail.

What is Botox for the face?

Botox, in other words, botulinum toxin, is a drug that is used in plastic medicine. In common parlance, the procedure is called “beauty injections.” The main purpose is to smooth out facial wrinkles. Valid only for a certain time. To achieve the desired effect, the procedure is repeated over time.

Recently, Botox rejuvenation has become quite popular. It is a safe procedure for evening out and smoothing the skin on the forehead, between the eyebrows and under the eyes. It is used in clinics and beauty centers as an alternative to surgical facial rejuvenation.

Photos before and after Botox injections:

First, it’s worth understanding what an injection product is? Botulinum toxin is a complex protein produced by the anaerobic bacterium Clostridium botulinum. This is a toxic substance that is used for therapeutic purposes in microscopic doses. The substance is divided into several types - C1, C2, D, A, E, F, G, H, B. Type A is used more often. A natural question arises - is Botox dangerous, because it is a poison?

For cosmetic purposes, botulinum toxin type A is used with a weakened effect and in very small doses. So it is not toxic to the body.

The drug began to be used in medicine in the 70s. It was used by A. Scott to treat blepharospasm. Subsequently, medications based on botulinum toxin began to be used for paralytic strabismus, muscle spasms, and various pain syndromes of a spastic nature. In modern cosmetology, it has been used to smooth out facial wrinkles.

Medications based on the substance - Dysport, Xeomin, Neuronox, Botulax.

How it works - the use of botulinum toxin in cosmetology

The drug is injected into a specific facial muscle. As a result of the effect, neuromuscular transmission is blocked and, accordingly, the formation of folds is prevented.

Botulinum toxin injections are used only to eliminate facial wrinkles. Other age-related changes - loss of elasticity, age-related wrinkles, drooping of facial contours - cannot be affected. The injection in such cases will not affect the structure and volume of soft tissues.

Using beauty injections will help remove many imperfections.

After just a few days, the first signs of improvement are visible:

1. wrinkles disappear in the injection area;
2. Facial spasms are removed;
3. the shape of the face is corrected - the tip of the nose, eyebrows, corners of the lips are raised;
4. defects are corrected - asymmetry of lips, eyebrows.

How does botulinum toxin work? Once injected into muscle tissue, the medicine stops the flow of nerve impulses. Under the influence of the substance, it stops contracting and thereby forming wrinkles. The result is muscle relaxation and wrinkle smoothing.

The drug is concentrated at the injection site and then enters the systemic circulation. If the injection is done correctly, the product does not affect the surrounding tissues. When used in small dosages, a systemic effect is not expected. It quickly undergoes a series of chemical reactions and breaks down into metabolites. The drug is excreted by the kidneys.

Indications for injections

With the help of the drug you can correct the following:

1. cheekbones and chin;
2. wrinkles in the corners of the eyes;
3. superciliary/frontal area;
4. nose – folds at the base of the nose, raising the tip;
5. area around the lips;
6. asymmetry of the face - lips, eyebrows.

It is recommended to resort to botulinum therapy only after 30-35 years. Until this age, the skin is very elastic and does not require the use of medication. Beauty injections can be combined with other techniques - microcurrent therapy, radio frequency RF lifting.

Video from an expert:

Contraindications for use

Contraindications to the use of Botox for wrinkles:

1. hypersensitivity to botulinum toxin;
2. pregnancy/breastfeeding;
3. oncological diseases;
4. period after surgical interventions (10-12 weeks after plastic surgery);
5. damage to the epidermis at the injection site;
6. hemophilia;
7. period of exacerbation of diseases or their acute stage;
8. myopia;
9. myasthenic syndrome;
10. frequent relapses of herpes;
11. critical days;
12. diseases of the hematopoietic organs;
13. long-term use of calcium supplements, anticoagulants;
14. endocrine pathologies;
15. benign neoplasms.

You should also consider combining botulinum toxin with antibiotics. This group includes polymyxins, macrolides, aminoglycosides, and tetracyclines. They enhance the effect of the drug, which contributes to the occurrence of unintended consequences. “Beauty injections” are best performed no earlier than 14 days after antibiotic therapy.

