Still trying to decide whether or not Botox® injections would be an adequate anti-wrinkle treatment for you? In order to make the best possible choice, you need to fully understand not only what Botox® is, but how it works and whether or not it is suitable for your condition, lifestyle, and budget. We wanted to give you the most extensive and detailed guide to Botox® injections available today. This resource is packed with information about how Botox® injections are used as an anti-wrinkle treatment and how transforming it could be for you and your unwanted lines.
Still trying to decide whether or not Botox® injections would be an adequate anti-wrinkle treatment for you? In order to make the best possible choice, you need to fully understand not only what Botox® is, but how it works and whether or not it is suitable for your condition, lifestyle, and budget.
We wanted to give you the most extensive and detailed guide to Botox® injections available today. This resource is packed with information about how Botox® injections are used as an anti-wrinkle treatment and how transforming it could be for you and your unwanted lines.
We have included everything you need to know about Botox® injections, from what the Botulin toxin is, how it works, how safe the treatment is, how quickly you can expect results and for how long, how painful the injections are, as well as important aspects which can impact your daily life such as comfort and movement post injection and obviously cost – so you can assess whether or not Botox® injections are the right anti-wrinkle treatment for you and your lifestyle.
Botox® has been used medical field for a long time to treat very specific muscular conditions such as:
Since the mid-1980s however, Botox® has also been used cosmetically to diminesh or prevent the appearance of wrinkles. Cosmetic treatments include:
But what is Botox® exactly? Botox® is made from a neurotoxin called botulinum toxin that is produced by the bacterium Clostridium botulinum, an organism found in the natural environment (including soil, lakes, and forests) where it is largely inactive and non-toxic. Infection with the organism is dangerous to human health as it causes a potentially fatal disease called ‘botulism’. Botox is, however, the purified form of Botulinum toxin A and is generally considered very safe when injected into the muscles or veins.
The drug carries an FDA warning stating it has the potential of spreading to other sites when the injection is administered. The warning was made compulsory in 2009, following deaths associated with Botox use. This does not mean the drug is unsafe though as there have not been confirmed cases of spread of the toxin away from the injection site when administered at the recommended dose for many of its approved medical and cosmetic applications. Many people have been successfully treated with the drug without any pronounced side effect.
The process of administration is simple. In its purest form, the Botulinum toxin comes in as a very fine white powder. The powder is then diluted in a saline solution which makes it easy for your practitioner to inject into the desired area.
Wrinkles are formed by a process called ‘dermal atrophy’ and repetitive contraction of the underlying facial musculature. This normal aging process is essentially down to the constant movement of the face and forehead (when eating, blinking, smiling, etc) and a loss of the skin’s elasticity over-time – creating fine lines in the early days and deeper wrinkles later on in life (for the most part)
Botox® allows practitioners to essentially tackle both dynamic wrinkles, those seen during muscle contraction, and static wrinkles, those which are visible at rest.
The Botulinum toxin is used to reduce fine lines and wrinkles and injected in very little concentrations into the desired area by your practitioner using a syringe and a small needle.
These small injections of Botox® work by targeting the nervous system and disrupting the signaling process that allows neurons to communicate effectively with muscles, thus weakening or paralyzing those muscles altogether.
From a more technical standpoint, this type of treatment relies on the fact that for muscular contractions, they rely on the nerves releasing a chemical component called acetylcholine, at the meeting point between the nerve endings and muscle cells. This chemical messenger travels down the nerves. It is then attached to receptors on the cells of the muscle, bringing about muscle cell contraction.
By injecting botulinum toxin in the treated area, it simply stops the acetylcholine release. This, in turn, means that acetylcholine does not travel down the nerves and therefore cannot attach itself to receptors on the muscle cells – thus thwarting muscle cells contraction.
The mechanism of action of Botox is basically the same for all the conditions the drug is used for. The brain controls all the activities in the body by the action of nerves which carry chemical signals. Sweat is produced by the sweat glands after receiving a chemical signal from the brain. Administration of Botox to the underarm region temporarily blocks the transmission of signals from the brain to the sweat glands present in the armpit. This stops sweat production in that region for the period through which the Botox injection acts. Hyperhidrosis is, therefore, adequately controlled in most cases.
It would only be logical to ask where the sweat is retained as you probably known that sweat is one of the body’s means of excreting waste products. The sweat technically is not retained in the body. Botox does not cause any significant change in the volume of sweat produced by the body. The sweat is still expelled but it is only produced and the release elsewhere. Body odor arises form underarm sweating because of the lack of free air movement in that region. Moisture is retained for longer periods and the bacteria producing the odor is allowed to thrive in the moist conditions. Most other areas of the body are adequately ventilated and production of sweat in those areas does not lead to body odor hence the life changing results for many people suffering from this disorder.
