Botulinum toxin (also popularly known as botox) is a substance used to reduce wrinkles. Botulinum toxin is used primarily to loosen facial muscles that take care of facial expressions. Because of this muscle slackening, wrinkles are hardly or not visible. Botulinum toxin is also used against migraine, tooth grinding and excessive perspiration.
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For more than 25 years, botulinum toxin has been used for various cosmetic treatments. The drug became rapidly popular in the 1990s as treatment with botulinum toxin proved to be the ultimate anti-ageing solution. Nowadays, women and men increasingly opt for treatment with botulinum toxin to maintain a fresh, youthful appearance. Botulin toxin is mainly used to relax the muscles that tighten when you make certain facial expressions. Think for example of frowning, looking surprised or laughing. The typical deep wrinkles caused by facial expressions will fade with botulinum toxin. The best effect is visible where the facial expression is best expressed. The agent is used for various mimic muscles. Usually, women and men opt for a treatment of frown wrinkles, forehead wrinkles and crow’s feet. In addition to reducing wrinkles, botulinum toxin is also used for eyebrow lift, excessive perspiration, migraines, tooth grinding and visible gums when laughing (gummy smile).
Botulinum toxin is a natural protein produced by the bacterium Clostridium Botulinum. Originally it was used to treat muscle spasms and other muscle tensions. Only later it was discovered by chance that it is also a suitable agent for cosmetic purposes. To tighten a muscle, it needs a stimulus from a nerve. This so-called stimulation transfer happens by the release of a stimulating substance from the nerve to the muscle. Botulinum toxin ensures that this substance is hardly or not released and the stimulus transfer is thus partially or even completely blocked. As a result, the muscle can hardly or no longer contract. In the treatment of excessive perspiration, botulinum toxin works in the same way. Blocking the stimulus transfer prevents the sweat glands from producing sweat.
Botulinum toxin and fillers are not the same. Botulinum toxin is often confused with fillers. Botulinum toxins and fillers are substances belonging to the injectables. As the name says, these are substances to inject. Both products work very differently. Botulinum toxin is used to treat dynamic wrinkles, i.e. wrinkles caused by muscle tightening, and fillers are used to treat static wrinkles, i.e. lines caused by sagging and ageing skin. What botulinum toxins and fillers have in common is that they are used to reduce wrinkles.
Before you undergo a botulinum toxin treatment at Betan Clinics, a free consult is scheduled to discuss your request for help and to check whether you qualify for a botulinum toxin treatment. During the consultation, you will have all the space you need to discuss your wishes. The plastic surgeon listens attentively and always gives free and honest advice to come to a personal treatment plan. He will clearly explain what is feasible in your case and what you can expect from the results. Before you come to the consult, we will send you a short questionnaire with medical questions by email. This will ensure that during the consultation with the plastic surgeon, there will be more time for your questions and discussing your wishes. The plastic surgeon will look at your medication use, medical background and the questionnaire you have already filled in digitally at home. All these details are necessary to ensure that a botulinum toxin treatment can and may safely take place. How the treatment is carried out will also be discussed. The plastic surgeons at Betan Clinics will assess your facial expressions and take into account that the natural features of your face will remain visible.
Philosophy of Betan Clinics: less is more! The typical media examples of excessive botulinum toxin use is an absolute ‘no go’ for Betan Clinics, and therefore we choose to use less rather than more botulinum toxin. In other words: less is more.
A botulinum toxin treatment takes place through an injection with a very fine needle. You don’t feel much of it, and you only notice it as a small pinprick. For comparison in women: tweezing the eyebrows or waxing the legs is much more painful. A local anaesthetic is therefore not necessary. Per treated zone, the plastic surgeon injects a tiny amount of botulinum toxin into the right muscle. Injection with botulinum toxin has no adverse health effects. After treatment, the skin may be somewhat swollen and red. This usually lasts for 1 to 2 hours. Botulinum toxin ensures that the nerves under the skin can no longer send a signal to the muscles so that the muscles can no longer tighten and wrinkles are barely or no longer visible. The treatment takes an average of 5 to 10 minutes, and you can go home immediately after the procedure. Have you had the treatment before? Then the result will remain valid for a more extended period up to about six months. Before you undergo the treatment, the plastic surgeon will ask you to sign a treatment agreement so that you and the plastic surgeon are aware of the procedure and expectations. Before and after the treatment, detailed photos will be taken to assess the result together with you as best as possible. The images will be securely stored in your medical file and will not be made public. Only with your own explicit, written permission can photographs be used for other purposes (e.g. for a congress).
A botulinum toxin treatment ensures that the muscles can no longer tighten so that no wrinkles are visible. How long this result lasts varies from person to person. On average, botulinum toxin is depleted after 3 to 6 months, and you can choose to repeat the treatment or not. Botulinum toxin is not used for volume treatment such as the treatment of lips and cheeks. Fillers are used to create more volume. Besides fading wrinkles, botulinum toxin is also used for an eyebrow lift or to soften folds in the neck, but also to treat migraines, tooth grinding and excessive perspiration. The plastic surgeon will discuss with you beforehand what the expected results are and will make sure that you are well aware of this expectation pattern. Results may vary from person to person.