It is not recommended to combine the procedure and the use of painkillers, in particular NSAIDs (non-steroidal anti-inflammatory drugs). The latter can affect blood clotting, which will lead to the possible formation of hematomas at the injection sites. Drinking alcohol 14 days before/after the procedure should be avoided.

Zone diagram - where can you inject?

Traditionally, injections can be made in the following areas:

1. Frontalis muscles – removes eyebrow folds, creases on the forehead.
2. Muscles near the eyes (under the eyes and in the corners) - with the help of injections in this area, the so-called crow's feet are removed.
3. Nose area – most often injected in the area between the eyebrows to eliminate folds.
4. Neck – wrinkles are eliminated, sagging cheeks are prevented.
5. Chin – carried out to prevent sagging of this area.
6. Lip area – elimination of wrinkles, correction of asymmetrical shape, raising of corners.

There is information about the possibility of injections in the lips to increase their volume. Actually this is not true. The product does not increase the volume of tissue in the injection area; it has the ability to constrain muscles. If the medicine in its pure form is injected into the lips, they will not be able to open on their own.

For this procedure, preparations based on synthetic hyaluronic acid are used. In some cases, a mixture of hyaluron with a small dose of botulinum toxin is used. This combination is recommended for very thin lips.

How many units do you need?

To achieve the desired result, the dosage of the product plays a role. Each zone requires a different number of units based on the desired result.

So, approximate dosages:

1. forehead area – 25 units;
2. eye zone – up to 15 units;
3. eyebrow space – from 10 to 25;
4. lip area – 5 units;
5. eyebrow height rise – about 4;
6. chin – 50 units;
7. neck – from 40 to 50.

When will the result be visible?

Some believe that you can see results within a few hours. But it is not so. The effect does not appear immediately, but gradually.

Neutralization of the receptors that control muscle contraction occurs after 48-72 hours. For the muscles to finally relax and the effect to be fully expressed, about 10 days must pass from the moment of the injection.

Duration of effect from botulinum toxin injection

After about 2-3 months, the opposite effect occurs - the effect of the medicine gradually weakens. After 4-4.5 months, the drug is only 1/5 active. 80% of muscle contractions are no longer subject to botulinum toxin. After about 6-7 months, the effect of the drug ends. The procedure is repeated if desired.

There are cases when the medicine stops working earlier than expected. In most cases, this occurs due to incorrect calculation of the Botox dosage. Intense physical training also reduces the duration of the effect.

Preparation and carrying out the procedure

The process itself is short-lived, practically painless, the only inconvenience is the moment of puncture.

The procedure takes place in the following sequence:

1. Before use, the area is treated with an antiseptic.
2. To determine the exact location, the patient frowns.
3. The injection area is outlined with a marker, then a dot is placed at the injection site.
4. A circle about 1 cm in diameter is shaded around it.
5. Local anesthesia is administered.
6. Next, the cosmetologist injects Botox into the corresponding muscles. The needle is inserted to a depth of 5-10 mm depending on the area at an angle of 90 or 45 degrees.
7. For lips - injection is carried out at a distance of 2 mm along the border.
8. For eyebrows - at a distance of 2 mm from the growth line.

The injections are carried out by a cosmetologist, taking into account all contraindications. As a rule, the patient is under the supervision of a doctor for half an hour after the procedure. But not all beauty centers follow this rule. The qualifications of a cosmetologist or doctor play a huge role. If carried out incorrectly, the effect and consequences may not be entirely favorable.

Botulinum toxin injections. Video:

How much does the procedure cost?

The number of injections (not units) plays a role in determining the price. Depending on the desired result, their numbers in one zone may differ. For example, to correct lip asymmetry, 4-6 injections are performed.

At the same time, to lift the corners of the lips - 2 injections. The price of one injection is for 1 unit. - on average 300 rubles.

What should you not do after injections?

