Botox is a drug prepared from botulinum toxin, which is a highly potent neurotoxin derived from the bacterium Clostridium botulinum. Botox has been gaining immense popularity and interest in Nepal in recent years, and it has only been a handful of years that the general public has become largely aware about its cosmetic uses. However, detailed information and knowledge about its uses has been limited.
Firstly, botulinum toxin exists in seven different serological subtypes, of which, subtype A (Botox, by Allergan) was the first commercially available type in the United States. Botulinum toxin type A is available in different forms, as well, but the one most commonly used in Nepal is onabotulinum toxin A, i.e., Botox® by Allergan. The pharmaceutical form of Botox is packaged and distributed in powder form, and doses of all commercially available botulinum toxins are expressed in terms of units of biologic activity.
How does Botox work?
Botox works by temporarily paralyzing or weakening the muscles by inhibiting the release of acetylcholine from presynaptic motor neurons. Intramuscular administration of botulinum toxin acts at the neuromuscular junction to cause relaxation of the muscles, thus smoothing the overlying dermis. It takes approximately two weeks to show effects on the muscles around the injected area and adjacent areas, which lasts for three to six months. During this time, the muscles relax, making wrinkles and creases on the skin diminish until the toxin metabolizes.
Cosmetic uses of Botox
In the field of aesthetics, Botox is primarily used for the reduction of appearance of facial wrinkles. It has beneficial effects on wrinkles caused by muscular contractions and hyperactive muscles in the face. The most common areas include glabellar frown lines, transverse forehead lines, and lateral canthal wrinkles (i.e. crow’s feet). It is also used for medial and lateral brow lifts. Besides, it can also be injected over the overdeveloped masseter muscles to improve the square jaw outlook of the face and get a more slimming effect on the face. It also works on platysmal bands for neck rejuvenation, gummy smile, bunny lines, drooping corners of the mouth, and smokers’ lines. Apart from wrinkles, Botox is also used for excessive sweating, i.e. hyperhidrosis—a condition where sweating occurs even while doing regular activities in normal temperature settings.
What is the right age to get a Botox injection?
There is no specific age that is considered right for getting Botox injections. However, mid 20s to early 30s could be considered good for getting a Botox injection, either for wrinkle reduction, or as preventive Botox treatment.
Is it painful to get Botox injections?
People worry that the injection will be painful, but most of the patients describe it as a small pinching sensation even without the application of any numbing agents.
Is it permanent?
Unfortunately, it is not. The effect of Botox lasts for approximately three to six months, after which one needs to get it done again.
What to expect if you are getting Botox injections?
Before the procedure: The patient is thoroughly assessed for the type of wrinkles that are to be treated. Once the patient decides to go forward with the procedure, it is important to note if the patient is taking any kind of blood thinner like aspirin, anti-inflammatory drugs, or alcohol, as these can increase the chances of bruising during the procedure. Numbing agents can be applied, if desired, for better comfort during the procedure.
During the procedure: Botox, which is initially in its powder form, is first diluted with saline before being injected into the skin. Several small injections of the Botox solution are injected into the target areas. Typically, it takes only 10-15 minutes to complete the whole process.
Post procedure and post care: There is no downtime as such after getting injected with Botox. The patient should avoid rubbing and frequently touching the injection site for 24 hours, so that the Botox injected doesn’t spread to another area. They are also advised to stay upright for four hours after the injection and refrain from exercising or performing any vigorous activity for at least 24 hours.