“And the beauty of a woman, with passing years only grows!” ― Audrey Hepburn

• Aging is an ongoing and inevitable process.  Even though it gives people an aspect of maturity and wisdom , the lines & wrinkles which come along with it are not welcome by most.
• Senescence of facial skin is attributed to various internal & external factors.

Internal – genetically determined natural slowing process of the body.

External –  UV radiation (exposure to direct sunlight), gravity, chemical pollutants, physical & mental stress, and social habits like smoking.

• As we age our skin looses moisture & elasticity making it more prone for wrinkles.  These wrinkles are initially Dyanamic- that is accentuation of normal skin creases when we use muscles to form facial expressions, which later become Static or Fixed – the creases that are present even at  rest becoem wrinkles.
• So how do we get rid of these? With the advent of  Botox, a minimally invasive,affordable, safe procedure with practically no down time, this goal is easily achievable.

What exactly is botox ? 

Botox or botulinum toxin, is an FDA approved natural purified protein that relaxes the muscles that cause wrinkles.

How does botox work? 

It relaxes the muscles contractions by blocking nerve impulses. As the injected muscles cannot contract, the wrinkles relax and soften.

Is there an age limit for taking Botox?

Any person between ages 18 to 65 years.

Who should be performing the botox procedure?

It should be done by a qualified and trained dermatologist or cosmetologist.

For what all conditions is botox recommended? 

• Horizontal lines on forehead
• Frown lines
• Crow’s feet around the eyes
• Brow lift
• Bunny lines on the nose
• Neck bands
• Downturned corner of lips
• Chin creasing
• Sagging jowls
• Hyperhydrosis – excessive sweating on palms , soles and underarms
• Mesobotox – to treat fine lines and mild sagging. Not related to any particular muscle group

When is botox not to done?

• Pregnancy
• Lactation
• Neuromuscular disorder  : eg myasthenia gravis
• If person is taking cerain drugs–succinylcholine, d-pennicilamine, anti malarials, aminoglycoside antibiotics, cyclosporine
• Infection at the injection site
• Hypersensitivity (allergy) to the drug

How long does Botox treatment take?  

One session usually takes around 10 min to 15min.

Is the treatment painful? 

Doctors usually numb the injection site with a cold pack or topical anesthetic cream which makes it absolutely painless.

Any special care to be taken after the procedure?

• Regular activities can be continued immediately post procedure; however patient is adviced not to lie down for 4 hours post procedure.  Sitting or reclining upto 45 degrees is permitted
• Activities involving strenuous bending like lifting weights, swimming, heavy workouts to be avoided for 24 hours after the procedure
• No steam, sauna, massage or manipulation of the injection site is to be done for 48 hours post procedure.
• Parlour services like facial and massage can be done 2 weeks after the procedure.

When are the results apparent?

Results start appearing within 4 to 5 days but full effect is seen only after 7 to 10 days

How long does botox effect last? 

It usually lasts for 4 to 6 months but results may vary.

Will the lines worsen once you discontinue Botox? 

Wrinkles will not worsen on discontinuation and will return as they were before treatment.

What are the possible side effects?

• Redness and bumps –they settle in a few hours.
• Bruising- settles in about a week’s time.
• Headache.
• Infection if proper asepsis is not maintained.
• Lid ptosis (drooping), brow ptosis—rare with experienced hands.

Does it give one a numb or frozen look? 

It does not affect the nerves that cause sensation or make you feel numb. Frozen look is only when too much of drug is used or botox is used inappropriately.

What are the pre-requisites to botox treatment?

• History & examination
• Understanding client’s expectations and sharing realistic approach about the outcome
• Written &informed consent .
• The patient should be off vitamin E, blood thinners and muscle relaxants for atleast  7 days before the procedure.

Are there other uses of Botox besides cosmetic? 

Yes, it is used to relieve symptoms in

• Migraine
• Cervical dystonia
• Blepharospasm (eye lid spasm)
• Squint.
• Cerebral palsy
• Parkinsons disease

Conclusion

Botox has been in the market since the last 30 years and its mysterious uses are still unravelling. It is such a paradox that a toxin when used in the right dose and in experienced hands can be an elixir for aging.

No wonder its truly called  a miracle drug!

Dr Pramila Shetty, Masters in Dermatology (MD); a practicing Cosmetologist for over a decade, has several awards and presentations to her credit. She specialises in treatment of Chemical peels, Microdermabrasion, Dermaroller, Laser for acne scars, Laser hair removal, Mesotherapy, Radiocautery, Botox & Dermal fillers.