To prevent negative consequences after botulinum therapy, it is recommended to adhere to the following rules:

1. limit intense physical activity;
2. do not visit the sauna/bath;
3. do not sunbathe;
4. do not take antibiotics or NSAIDs before/after the procedure;
5. do not scratch or massage the injection areas;
6. immediately after the procedure (4-5 hours) do not bend over, lie down or do exercises;
7. do not use cosmetics during the period of adaptation and healing;
8. do not rub, heat or cool.

Unsuccessful consequences of botulinum therapy

According to experts, Botox is considered a relatively safe remedy that is used for facial rejuvenation. It refers to drugs for medical purposes. And any medicine can cause adverse reactions, especially if it is administered incorrectly.

Unsuccessful consequences and side effects of botulinum therapy include:

1. at the injection site there is pain, bruising, hematomas, swelling;
2. the formation of new wrinkles in neighboring areas;
3. compactions in the injection area;
4. asymmetry of the oval face;
5. acquisition of unnatural facial expressions and articulation;
6. numbness at the injection sites;
7. incomplete opening of the eyelids, drooping;
8. headaches and general weakness - they go away after a certain time;
9. atrophy of paralyzed muscles.

The consequences of unsuccessful Botox injections in the photo:

Many people are interested in what consequences from constant Botox injections may appear in 10-15 years? With regular injections, the aging process of the face may accelerate and general muscle sagging may appear.

Is it worth getting Botox - pros and cons

There are different opinions regarding rejuvenation with botulinum toxin. First you need to familiarize yourself with the advantages and disadvantages of the presented methodology.

The positive aspects include the following:

1. painlessness and quick results;
2. efficiency;
3. relatively safe correction of facial defects;
4. lack of recovery period compared to plastic surgery;
5. correction of neurological problems;
6. cheaper procedure compared to plastic surgery;
7. Suitable for different age categories.

Among the disadvantages of botulinum therapy:

1. limited period of validity;
2. the result and quality depend on the competence of the cosmetologist;
3. lack of results in certain areas (for example, cheeks);
4. the load goes on the muscles that are next to the “inactive” ones;
5. possible adverse reactions from the body;
6. effective only for superficial wrinkles.

Video from Dr. Malysheva:

Botox cosmetics – is there an effect?

The beauty industry offers cosmetics with the addition of botulinum toxin. There are many similar products on the domestic market. One of the representatives is TsiKlim cream. To achieve this, it is necessary to use it in long-term courses (about 3 months).

Some users in reviews of Botox cream talk about a pronounced result, others - about a less pronounced effect compared to injections. True, the result will have to wait a long time. Also, imperfections associated with asymmetry cannot be corrected using an external remedy.

But there is one advantage of using such creams - facial expressions remain alive, and there are practically no unwanted consequences.

Reviews from cosmetologists and women after Botox injections

There are plenty of reviews about Botox for the face from cosmetologists and patients on the forums. Satisfied women note a visible rejuvenation effect and improved appearance. Dissatisfied patients indicated swelling and unexpected reactions of the body to the medicine. Experts speak in a neutral manner.

I want to share my sad experience of using Botox. I chose the salon based on reviews. There the benefits of the event were described to me in all colors. They advised me to inject Botox into my forehead and into the masseter muscle to give my face a “standard” look. I agreed, trusting the master. For two weeks I was bothered by the feeling of being “frozen.” Then, thank God, it passed. The result was absolutely amazing - my cheeks looked like bulldog jowls, and a wave went down my chin. At the clinic where I had this procedure done, they sent me away politely. This was explained by an individual reaction to the drug. Then I turned to a neurologist. And he made me glad that this was not the first time. So judge for yourself.

Karpenko Victoria, 35 years old, Moscow

I had a problem with eyebrow asymmetry. This caused discomfort primarily to me and the eyebrow masters. No matter how you draw and pluck, the defect is not removed. I was advised to get Botox. At first I wasn’t very fond of him; I didn’t want to get my face chipped. Then I decided. Before the session, they explained to me in detail what can and cannot be done, and were told about the possible consequences. Already on the 5th day I saw the desired result - the edge stopped “flying”.

Volodina Svetlana, 39 years old, Chelyabinsk

I also want to leave my review. I decided to remove facial wrinkles in the eye area. The result seems to be good, but there is a downside. The eyelids swelled and took on a slightly puffy appearance. It turns out that the drug also affected neighboring muscles, relaxing them.

