Botulinotherapy of Mimic Wrinkles of the Forehead, Between the Forefeet, Eye Area, Lower Thirds of Face

Botulinotherapy is an injection method used in cosmetology to smooth out facial wrinkles and treat hyperhidrosis. For this purpose, known drugs Dysport ("Disport"), Botox (Botox), Xeomin ("Xeomin"), Lantox ("Lantox"), authorized by the Ministry of Health in the territory of Russia. In Russia they have been used for more than 15 years.

"Dysport", "Botox" are preparations based on botulinum toxin type A, produced by Clostridium botulinum. The active ingredient is a protein that blocks the release of acetylcholine and relaxes the muscles. The drug is a muscle relaxant.

The use of "Disport" ("Botox") for face correction is the most common procedure. This is a well-studied and scientifically proven method. The world clinical and research experience of treatment with the use of "Disporta" (Botox) confirmed its safety and effectiveness both in the short and long term period. Antibodies to botulinum toxin after repeated injections are formed in 1-5% of patients. In the case of antibodies to botulinum toxin, the effect of subsequent injections may be reduced or not manifested at all.

Indications for botulinum in cosmetology

• Mimic wrinkles of the forehead, between the eyebrows, the outer corners of the eyes (treatment of local muscle spasm to smooth wrinkles in adults).
• Asymmetry of the face.
• Correction of the lower third of the face (treatment of the moderate-moderate degree of gravitational ptosis of the lower third of the face - the "blurred" mandibular line, spastic vertical wrinkles above the upper lip - pincer wrinkles, chin hypertension - with age, the chin can rise up and form a chin wrinkle, descending corners of the mouth.
• Hyperhidrosis of the palms, armpits, feet.

There are 2 types of facial wrinkles - hyperdynamic and hyperkinetic:

1. Dynamic - wrinkles that appear when expressing emotions, i.e. When moving facial muscles, at rest they look like little lines or not visible at all. When we start botulinum therapy of these wrinkles at this stage, we prevent their appearance in the future.

2. Static - wrinkles of "rest". These wrinkles, of varying degrees of severity, are visible on the face, regardless of the manifestation of emotions, they spoil the appearance, giving the face more years than it really is. They are amenable to correction, but in addition to botulinum, additional cosmetic procedures may be required, such as chemical peelings, fractional photothermolysis, filling with wrinkles by the filler. Patients with severe deep wrinkles may have unreasonable expectations of treatment with the use of "Disport" or "Botox".

Botulinotherapy planning includes understanding, assessing the patient's desires and preferences in the context of a general treatment plan. The facial muscles do not act in isolation, but have a complex of interactions, so relaxing one muscle, we can strengthen the tension in the other.

There are favorable and unfavorable facial wrinkles, it depends on whether it is possible to inject botulinum toxin in this area, or this zone is taboo for the above injections. This applies only to the forehead. Favorable wrinkles are in the upper half and middle of the forehead, and unfavorable wrinkles are below the middle line of the forehead.

The center of the upper third of the face is the eyebrows. Therefore, before any injection in the upper third of the face of Dysport or Botox, potential effects on the shape and position of the eyebrows are taken into account. Using botulinum therapy, you can save or change the position of the eyebrows, make the eyebrow more straight or raise the tips of the eyebrows; If one eyebrow is higher than the other, you can align the position of the eyebrows.

Before the procedure of botulinum therapy, mimic samples are performed for the exact determination of the injection site. It is necessary to discuss with the patient what kind of result it would be desirable to achieve, determine which wrinkles to relax and which ones to not touch, if possible. If there was a previous anamnesis - we take into account it.

Botulinotherapy is a dose-dependent procedure. The dose of Dysport (Botox) is determined individually for each patient according to the nature, severity and localization of muscular hyperactivity.

The recommendations given by the doctor after the procedure must be strictly adhered to:

1. The first 30 minutes to perform active mimic movements in the area of injections.

2. Keep the vertical position for the first 4 hours.

3. The first night after the injection, sleep only on the back.

4. To exclude visiting of a sauna and a bath within 2 weeks.

5. To exclude the use of alcohol, salted food for 1 week.

The effect after injections of botulinum toxin occurs 3-5 days, reaches a maximum of 10-14 days and lasts approximately 4-6 months, but often the muscle relaxant effect is prolonged up to 8-10 months. The procedure can be carried out repeatedly.

Side effects

1. Local reactions in 2-5% of cases are directly related to injections - microhematomas, pain at the injection site for up to 1 day.
2. Reactions associated with the spread of the drug to muscle groups located near the injection site. Since the muscles on the face do not have fascia and if the doctor's recommendations are not observed, the drug may diffuse to the adjacent muscles, which we did not plan to relax. Very rarely - this ptosis (omission) of the eyelids, lateral sections of the eyebrows, asymmetry of the corners of the mouth, violation of articulation. As a rule, these side effects regress within 1 month.

Contraindications

• Pregnancy (although unintentional use did not cause any teratogenicity or pregnancy problems.
• Lactation (as it is not known whether the drug is excreted in human milk and whether it has any effect on the nervous system of the child).
• Myasthenia gravis (chronic autoimmune disease, in which the ability of the muscles to reduce, which manifests itself in the form of loss of strength in them).
• Inflammation of the skin at the injection site.
• The use of certain antibiotics (groups of aminoglycosides, erythromycin, tetracyclines, polymyxins, fluoroquinolones) that enhance the effect of botulinum toxin, if not more than 2 weeks after the treatment.
• Acute infectious diseases.

Be healthy and beautiful!