For the treatment of TMJ/Bruxism with Botox, the masseter, temporalis and the medial pterygoid muscles are typically injected. Treatment with Botox is being explored since TMJ pain and Bruxism have been discovered to occur as a result of multiple factors. A multidisciplinary approach to management of the pain is advocated. Botox is thought to reduce Bruxism by disrupting the transmission of signals in the trigeminal motor nucleus, inhibiting the central Bruxism generator through the paralysis of the mandibular muscles. Another mechanism thought to be responsible for the activity is the deactivation of the periodontal mechanoceptors during mastication. This would aid the closure of the mandibles by the motor neurons.
‘It’s completely painless’ has to rank as one of the most told lies in history. So often, nurses trying to be kind have told us or our kids that an injection won’t hurt a bit. Many times the statement ends up being believable, as only slight pain is felt. Some other times, it’s an outright lie. Botox injections have to fall under the “many times” category in this discussion. Under normal circumstances, experiencing a Botox injection has not been associated with moderate pain, or anywhere near severe pain but simply as the normal pain/discomfort that is expected from inserting a needle into any part of the body, a Botox injection does not cause more than a pinch or sting to be fair.
The site of injection also influences the sensation of pain. Patients receiving the injection around the eye area and lips tend to feel more pain than other sites. Injections administered to the forehead are typically less painful due to the thicker and less sensitive skin in that region. This is, however, not a general rule for everyone. Some may find other areas more painful than the ones mentioned. Genetics also play a role in skin sensitivity and consequently, the sensation of pain. So the next time you see adverts describing Botox injections as pain-free, you should know that it may not be completely true as different people have different pain thresholds. What is true, however, is that it is very uncommon to see a patient writhing in agony when leaving the doctor’s office after undergoing Botox injections.
If you feel you are unable to tolerate any form of pain, a local anaesthetic or numbing cream may be administered prior to your Botox injection as well as using cold compress or ice before infection. Although this would make the injection less painful, it is rarely needed. An experienced practitioner and their technique will always be able to address a patient’s fears, anxiety and manage their pain during treatment.
A typical Botox treatment only takes a few minutes. Your doctor may have already prepared the dilutions before you get to the clinic for your appointment. All that remains is locating the right muscles and administering the injections. You can always get right back to work or resume your daily activities on the day you receive your Botox injections. You have to remember that the first few hours after your injection is crucial if you are to avoid unwanted effects. Refrain from rubbing/massaging the injection site or lying down within that period to prevent Botox migration.
Botox injections typically wear off in about three to six months. Your wrinkles may start re-appearing within the said period and you may need to start thinking about getting a top up. The appearance of wrinkles is a normal sign of ageing but can be appropriately managed with long term use of Botox.
The onset of results for Botox treatments vary with individuals as well as the area of the body treated. Generally, Botox is expected to start having visible effects within three to four days after injection. Some patients may see the results earlier while it could be delayed for some others. On the average, it takes about 2 weeks for maximum results to be seen. So if you are planning to have a Botox treatment to get you ready for an event, tailoring the treatment to about 2 weeks prior to the event would be a great idea. You would be experiencing the full effect of the drug by then and whatever bruise or discomfort you may get from the administration would have been long gone by then.
The results after the Botox injection are expected to last for about three to six months. The binding to the nerve that causes muscle paralysis is not permanent. As the muscle gradually begins to regain its mobility, the wrinkles begins to re-appear. The re-appearance indicates the effect of the Botox injection is wearing off and another shot may be necessary. With continued use of Botox, the lines and wrinkles gradually become less severe as the muscles begin to shrink (atrophy) after an extended period of inactivity. Topical forms of hyuloranic acid creams and serums should be used in order to keep skin hydrated and glowing in conjunction with the use of botox in order to achieve the best results long term.
Botox is an FDA approved treatment for a specific number of areas and conditions. If administered by a professional, Botox injection is generally safe and the incidence of severe side effects is very minute. Like any drug though, the potential for side effects cannot be completely overruled. Due to the route of administration, the risk of bruising or swelling of the injected area is always present. This could come with pain and discomfort. You may need to take an analgesic for your pain but if the pain remains at uncomfortable levels, you may need to see your healthcare provider.
If you had your Botox injection close to your eye, you may experience drooping of the eyelids due to Botox migration. If this occurs, it could last until the effects of the injection wears off (about 3-6 months). You may have to live with it if it doesn’t cause any symptoms. If you are however experiencing other symptoms such as double vision, please contact your healthcare provider immediately.
Administration around the lips also poses a great risk. If incorrectly administered, the drug could paralyze all the muscles in the lips, leading to inability to move the lips and consequently, inability to carry out some essential functions such as speaking coherently.