Ruslana Ivanova, 42 years old, St. Petersburg

I was lucky with both the cosmetologist and the result! The eye procedure itself is not entirely painful, the sensations are quite tolerable, a little tear came out. Everything took about 15-20 minutes. First, they scrubbed my skin with a product with a rejuvenating effect. Then they injected 1 unit under the eyes, 2 units into the corners of the eyes. For 30 minutes I was asked to work on facial expressions. Within a few days I saw amazing results. Now I can smile without wrinkles. I definitely recommend it! But you don’t need to go to the first master you come across.

Reshetnyak Natalya, 36 years old, Moscow

A suitable procedure to improve the appearance of the face. After Botox, the face needs active care. Anti-aging products are used to even out skin texture, moisturizing and nourishing creams.

Velichko Lidiya, cosmetologist

I have been working with botulinum toxin for 6 years. For the last year I have been injecting the Japanese drug Refinex. Smoothes out facial wrinkles well, refreshes and rejuvenates. The skills of the master and the insertion technique play a very important role. There are times when the body reacts to the drug. It depends on individual characteristics.

Tatyana Marinina, cosmetologist

A good non-surgical method for correcting age-related changes and facial asymmetry. However, after 55 - 60 years, a different anti-aging program is required. The medicine may not respond to deep wrinkles.

When to start doing Botox? To lie down or not to lie down after the procedure? How to choose a drug? Yulia immediately collected all the questions that interested her about Botox and asked them to her cosmetologist Elena Selivanova from Petrovka-Beauty.

After our post about the first experience with Botox, many people seem to have more questions than we answered in it. Therefore, we decided to talk about it again. Elena Selivanova is a doctor whom I periodically go to at Petrovka-Beauty for various procedures: peelings, cleansing, laser, and most recently Botox. Elena specializes in anti-aging programs, injection and laser techniques; participates as a speaker on anti-aging programs in conferences and seminars held in Russia and abroad.

1. Should I not lie down for 4 hours after the injection?

— Doctors have recently stopped insisting that the patient should not lie down for at least four hours after a botulinum toxin injection. So is this necessary or not?

— Formally, yes, there are still such recommendations. But in general, the requirements are becoming softer. We see from experience that you can do almost anything after the procedure.

Where did the information about 4 hours come from? Because unpredictable diffusion of the drug is theoretically possible. But at the same time, we now know that a toxin injected into a muscle in a certain dose binds to the receptors there within a maximum of 30 minutes and is destroyed. The 4 hour rule is to be on the safe side. It is more important to perform facial contractions with the muscle where the drug was injected.

The toxin changes over the years - even from my experience it is clear that it has become weaker. When he came to aesthetic medicine from neurology, his toxicity was higher. By the way, it can vary - each bottle has its own indicator, and the manufacturer tells us that in this batch the variability can be from 100 to 120 units, for example.

— Does this mean that Botox today does not last as well as it used to?

— Botulinum toxin is a dose-dependent drug. The higher the dose, the longer the temporary blocking of the muscle lasts. When I studied 10 years ago, the doses were different - much higher than we use now. But fashion was different then - now many people want to look natural, but then they walked around with stone foreheads.

2. How do you know if you need Botox?

— The most common question: how do you know when it’s time for you? Some people are already starting at 20+, others wait until they are 40 years old and are proud that they still haven’t had injections.

— The main thing is not to come to a cosmetologist for the first time with the request “Oh, I need Botox.” This is the wrong approach. You need to constantly work on the quality of your skin. Botox is done when other methods are no longer effective.

The first indication for Botox, reviews of which are completely different, is muscle hypertonicity. This means that the muscle is constantly contracting and for some patients, in addition to the formation of wrinkles, this causes pain and tension - especially for those who work a lot with the computer. They frown, a crease forms between the eyebrows. And if because of this there are already wrinkles in a static position, at rest - when you are not frowning, but there is a wrinkle - a crease has formed and this is an indication to do the procedure.