On average, botulinum toxin is depleted after 3 to 4 months and you can choose whether or not to repeat the treatment.
Treatment with botulinum toxin is safe. In general, there are no complications or dangers during treatment. There is a very small chance of allergic reactions. This risk is small because the dosage used is very low. There are hardly any side effects of botulinum toxin. When treated with botulinum toxin, an undesired reaction can never be ruled out 100%. In exceptional cases, injection with botulinum toxin can unintentionally cause an asymmetry. A drooping eyelid can then develop. This is temporary and will disappear over time. Infections are also rare. That is why the plastic surgeon will carefully assess during the consultation whether you qualify for treatment with botulinum toxin. For example, pregnant women, women who are breastfeeding or people with a muscle or nervous disorder for which they are being treated are not allowed. In 1 to 2% of the cases, someone has natural antibodies against botulinum toxin and the treatment will have no or insufficient effect.
Frequently Asked Questions (FAQ)
Botulinum toxin is a toxic substance in very high concentrations. In cosmetic treatments, botulinum toxin is used in very diluted concentrations and is therefore non-toxic and not harmful to your health. Botulinum toxin is also a natural protein that is broken down by the body over time. The treatment is entirely safe.
With age, wrinkles become more profound and more visible. An early wrinkle at a younger age can, therefore, disappear completely with botulinum toxin. For deeper wrinkles at an advanced age, a combination of botulinum toxin with wrinkle fillers is a more suitable solution. An advantage if you are treated early with botulinum toxin is that wrinkles do not get deeper because you hardly or not at all use the muscles. At a later age, you do not need additional wrinkle fillers or other treatments. The legal minimum age for a botulinum toxin treatment is 18 years.
There are few known objections not to be treated with botulinum toxin. The treatment is not possible if you are pregnant, breastfeeding, under 18 years of age or if you have a specific muscle or nervous disorder.
We advise not to consume alcohol for 24 hours in advance. Do you use blood thinners? Then discuss with the plastic surgeon whether you should stop them temporarily for the treatment.
The plastic surgeon will discuss the medication with you beforehand. Usually, it is not necessary to stop taking medication except for some blood thinners.
Regardless of whether or not you are undergoing treatment, we advise you to stop smoking. Smoking harms the blood flow to the tissues, especially when the tissues recover after treatment. We therefore urge you to stop smoking a few weeks before procedure and to continue this after the treatment as quitting smoking has a beneficial effect on slowing down the ageing process.
No, this is not allowed. The plastic surgeons will not treat you if you are pregnant or breastfeeding.
By a zone we mean an anatomical region in the face that is treated with botulinum toxin. Examples of zones are the frown, the forehead or the eyes (crow’s feet).
Injections with botulinum toxin are made with very fine needles that usually feel like a pinprick. It is not perceived as painful by most people. The skin can be cooled with cold packs before and after treatment to reduce any discomfort.
Botulinum toxin is depleted after 3 to 4 months. The duration of the effect depends, among other things, on the number of treatments you have already had. If you have had more treatments, the result will last longer. Botulinum toxin does have a long-term improving effect on the skin if it is used for several years. Because of the treatments, the wrinkles can hardly or not deepen, and there is a good chance that you have lost the ability to use these muscles (e.g. the muscles for frowning).
At Betan Clinics, we strive to preserve a natural mimicry. Plastic surgeons achieve this by using very selective botulinum toxin with the right amount in the right place on the face. A typical ‘poker face’ or an expressionless face is always avoided.
Treatment with botulinum toxin does not lead to scars.
In exceptional cases, this is an unintended result of botulinum toxin, and you will feel heavy above your eye for a few weeks. This will disappear over time. Thanks to the vast experience of the plastic surgeons and detailed knowledge of anatomy, this risk is reduced as much as possible. By selectively injecting the botulinum toxin, this risk can be prevented.
You may and can return to work immediately after treatment provided you can keep your head upright. One day after the treatment (or even the same day), you will be fully presentable again without redness or swelling.
We advise you to keep your head upright for up to four hours after treatment and not to lie down. This promotes the action of the botulinum toxin in the desired zone and prevents it from spreading to other muscles.
We advise not to consume alcohol 24 hours before treatment. You are free to drink alcohol after the treatment. This does not affect the treatment or results.
Apart from the natural ageing process, you will not have more wrinkles than before the treatment. Because you have hardly been able to tighten the muscle for a few months, no new or deeper wrinkles appear, and the skin has had time to recover. Also, you have not been able to use the muscle for several months, so you may have lost the ability to use this muscle frequently. Think, for example, of frowning.
If botulinum toxin is injected the wrong way or in the wrong place, unintended effects such as asymmetric movements in the face, a drooping eyebrow or eyelid or an expressionless face may occur. These effects are temporary but undesirable and should always be avoided.
It is not possible to pay afterwards or in instalments.