What is Botox?
It is a neurotoxin, a protein secreted by Clostridium Botulinum, a bacterium. Contrary to what is known, it is not related to snake venom. Botox is the name of the commercial preparation and its original name is Botulinum neurotoxin type-A. It is used to relax the muscles. In 1980, it was started to be used in the treatment of strabismus, it was observed that wrinkles between the eyebrows improved in these patients and cosmetic use of botox started in the 1990s. In 2002, it was approved by the FDA.
How Does Botox Work?
It is effective on wrinkles caused by muscle movements, that is, mimic wrinkles. By relaxing the muscles, it is possible to relax and soften wrinkles with botox. It prevents the release of a neurotransmitter called Acetylcholine, which is released from the nerve endings, which allows the muscle to contract. Thus, it provides temporary relaxation in the muscles. Acetylcholine is also the neurotransmitter that stimulates eccrine sweat glands.
For Which Areas Is Botox Suitable for Wrinkle Treatment?
It is mostly used in the upper face area for aesthetic purposes, namely wrinkles between the eyebrows, wrinkles around the eyes (crow’s feet) and forehead wrinkles.
It can also be combined with other aesthetic methods and used in the perioral, chin and neck area. The use of the lower face requires a good knowledge of anatomy and should be performed by experienced physicians:
Bunny lines (Bunny lines): These are the lines formed on the upper edges of the nose. In some people, they may extend to the cheek and lower eyelid. These lines appear when the patient laughs or frowns, and sometimes they are formed by too much contraction of the nasal muscles to compensate for the relaxation of the muscles between the eyebrows, forehead and eye edges after botox for the upper face area. If the botox applied here is done incorrectly, upper lip sagging and drooping in the corner of the mouth may occur.
Nasal tip lift can also be achieved with botox.
Perioral wrinkles, that is, vertical wrinkles above the upper lip; It occurs with the decrease in the support in the upper lip with age and excessive movement of the muscle surrounding the mouth. Botox can be used as an auxiliary treatment method in these wrinkles. However, it should be applied with caution, eating, drinking and speaking may be adversely affected, and side effects such as mouth asymmetry, drooping of the corner of the mouth, and inability to swallow saliva may occur.
Botox can also be used in sagging at the corners of the mouth called marionette lines. These lines make people look sad and dissatisfied. But this application alone is not enough, it is recommended together with filler injection.
Again, small touches can be made to the wrinkles in the upper cheek area.
It can also be used in hypertrophy (thickening) of the chewing muscle in the lower cheek area seen in some people.
The orange peel-like chin is formed by the contraction of the jaw muscle and Botox can be used to achieve a flat appearance. If there is also a decrease in subcutaneous fat tissue and collagen loss in this area, it should be supported with filler injections. Incorrect applications cause lower lip dysfunction and inability to swallow saliva.
Again, necklace-style wrinkles in the neck area and vertical bands that appear in some thin people when they speak or laugh can be treated with botox. Those who will benefit the most from this treatment are young patients with good skin elasticity. However, swallowing difficulty, breathing difficulty, hoarseness, inability to lift the head from the pillow may be observed after this application.
The effect starts to be seen 48 hours after the application, it takes its final form in 10-15 days. Therefore, retouching is done after 10-15 days.
Although the effectiveness due to botulinum toxin may be different between individuals, it usually lasts 3-5 months. However, some prolongation of the effects can be seen in those who have regular botox. Even once a year is enough for these people. It may be necessary to use the treatment more frequently in those who have larger facial muscles or use facial muscles more. Over time, the facial muscles have the habit of not moving much and the time between sessions is prolonged and the dose is reduced.
Botox is a reliable, risk-free application that can be an alternative to some surgeries in competent hands that provide highly controlled application. Recently, botox and filling procedures are performed even in beauty salons and hairdressers. Please do not surrender your face to people who are not trained in facial anatomy and medicine. Botox and other medical procedures are prohibited in such places, even if performed by a doctor. Even dentists or other branch doctors are prohibited from performing such procedures. Only DERMATOLOGIST and PLASTIC SURGERY doctors can do it.