- So should you still do Botox before the formation of a crease or after?

— It can also be done preventively. But in general - at the first sign of a crease on the skin in a calm position.

- And only Botox will help here?

— You can try to improve skin tone and elasticity. Peels, lasers, biorevitalization, moisturizing. It is important to assess the general condition of the skin. Perhaps a course of peelings will remove, for example, hyperkeratosis and the skin will smooth out.

— Should I delay the start of Botox procedures?

— Everything must be done on time. This is very individual and needs to be decided with a cosmetologist. I usually tell you all the options for resolving the issue. You can do courses of care, which is long and expensive, you can quickly inject yourself and that’s it. In terms of price-quality and patient satisfaction ratio, Botox, of course, ranks first among all procedures. It's fast, painless, inexpensive. But Botox for the face still won’t eliminate the need to work on skin quality.

3. How to choose a drug?

— In addition to the classic Botox from Allergan, there is also Dysport, Russian Relatox, Xeomin. Which to choose?

— Botox and Dysport are two leaders who are beyond competition. Relatox has good reviews. In terms of price per procedure, they are almost all the same.

- What are the differences between them?

— Differences in the binding agent. There is a neurotoxin, the botulism bacillus - and it needs to be conveyed in some way, a substrate is needed. For this, each manufacturing company uses its own component. For example, Botox has albumin, Relatox has gelatin, etc. And the units of toxicity will be different for everyone. Botox, Dysport and Xeomin units cannot be compared.

- In fact, it is the doctor’s preference, what he works with longer and what he understands better. I do both Botox and Dysport, for example. And I like Botox and that’s it – I work with it more, I know it well. Dysport too. And from them I am aware of various technical nuances that arise in the work.

— With Dysport, the “diffusion”, that is, the spread from the injection point, is slightly higher. Therefore, if we want to get, for example, eyebrow lifting, then we inject Dysport higher than Botox. It cannot be injected below, unlike Botox, otherwise the eyebrows may, on the contrary, “fall”. Each drug has such nuances.

4. The most common complications

— Falling eyebrows is one of the most common complications after the procedure?

- Yes, that is right. And it can happen to any doctor. What should we do? Assess the patient's facial performance individually. Not everyone has the same structure, there are always variations. And these features of facial movements and muscle interactions need to be understood: what will happen if we relax here? Falling eyebrows happen when the frontal forehead muscle, the widest muscle, becomes over-relaxed. I can now predict that this could happen, and I warn the patient about the risk. This is a certain type - for example, when the forehead is low and this muscle is short. And these are also patients with unexpressed activity of the forehead muscles. That is, the muscle itself is small, and it needs a smaller dose. If you do it as usual, your forehead will be stony, your eyebrows will not rise, you will feel like they are directly pressing.

— Is this complication going away?

— Yes, sometimes even in 3-4 weeks everything goes up.

Here the mechanism is this: when we relax the upper part (sometimes even injecting it under the hair if the muscle goes there), the lower part of the frontal muscle, which is woven into the eyebrows and adjacent to the corrugator, contracts compensatoryly. This is the first eyebrow lifting mechanism. The second mechanism is relaxation of the orbicularis oculi muscle: the eyebrow is located directly above it and by relaxing one small area (these are the so-called “injections under the eyebrow”), we also get eyebrow lifting.

But if you over-relax the frontal muscle, everything will be the opposite. It doesn’t have to all fall down; it can simply become fixed in a way that makes the patient uncomfortable. And the frontalis muscle is the only levator muscle that lifts our entire upper third of the face. All others are depressors. The orbicularis oculi muscle, procerus, corrugators - everything is pulled down. The frontal muscle is the only one that lifts, and it must be protected, groomed and cherished so that it does not fall and “drop” our eyebrows.

5. Can Botox smooth out wrinkles around the eyes?

— Is Botox also injected in the area around the eyes?

— Yes, and wrinkles there are smoothed out due to relaxation of the orbicularis oculi muscle. It stops working and you no longer squint.

Here you need to understand that the orbicularis oculi muscle is large; it lies like a patch from the ciliary edge to the eyebrows and sometimes even higher. And in the eye area, you can only relax certain parts so as not to get ptosis.

