Botox is a substance produced by bacteria (clostridium botulinum), used for its muscle relaxant properties; first used in medicine to correct strabismus in the late 1970s. Since the 1990s, its medical indications have spread (blepharospasm, spasmodic torticollis, dynamic deformation of the equine foot in children, hyperhidrosis severe axillary .)

Aesthetic signs appeared with the correction of expression lines.

here are 8 different subtypes of botulinum toxins. The strain used in aesthetic medicine is botulinum toxin A, which markets under the name Vistabel (ALLERGAN lab), Azzalure (GALDERMA lab) or Bocouture (MERZ lab).

Among the different treatments for correcting wrinkles, Botox has one particularity: it will correct wrinkles indirectly by muscle relaxation. It works at the neuromuscular junction of striated muscles by blocking the release of acetylcholine, a chemical that causes muscles to contract. By preventing the muscle from acquiring, it will help erase the wrinkles next to the injection points.

You should know that the eyebrows position ensures a balance between the lowering muscles located near the eyebrows (orbicularis, corrugator, and procerus) and a levator muscle (the frontal muscle). Horizontal forehead wrinkles are due to the contraction of the frontal muscle, while vertical lines between the eyebrows are due to the action of the lowering muscles. It will always be preferable to treat both types of muscles to harmonize the muscular balance of the upper face.

The treatment does not require any special preparation; to minimize bleeding, Avoid taking aspirin and anti-inflammatory drugs the week before the operation.

Before any treatment, your doctor will check that you have no contraindications to botulinum toxin injections (myasthenia gravis, Lambert Eaton’s syndrome, and any peripheral neuromuscular disorders.

Allergies or intolerance during previous injections, pregnant or breastfeeding women, etc.).

You should report any ongoing treatment so that your doctor can check that there are no interactions, which may contraindicate treatment with Botox (antibiotics of the aminoglycoside class, etc.).

After a static and dynamic examination of the area to be treated, your doctor will inject multiple intramuscular injections of Botox into your face. The needle used is very fine, and the treatment only lasts a few minutes. The use of doses adapts to each case. The muscle power being different from one patient to another avoids the “frozen” aspect often feared by patients.

Botulinum toxin injections reduce problems with excessive sweating (hyperhidrosis) in the armpits. The treatment is very effective and can stop sweating for several months (on average 6 to 8 months). The Botox will block the muscles that contract the sweat glands, and the area will no longer produce sweat.

Your doctor will determine the areas most marked by the Minor test: after applying betadine and then corn starch, the areas of excessive sweating will turn black. The distributions of injections are around this area.

50 units of botulinum toxin per side will be required, corresponding to one vial of Vistabel per side.

The effects are not immediate, set in after a few days, and last for about 5 to 8 months. The treatment is fast, simple, effective, and the side effects are local and minimal (redness, rare bruising, etc.).

The price is 720 euros per session.

• The result is not immediate. Muscle paralysis begins within the 24th hour and the 4th day after injection; time varies according to the patient and the volume of the muscle injected. The erasure of wrinkles is therefore visible after a few days.
• We obtained the maximum result around the 15th day. It is advisable to wait before appreciating the result because asymmetry or incomplete erasure of wrinkles is possible during this period.
• The effects will last for 3 to 6 months on average.
• We recommend never to bring the injection sessions together unless 3 months are under penalty of creating resistance to the product.
• From the 2nd injection, the effects may be lasting (6 to 8 months). The result will also be improved throughout the sessions, especially if the wrinkles are profound; it takes an average of between 3 and 8 injections to achieve a specific stabilization of the result.

Treatment with botulinum toxin A (Botox) is one of the world’s safest and most widely used cosmetic treatments. Complications are infrequent and are mostly always reversible. It is important to tell your doctor about any side effects or reactions that you think are abnormal.

The possible complications known to date are :

• Sensitivity disturbances or a feeling of tension in the injected area for a few days,
• Fleeting facial or eye pain,
• Headache after the injection, regressive within a few hours.
• Falling eyebrow: when injecting the forehead, a feeling of “heaviness” upon eyelids may occur, or even sagging of eyebrows; this is more common in patients who already have their eyebrows low before the injection or if there has been too much product injection. This problem resolves spontaneously within a few days or weeks.

• Eyelid fall: partial fall of the upper eyelid can last several weeks, is very rare (less than 1%) and always disappears.
• Temporary discomfort when smiling when swallowing during injections in the corners of the lips or the neck,
• Allergic reactions (skin rash, hives, difficulty breathing, etc.), dry eyes, nausea, dizziness, fever, etc. vertiges, fièvre…

All these risks can be added as preliminary results or an asymmetry that it is possible to treat with a touch-up injection of Botox about 3 weeks later. Still, only your doctor will know how to appreciate it.