Some other side effects have been reported following Botox use but most are usually mild and resolve in 24-hours or less. Such side effects may include nausea, facial tightness, dry-mouth, sore-throat, flu-like symptoms, etc. If these symptoms persist or worsen, you may need to seek medical attention. The possibility of severe allergic reactions also exists; just like those present for any other medication. Such reactions normally occurs almost immediately after the drug is administered. Since you would be having your injection from a licensed practitioner, adequate provisions would be made in case such a reaction occurs. In the unlikely event that the reaction is delayed, please contact an emergency service if you notice symptoms such as difficulty in breathing, tightness in your chest, bulging tongue, severe itching around injection area or all over the body etc.
Studies are ongoing to establish the long term safety of Botox injections. At present though, no debilitating long term side effect has been observed. Some studies have shown that prolonged use of Botox may lead to muscle atrophy and appearance of new wrinkles in sites that are compensating for the lack of movement elsewhere. Botox has also been reported as addictive, especially if started at an early age.
The drug carries a boxed warning citing the potential for a very serious complication. This could occur if the toxin is not diluted properly or is allowed to enter the systemic circulation or spread to other areas of the body. The classic signs of botulism including weakness, trouble seeing, fatigue and slurred speech may occur. This condition is life-threatening and should be treated as an emergency.
Reports of such occurrences have majorly been attributed to the illegal use of Botox. It is important to ensure you get your injections from a registered physician.
If you are taking any other medicine, please inform your doctor before getting a Botox injection. Interactions with antibiotics, blood thinners, muscle relaxants, sleeping pills, cold or allergy medicine, bronchodilators, and many other prescriptions and over the counter drugs have been reported. These interactions could affect the activity of Botox or the drug it is coadministered with.
There has been no definite conclusion about the safety or otherwise of Botox during pregnancy. It is generally advised that Botox for cosmetic purposes should not be given to pregnant women as the benefit does not outweigh the risk.
You should also inform your doctor if you have any disorders such as bleeding disorders or muscle and joint disorders.
Botox treatment typically doesn’t end with the administration of the injection. You still have to take some precautions if the treatment is to be effective and some undesirable effects are to be avoided. Immediately after Botox administration on your face, you should never lie down or massage the injection area for at least four hours. This is to prevent the drug from spreading to other regions of the face where it would only produce odd results. This concept is known as Botox migration and it is principally responsible for drooping of the eyelids occurring in many people after receiving Botox injections. You should take even more precaution if you received the injection around your eye. Your practitioner may also recommend face exercises at intervals. The exercises are typically recommended within one to four hours post treatment. The exercises are considered beneficial because Botulinum toxin attaches more strongly to nerves that send signals to muscles that are active or in regular use. Remember, no matter how beneficial your practitioner may say the exercise is it should never involve touching or rubbing your face.
Disinfection of the treated areas may be necessary to prevent infection. The wound inflicted on the injection site is always tiny and should not take more than a day to heal up. Within the 24-hour period, you should not touch your face with unwashed hands. If you start feeling persistent pain or notice excessive swelling or redness in the injection area, applying an ice pack should make your symptoms go away. You should wrap the ice in a towel before applying it on the affected area with slight pressure. Makeup should be avoided immediately but hydrating creams and serums on clean skin should be encouraged to help keep skin healthy and glowing.
Complications are rarely seen if the Botox administration is handled by a professional. If the administration goes as planned, you should be able to return to work on the same day. You need not suspend your daily activities but it is advised to refrain from extensive physical activity like gym, swimming, sauna immediatly after injection to avoid migration of the product.
Botulinum toxin is commercially sold under the following names in the UK:
Cosmetic use of Botox is not generally covered by health insurance and although Botox treatment is usually less expensive than surgical interventions, you should still consider the cost before undergoing Botox injections. As a recurring expense due to the limited longevity of effects, one must factor into a yearly budget the administration of botox every 3-5 months.
The overall cost of Botox injections hinges on a number of factors including location of clinic, the level of expertise of the physician, range of areas treated and the type of botox used. Botox treatment may range between £100 - £500 or more depending on the factors listed above. Many practitioners offer promotions throughout the year so you may think about getting your Botox injections in that period if you are on a budget. Discounts are usually offered to repeat customers and customers treating multiple areas at once. You should be wary of prices that are looking too affordable because the quality of Botox injections could be compromised. Always ensure you get your shot from a registered physician, cosmetic surgeon, dentist or aesthetic medicine practitioner.
If you are looking for a dentist or facial aesthetic practitioner that does dermal filler injections in your local area, look no further. Smileo has over 2,000 private dentists in the UK, all performing a range of different facial aesthetic treatments including botox injections, dermal fillers, lip augmentation, non-surgical rhinoplasty, PRP injections, thread lifts, or chin augmentation. To find a practitioner near you, simply enter your preferred location in the search bar below and refine your search results to find the dentist that best suits your needs.
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