Botulinum toxin injections (Vistabel, Dysport, Xeomin, Alluzene) for correction of mimic wrinklesVarious aesthetic medicine techniques are applied for elimination of face skin involutional and structure changes, hyperdynamic and static wrinkles, skin excess. Botulinum toxin A is most widely used preparation for non-surgical correction of mimic wrinkles.

Mimic wrinkles

The first mimic wrinkles usually start forming at a young age due to constantly repeated emotional expression as well as due to inherent tendency to start emerging in case of increased activity of certain muscles. The nature of these wrinkles is determined during the adolescence period and they become persistent gradually.

Wrinkles are always characterized by individual picture. Barely visible at first, these wrinkles become more visible and deeper in time. Their kinetic types are distinguished.

Kinetic – formed by the movement of face muscles directly related to emotional expressions and completely even up during the rest period.

Hyperkinetic wrinkles are usually more expressive in the forehead, bridge and periorbital area (around eyes), causing mostly occurring aesthetical discomfort. Constant, repetitive and too intensive activity of face muscles is one of the provocative factors of the development of mimic wrinkles accelerating the involutional processes. These wrinkles are mostly visible with the movement of muscles that move more frequently and are not always related to expressed emotions, and during longer rest period they even up, e.g., during sleep, wrinkles usually leave soft “path” at the beginning that becomes more deep in time.

Hypertonic wrinkles. Even during the rest period the muscles are intense, therefore, they cannot become fully loose and do not depend on human will.

Static wrinkles are formed due to degenerative changes in face skin and muscle apparatus that are related to ageing tissue changes are also stimulated by environmental factors (UV rays exposure, gravitation, harmful habits, etc.). These are mostly visible during the rest period when no movements are made.

How botulinum toxin works?

Injected botulinum toxin A inhibits the neuromediators acetylcholine in neuromuscular connection and anatomic cholinergic ganglia. Without the effect of nervous impulse muscles do not contract. In this way, botulinum toxin A temporarily relaxes face muscles by softening or completely eliminating the formed folds or wrinkles composed due to specific interaction of contraction of muscles or their groups.

Botulinum toxin injections Is that safe?

1987 – a significant push in aesthetic medicine. It was the first time, when A. and J. Carruthers used botulinum toxin A for cosmetic purposes. Since then, the discovered influence of botulinum toxin has launched the era of non-surgical correction of mimic wrinkles. Once known to be a poison, Botulinum toxin has started to be widely used in aesthetic medicine for safe and effective correction of ageing skin changes.

There has been various myths lingering in the air.

One of them – whether botulinum toxin is poisonous? It is not possible to be poisoned with botulinum toxin as only small doses of preparation are used. Injections are made to specific muscles responsible for formation of mimic wrinkles.

Is muscle atrophy possible? Muscle atrophy is impossible since denervation is only temporary and is fully restored within 3-12 months. Normal metabolism processes remain in muscles during the whole time.

Botulinum toxin A is extracted from bacterium Clostridium botullinum. Preparation (Vistabel) Allergan Pharmaceuticals (Irvine, California, USA) – botulinum toxin A contained in a complex the molecular mass of which conditions the lower diffusion of preparation ant that means exact, predictable result, longer lasting effect and more natural face expression.

At what age the botulinum injections could be used?

Botulinum toxin is used for aesthetic purposes for persons of the age of 18-65. Everyone chooses the time for the first injection subject on the self situation and introspection.

For some, the perfect time can be at the age of 20-25, for others – at the age of 50. Botuline injections acting on the etiological factor of mimic wrinkles are used not only for correction of wrinkles but also for their prophylaxis.

Injections started to be used at the age of 30-35 or earlier block involuntary mimic and are applied for prophylaxis of first wrinkles. Wrinkle prophylaxis is also recommended in case of very intensive muscle activity.

Quite often, injections are started at the age of 30-45 when the mimic wrinkles began to intensify due to reduction of skin elasticity.

Third stage – the menopause at the age of 45-55. With intensive reduction of estrogens and progesterone the synthesis of collagen and elastin is reduced and skin cannot retain moisture, becomes dry, starts to get thinner and various wrinkles included the mimic wrinkles become more visible.

The course of procedure

In clinic, the procedures are performed by aesthetic medicine doctor. Usually, before the procedure, the area of injection is not anaesthetized due to inconsiderable pain. In case of hypersensitivity, you will be provided with the proper technique of anaesthesia. Subject to age, gender, deepness of wrinkles, localization and all accompanying individual factors s small dose of preparation is injected by special thin needle in the respective points. Microinjections block hyperactive muscles responsible for formation of mimic wrinkles. After stopping the contraction of muscles, the wrinkles become more even. The procedure itself lasts for several minutes. After the injection, the ice is placed on the injected area.

Effectiveness

Usually, the impact starts to be visible on the 2nd-7th day, however, sometimes the effect fully manifests within 14 days. Mimic muscles are relaxed and the skin becomes even in problematic areas. The effect lasts for 4 to 6 or even 8 months. Sometimes – up to 1 year. Emotions can be expressed like before, however, they are not accompanies with increased wrinkles of face skin.

How often can botulinum toxin be injected?

In the length of time, innervation is restored and injections can be repeated. In order to maintain constant effect, the course of injections is performed every other 4, 6 or 8 months. With repetition of injections, the impact of botulinum lengthens up to 6 to 9 or even 10 months, the habit to wince conditioning the formation of mimic wrinkles is sometimes lost, therefore, mimic wrinkles can be less intensive. It is not recommended to repeat botulinum toxin injections more frequently than every 3 or 4 months.

Recommendations before the procedure

In order to avoid the increased bleeding, the usage of non-steroid anti-inflammatory medication shall be avoided before the procedure.

Recommendations after the procedure

  • You can return to normal everyday routine immediately.
  • The massaging of injected areas shall be avoided for 12 hours after the procedure.
  • The vertical position shall be assumed for 4-5 hours after procedure.
  • During the first days after the injection any sports activities, alcohol consumption and sunbathing shall be avoided.
  • Overheating (hot tubs, saunas) shall be avoided for 7-10 days after the injections.
  • The usage of aminoglicozides, tranquilizers shall be avoided for two weeks after the procedure (the application of these preparations can reduce the effect of botulinum toxin).

When the procedure shall be avoided?

Absolute contraindications:

1. Illnesses with disorder of transmission of nervous impulses (myasthenia, etc.);
2. Pregnancy;
3. Lactation;
4. Local inflammatory processes;
5. Haemophilia;
6. Increased sensitivity to preparation components.

Relative contraindications:

1. Kidney disorders in anamnesis;
2. Usage of anticoagulants;
3. Exacerbation of somatic disorders;
4. Usage of medication acting on the activity of botuline toxin: some kinds of antibiotics, myorelaxants.

Interaction of aesthetic procedures

Botulinum toxin injections are well combined with hyaluronic acid contour and volume plastic injections, biorevitalization, mesotherapy, peeling, laser rejuvenation procedures, photorejuvenation, rejuvenation by using light diodes. All of them have their own important roles in prophylaxis and restoration of skin involutional changes. Complex, properly coordinated procedures allow for achieving long-term results. During the initial cost-free consultation the aesthetic medicine doctor will evaliate skin condition, ageing skin changes and will recommend you the best procedures, their schedule and, upon demand, will compose short-term (from 6 months to 1 year) or long-term (1-2 years) antiaging programme.