A very common complication after injections into the orbicularis muscle is that the skin begins to form wrinkles under the lower eyelid. This is compensatory. Because any relaxation of a muscle means that another muscle will take over its function and it will begin to contract. For example, we blocked the eyes and between the eyebrows - the nose will begin to frown. You will still laugh anyway. The key to success is to correctly assess the work of the muscles in collaboration before the injection.

6. Is it possible to influence the duration of action of botulinum toxin?

— Are there ways to prolong the effect of Botox or, on the contrary, to shorten it when something goes wrong?

— There are mechanisms, but they do not have a 100% evidence base. It can be extended, for example, if the neuromuscular impulse is better transmitted - this happens when there is a sufficient amount of calcium and potassium in the body. And sometimes these drugs are prescribed to enhance the effect.

Previously, it was believed that local cold also affected the result. That’s why I kept ice on patients’ foreheads after the procedure. Not now, because I see that the effect does not change.

There is an opinion that B vitamins reduce the effect because they affect neuromuscular conduction and accelerate the process of innervation. But an article was recently published with evidence that no, they do not.

There are statistics that in the hot season the effect goes away faster. I can even say this from myself. Plus, any improvement in blood circulation, active physical activity, baths, saunas, solariums lead to a decrease in the effect.

Well, Botox is still a fairly subtle drug and it varies from one patient to another. Sometimes the relaxation effect is a little stronger, sometimes weaker, all things being equal.

7. Will Botox work for an athlete?

— There is a myth that Botox does not last in athletes.

- No, this is not a myth. But this does not mean that it does not make sense for them to do it. We do it, but we take a higher dose. The muscles are more powerful, and this applies to men in general. Active physical activity reduces the effect, but this does not mean that it will not happen - you can always work with the dose.

8. How common is Botox insensitivity?

- about 1%, that is, extremely rare. What kind of insensitivity is there?

Primary insensitivity - they did it and there was no effect. I had such a patient - no results at all. We repeated it two months later - the same thing again.

Insensitivity often occurs in men who served in the army during Soviet times and were vaccinated against botulism. Botox doesn't work for them. Such vaccinations are also given to travelers who travel to exotic countries.

And there is secondary insensitivity. This is when they did it the first time and everything was fine, but the second time there seemed to be no effect. It is necessary to understand the characteristics of the body, why it has developed antibodies to this dose. This happens to those who take small doses.

— So it’s better to freeze a muscle 100% than 80%?

— You need to take into account aesthetics - if you want your eyebrows to move, then let them move. If there's just a little bit of movement left, that's fine. But the effect will pass faster than if we “froze” it completely.

— It turns out that it is better to choose high doses?

- Everyone chooses for themselves. A high dose means less facial expressions and will last longer. Low doses - it will go away faster, but it will be natural. But naturalness also depends on the chosen injection points.

- Well, what about addiction?

— Constant needling with small doses leads to insensitivity. That’s what people call it – “to finish off”. For example, you did the forehead first, then after 2-3 weeks the eyes. Then I thought and decided that I should have the lower third of my face done in a month. And these small doses from constant pinning can lead to insensitivity over time, as antibodies to the toxin are being produced. It is also important to maintain intervals between injections - 4-6 months, even if at first it seemed that the dose was small for you.

- And if you do it at high doses, then there will be no problems, insensitivity will not develop?

- No. But it is important to observe the interval. And each patient has his own dose. When a patient first comes to me, I ask - what dose was used before? If he doesn’t know or is the first time, I always start with the minimum, but depending on what I see. It happens that a muscle is powerful, “athletic”, and the minimum dose will not have an effect on it. We choose what is necessary for relaxation. Or do we take into account the patient’s wishes – more facial expressions or less? These variations of 5-10 units are obtained.

— When can Botox be repeated?

— On average, once every 6 months. But we always look at the patient specifically. There are those whose effect lasts up to 8 months or a year. The main thing is to wait until the muscle has fully recovered. Now it’s moving, the axons are all working – you can do the next procedure.

