Botulinum toxin botox®– Explanations: Doctor POIGNONEC plastic surgeon in Paris

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Botulinum toxin injection what is it?

Botulinum toxin injection treatment has become the most commonly used technique worldwide, becoming the best technique to soften the most unsightly facial expressions (aging, fatigue, stress, sadness), and their wrinkles of expression.

For aesthetic procedures, only two products have been authorized. The (Botox®) is a specific brand name that sells this molecule, exclusively reserved for the field of neurology.

Botulinum toxin for wrinkle treatment

Duration of the gesture : To inject a face, it is necessary to count 15 minutes about.

These techniques have progressed with an infiltration capacity that produces an effect facelift or immediate mini-lifting, without surgery.

The principle of the treatment is to inject certain strategic points of the facial muscles to lift facial structures, for example, eyebrows, chin, nose and cheeks which gives a fresh and natural look, and thus improves the tired appearance or a sad face.

Wrinkles treatment by injection is particularly suitable for :

• Front wrinkles
• Lion wrinkles
• Crow’s feet
• Rabbit wrinkles
• The most naso-genian
• “Bitter wrinkles”
• Platysmal neck strings

What techniques to choose to fill facial hollows and wrinkles that make you look tired?

For all those who wish to remain elegant at any age! The first step is to fight with small arms. You have to cheat a little. The first steps in the fight against ageing can be taken without a scalpel.

The combination of botulinum toxin treatment with remodeling

It is thus necessary to choose soft techniques to fill the hollows of the face and the wrinkles which give the tired air in order to have a younger, more fleshy, and more dynamic face.

Which wrinkles are treated with botulinum toxin ?

• Botulinum toxin injections soften, without surgery, expression lines due to the contraction of facial muscles and forehead or horizontal wrinkles, as well as those between the eyebrows called “lion wrinkles”, or even those around the eyelids called “crow’s feet”…
• To reduce facial folds such as nasolabial folds, bitterness folds or chin folds…
• To erase the breaks at the edge of the mouth (the stamp-like appearance). Although its effect is transient, its implementation is easy and less traumatic, allowing its effects to be extended indefinitely by series of injections.

Botulinum toxin before after

Pre-injection preparation

The practitioner evaluates all the regions to be treated and the different types of wrinkles.

• He then prescribes a anesthetic cream to be applied 30 minutes before the session and, if you are easily subject to hematoma, homeopathic arnica to be hung for the 3 days preceding the treatment.
• It is better to avoid aspirin and anti-inflammatories one week before and after treatment.

How does a botulinum toxin injection work?

• For forehead wrinkles and eye contour, the doctor will prefer this molecule that smoothes the skin and relaxes the eyes by relaxing the muscles.
• The botulinum toxin aims to release them, which prevents the formation of expression lines. The muscle is pricked in several places with very fine needles; this practice is not painful. The injection is fast, the quantity of liquid is tiny, barely a few millilitres.

What are the recommendations after treatment ?

• Maintain the vertical position of the body during the first 4 hours.
• Do not massage or knead injection sites.
• Avoid exposure to high temperatures at the injection site within the first two weeks (warm compresses, bathroom, sauna, solarium) due to possible decrease in effect.

By choosing a qualified and competent practitioner, trained in this type of treatment, you limit these risks as much as possible without however completely eliminating them. In any case, after these injections, do not hesitate to contact the plastic and aesthetic surgeon, if you have any concerns.

• By the end of the session, wrinkles have already disappeared. But the final result is visible only about ten days after the operation. For botulinum toxin, it is necessary to plan one injection every 6 months …
• The more you do these injections on a regular basis, the longer the efficacy increases.
• Small transient rednesses can sometimes appear, or even haematomas. In all cases, the effects are completely reversible with a return to the initial state in case of dissatisfaction.
• The result is often spectacular especially for the position of the eyebrows and the opening of the glance, rejuvenation effect is undeniable and we really gain ten years if the injection is well conducted.
• People with migraine risk a headache because the product tends to cause headaches.

What are the contraindications of the procedure?

• Pregnancy, breastfeeding.
• Somatic diseases in the acute phase.
• Acute infectious diseases.
• Local inflammation for the injection site.
• Neuromuscular disorders (myasthenia gravis).
• Hemophilia.
• Antibiotics (if no more than two weeks after treatment).

Some rare side effects may occur

Side effects are transient.

It can be

• Redness: localized redness at injection sites has sometimes been reported and rarely persists beyond 3-6 days.
• Ecchymoses (“bruises”): bruises are in fact rarely observed in the injection areas and may last a few days.
• Oedemas: swelling, most often around the eyes, may develop gradually over 4 to 5 days, then decrease in a few days to a few weeks.
• Sensitivity disorders: a sensation of tension or fixity of the forehead, mouth or neck, depending on the areas injected, as well as a change in sensitivity often linked to a sensation of cardboarding may persist for several days.
• Fugitive ocular or facial pain: such pain has been described in the injected areas in a quite exceptional way.

What are the possible complications following botulinum toxin injections for aesthetic purposes?

Complications are very rare.

The possible complications known to date are as follows :

Loco-regional complications :

• Headaches: they may be present during the first injections and disappear after a few hours to a few days.
• Eyebrow ptosis: forehead injection may cause a slight lowering of the eyebrows. This descent is usually due to the fact that the eyebrows were already in the low position before the injection. This slight lowering of the eyebrows usually regresses in a few weeks.
• Eyelid ptosis: the injection of the lion’s wrinkles can cause a partial fall of the upper eyelid which can last 4 to 8 weeks. It is rare (less than 1% of cases), and always disappears beyond a few weeks.
• Sore or smiling and swallowing: injection into the lips may cause discomfort to the smile or small abnormal movements. Neck injection may cause difficulty swallowing.
• Dry eyes: by reducing tear secretion, which can lead to keratitis, especially in patients wearing contact lenses (in this case, the cornea should be well hydrated).
• Paradoxical muscle contraction and facial expression disorders: in the days following injection, the treated muscles may present some paradoxical movements (spontaneous contractions) without gravity.

General Complications :

They are quite exceptional

• Allergic reaction: rash, hives, general allergic reaction.
• Nausal, dizziness
• Tiredness, fever, flu syndrome
• Dry skin or dry mouth.