What Is a Facial Toxin or Botulinum Toxin?
Botulinum toxin, widely known as botox, is injected into the face to reduce wrinkles and smoothen fine lines. In addition, botox injections are also used to manage other conditions, including neck spasms, overactive bladder, lazy eye, and excess sweating. In some situations, these injections have proven effective in preventing chronic migraines. They comprise neurotoxins that specifically target the nerves and induce muscle weakening. Some patients might require a botulinum toxin injection for medical or cosmetic purposes. Doctors usually inject a small amount of it into the muscles to smoothen fine lines and wrinkles and treat other conditions. The doctor must remain careful about the dose being injected.
Why Are Toxins Injected Into the Face?
Botulinum toxin injections inhibit the release of chemicals from the nerves that stimulate muscle contractions. In addition, botox injections relax the wrinkle-causing muscles of the forehead and those surrounding the eyes. Though the effects of botox injections are temporary, they can last from several months to years. Some of the other uses of botox injections are listed below:
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Cervical Dystonia - It is a painful condition wherein the head rotates in an uncomfortable position due to the involuntary contraction of neck muscles.
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Muscle Contractures - Muscle contractures mainly occur due to neurological conditions like cerebral palsy. Hence, Botulinum toxin injections can be used to relax these contracted muscles.
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Lazy Eye - Lazy eye or amblyopia is a consequence of the irregular position of the muscles.
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Hyperhidrosis - It is a condition wherein the patient sweats excessively even in the absence of hot temperatures.
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Migraine - Botulinum toxin injections are useful for patients who experience migraines more than 15 times a month.
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Bladder Problems - People with bladder problems can reduce symptoms through botox injections.
What Is the Mechanism of Action of Botulinum Toxin?
Botulinum toxin specifically targets facial wrinkles. These wrinkles are formed due to skin atrophy and repeated contractions of the facial and eye muscles. When botulinum toxin is injected in small quantities, the muscles relax, and the wrinkles become smooth. Botulinum toxin is obtained from the bacteria Clostridium botulinum. It is a neurotoxin whose effects are observed on the neuromuscular junction. It prevents the secretion of acetylcholine, resulting in chemical denervation. Studies report that botulinum toxin works at the cellular level to control the release of proteins that stimulate the formation of acetylcholine. As a result, muscle contractility gets restored.
How Does the Facial Toxin Injection Treatment Work?
Botulinum toxin has been used in plastic surgery procedures for over 20 years to treat many conditions, including strabismus, migraines, and muscle spasms. It was first approved by the US (United States) Food and Drug Administration (FDA) in 2022 to treat muscles that produce wrinkles or fine lines. In addition, it has been used off-label for various cosmetic procedures on the face. However, using botulinum toxin in the lower one-third of the face is challenging.
Selection of Patients:
The ideal candidates for botulinum toxin treatment are those with dynamic wrinkles on their faces and who show dramatic improvements post-treatment. In addition, patients with wrinkles that become visible on rest can also be considered eligible for treatments. However, such patients would require two or three botulinum toxin injections or additional treatments with dermal fillers to achieve the desired outcomes. Before initiating the procedure or during the initial consultation, the patient must be counseled to have realistic expectations regarding the treatment's success. Patients with keloid scars, neuromuscular disorders, unrealistic expectations, and body dysmorphic disorder are absolutely contraindicated from these procedures.
Consultation With the Doctor:
An expert physician must inject Botulinum toxin carefully to avoid any side effects or complications. The facial areas are examined by the doctor and the patient with the help of a handheld mirror during the consultation. The doctor identifies the areas of facial asymmetry and irregular contour. Next, they are prioritized, and the doctor discusses the treatment, outcomes, and complications with the patient. The additional treatment options for smoothening static wrinkles include chemical peel, vs microdermabrasion, lasers, or topical products like retinoids. The doctor must obtain the patient's photograph to determine the changes at every stage. Normally, static and dynamic images are taken before, during, and after the treatment to determine success.
Preparation for the Procedure:
Some people might be uncomfortable during the procedure because of the injections. However, the patient need not worry as the doctor will anesthetize the patient's skin beforehand to avoid pain. People who are receiving treatments for their palms or soles and have the problem of excess perspiration need to be administered anesthesia. In addition, the patient must prepare a list of all the medications, including prescription, over-the-counter drugs, herbal supplements, or anticoagulants like Warfarin or non-steroidal anti-inflammatory drugs. This is because these drugs can interfere with the procedure and increase the risk of bruising, hematoma, and other complications. The patient must avoid consuming alcohol 24 hours before the procedure to avoid the risk of additional complications.
What Happens During the Procedure?
It is a simple procedure wherein botulinum toxin injections are inserted into the treatment areas. The frequency of botulinum injections depends on the severity of the patient's condition. In addition, the patient must know the following additional points about botulinum toxin therapy:
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Botulinum toxin injection is an outpatient procedure. Hence, the patient can return home the same day.
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Patients might have mild discomfort or stinging sensation due to the injection. However, the condition becomes normal after some time because the procedure gets completed quickly.
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The patient getting treated for an overactive bladder might receive local or regional anesthesia.
What Are the Risks of Botulinum Toxin Injections?
A plastic surgeon must only insert botulinum toxin injections. Some of the complications of the procedure are listed below:
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Pain.
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Swelling.
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Bruising at the site of injection.
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Headache.
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Drooping of eyelids.
Some of the uncommon side effects of botulinum toxin injections are listed below:
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Flu-like symptoms.
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Dryness of eyes.
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Weakness of muscles.
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Problems in vision.
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Swallowing difficulties.
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Respiratory problems.
Conclusion:
Injection of facial toxins or botulinum toxin is widely performed in plastic surgery to correct facial deformities. However, the patient must be counseled about the side effects and the outcomes of the procedure. Consult a plastic surgeon to learn more about facial toxin injection treatment.