The pain during the procedure depends on the pain threshold of the patient. The anaesthetic cream applied beforehand reduces the sensation of needle insertion, but does not reduce the burning sensation caused by the drug itself. Since the procedure is very short, there is no unbearable pain.
The use of anaesthetic cream before the application is 15-20 minutes. Afterwards, the procedure takes about 10-15 minutes. It is performed while the patient is sitting in an upright position.
What to do before and after Botox?
Aspirin, painkillers other than paracetamol, vitamin E-containing agents, gingko biloba, green tea should be discontinued 10-14 days before the procedure to reduce bruising. Alcohol intake up to one week before the procedure also increases the risk of bleeding and bruising. A control examination is called 15 days after the procedure and touch-ups can be made.
After the procedure, the patient should sit upright for 1-2 hours, the head should not be tilted and frowning, raising eyebrows and laughing movements should be repeated 5 times in 5 minutes for 1-2 hours. The aim is to ensure that the drug stays where it is given.
What are the Complications of Botox?
If not performed by specialists, asymmetric eyebrows, eyelid drooping, bruising, double vision, outward curling of the free edges of the eyelids (ectropion), asymmetric smile, eyebrow drooping, mask face, asymmetric raised eyebrow (devil’s gaze) may occur after botox treatment of interbrow, forehead and crow’s feet lines. Mask face, which is one of the most feared side effects, depends on the amount of medication given.
The properties of the drug, application methods and the experience of the person performing the procedure are the most important factors affecting success.
Who Cannot Receive Botox?
Those with neuromuscular disease, pregnant and breastfeeding, those who use aminoglycoside and similar drugs (the effect increases), those with skin disease or infection in the injection area, those who are allergic to its content (such as albumin).
Reasons for Differences in Botox Prices?
The difference in Botox prices depends on 2 reasons. One of them is the price of the drug and the other is the value of the doctor’s art.
There are 2 most commonly used preparations: BOTOX and DYSPORT. These drugs are very expensive drugs that need to be transported by cold chain. Apart from these two products, which are purified by different methods and have different properties, there are much cheaper Chinese-made preparations that are not FDA approved and have a high potential for side effects.
The drug is diluted and applied immediately before application. One vial of the drug is usually sufficient for two young women with few mimic wrinkles. In this case, the price of botox is more affordable. However, a single vial is used in women with more mimic wrinkles or in men with strong facial muscles.
Sometimes the drug is diluted more than recommended, thus cheaper botox price can be given. In this case, your wrinkles may not be opened and even if they are opened, the effect may pass in a shorter time. There is also an increased risk of side effects.
As of 31.12.2013, with the decision of the Ministry of Health, the use of Botox has been regulated to be used by responsible medical doctors in private hospitals and practices, and its retail sale through pharmacies has been stopped.
People who want to have Botox should carefully approach cheap prices, before having Botox, it should be questioned how long the doctor has been doing this procedure and the brand of the drug should be investigated.
What is excessive sweating?
Excessive sweating can be localised or widespread. It is usually caused by emotional or thermal stimuli. Regional excessive sweating can be seen in the palms, soles of the feet, armpits or head. The cause is usually structural. Aluminium salts, iontophoresis, medication and surgical treatment can be applied in the treatment, but the effectiveness of some of these treatments is low and the risk of complications is high. Recently, botox application has emerged as an effective and reliable treatment.
Diffuse excessive sweating develops secondary to endocrine, metabolic, neurological or neoplastic conditions. It is treated by eliminating the underlying cause.
Mechanism of Action?
It prevents cholinergic stimulation of eccrine sweat glands and prevents sweat secretion caused by stimulation of eccrine glands.
Which Areas Is It Applied?
It can be applied to the armpits, palms and soles of the feet. However, hand and sole applications are quite painful. The effect is not as strong as armpit botox.
When does the effect start and how long does it last?
The effect starts after 2 days and is completed in 15 days. It lasts for 6-9 months. Most patients prefer to have it done once a year in March-April periods in order to spend the months with the most sweating comfortably.
Side Effects?
Bruises may occur, fatigue and weakness may be seen for about a day.
What to do afterwards?
24 hours of excessive exercise should be avoided.