9. Is it true that Botox is only used in the upper thirds of the face?

- You are talking about the lower third of the face - I thought Botox is injected only into the upper part of the face.

- Depends on the drug. Some are only certified for the brow area and around the eyes. Others can also be injected in the lower third of the face.

- They relax muscles that are hypertonic. With age, some muscles weaken, and some, on the contrary, become hypertonic. For example, this is a spastic chin. At many conferences and lectures on botulinum toxins, they say that when a child is in the womb, his facial skeleton is closed like a flower, and it gradually unfolds and straightens out. But with age, the opposite is true - bone tissue is destroyed, some parts of the face collapse, the jaws - the person seems to close. This is accompanied by a spasm of the depressor muscles. To straighten this and to prevent ptosis, these muscles are relaxed. These are interesting techniques, but not all doctors work with them - this requires skill and professionalism, this is the next step in working with the toxin.

You can inject the mentalis (mentalis muscle), the corners of the mouth. You can correct a gingival smile (when the gums are visible) - there is a muscle that lowers the upper lip, it can be slightly relaxed. Botox for the face is applied to the masticatory muscles.

- Also for hypertonicity. For example, you cannot sit at the dentist for a long time with your mouth open - this is one of the signs. I'm like that myself. Due to hypertonicity of these muscles, the face may acquire a diamond shape. And when you block these muscles, your face becomes narrower. To people from the outside it seems that the person has lost weight.

10. How to combine Botox and fillers?

— Quite often during Botox they say: “If the wrinkle does not smooth out, you will also need to put filler in it.”

— The need to use filler can be predicted during consultation. A patient comes in with wrinkles on his forehead, he begins to frown, and we evaluate how active the muscle is. It happens that we say that we will do Botox, but the wrinkle will not go away, because over the years it has become wrinkled and turned into deep scar tissue. Then what can you do? First, do the maximum work with the skin: grinding, fraxel, separation (a method when we first try to loosen and separate these creases a little). And only then we do botulinum toxin, and then, if necessary, filler.

— It turns out that it’s too late to get Botox?

- Yes, this happens. Our task is to explain all possible options. For example, if you do not want and are not ready to go to a course of procedures, you can at least take professional care home. The effect will be slow, but work will be done on the quality of the skin. And only the patient decides what he is ready for.

11. When should Botox be done with caution or not at all?

- Hernias of the upper and lower eyelids - they can get worse. Because the muscles in this area (interbrow and orbicularis oculi muscle) also have a lymphatic drainage function. And if you relax them, that’s it, they don’t drain. And the lymphatic and venous vessels do not have their own muscular wall, like an artery; they themselves do not contract - only when they are between the muscles. Why is it advisable to walk when your legs swell? Because the muscles don't work. And if you force them to contract, circulation will begin. It's the same here. The muscle doesn't work - here you have swelling. This is not the case for everyone, we must take into account the anatomical structure of each patient, but cases do happen.

When a person has straight eyebrows, we also need to understand that we will relax the area between the eyebrows and the forehead - and the eyebrow will become even straighter or upturned.

Or, when assessing facial movements, we see that the tails of the eyebrows do not rise - these eyebrows cannot be “raised” due to the redistribution of muscle work thanks to botulinum toxin, no matter how you try.

12. Is it possible to “undo” Botox or change something after the procedure?

— The issue of alteration is debatable. Sometimes it is simply impossible to raise “fallen” eyebrows. What can be done? For example, microcurrent therapy, i.e. procedures that activate blood circulation and restore facial activity.

A direct antidote with the opposite effect is DMAE (dimethylethanolamine), a substance that enhances the production of acetylcholine in the muscle to improve its contraction; essentially tones the muscle. This is a lifting component, it is found in mesotherapy cocktails, it is administered deep intramuscularly, among other things. We recently had such a request from a patient, we discussed it at an internal meeting of the clinic. The patient took DMAE internally and externally - can she have Botox? Our doctors had different opinions. In general, we recommend that patients exclude mesotherapeutically and locally DMAE if botulinum toxin has been administered.

Are there any other questions? Write them in the comments -).