What is Botox?

Botox injections are used to achieve Cosmetic Denervation.

Cosmetic Denervation is a procedure used to improve the appearance of worry lines, crow's feet, laugh lines and other so-called dynamic wrinkles. Dynamic wrinkles occur when we smile, laugh or frown, and the delicate muscles underlying ageing skin contract. In cosmetic denervation, botulinum (Botox) is injected into these muscles. Botox works by weakening these tiny facial muscles very precisely. After treatment, the overlying skin remains smooth and unwrinkled while untreated facial muscles contract normally, allowing normal facial expression to remain unaffected. Though cosmetic denervation is a relatively new treatment for dynamic wrinkles, Botox injections have been safely and effectively used for over a decade for many neurological and opthalmological disorders. Thousands of Botox injections are performed each year for a variety of conditions ranging from strabismus (squint or cross eyes) to spasmodic torticollis (twisting of neck with painful muscle spasms). Botox was first shown to be beneficial for dynamic wrinkles by neurologists and opthalmologists treating other conditions. Today, paralleling and exponential increase in our knowledge of the science of ageing, cosmetic denervation has emerged as an exciting, not officially listed new treatment for ameliorating the visible consequences of ageing.

How is Botox performed?

Cosmetic Denervation is a simple and safe procedure. A very small amount of Botox is injected with a very fine needle into several locations in the face. Because the needle is so fine and only a small amount of liquid is used, the pain associated with the injections is minimal. No sedation or local anaesthetic is required, and you will be able to drive and engage in all of your usual daily activities immediately after your injections. You have slight temporary bruising of the skin at your injection sites, but otherwise, there will be no visible signs of your treatment.

Are there any side effects?

Because the medication can sometimes cause excessive weaknesses of injected or nearby muscles, rarely there can be transient weakness of eye closure, drooping of eyelids, or asymmetry of facial expression. The risk of any side effects depends on the muscles injected. Because Botox is completely reversible, any side effects related to excessive weakness are temporary, lasting only days or weeks.

What kind of results can I expect?

If dynamic wrinkles are making you look older than you should, cosmetic denervation can smooth these out and give you a more youthful appearance. However, this procedure will not improve the more common static wrinkles that are unrelated to facial contraction. If you have a combination of the two, your improvement may, therefore be limited. Because of this, a combination of a chemical peel or laser abrasion with cosmetic denervation may be more appropriate for you. Your doctor will discuss these possibilities with you and recommend the best alternatives for your situation. You should also understand that cosmetic denervation will not improve loose or sagging skin and does not serve the same function as a face lift. Unfortunately, cosmetic denervation is not a permanent solution to the problem of dynamic wrinkles. Early results from clinical trials suggest that the duration of benefits increases with time so that you may require injections less frequently in the future, but this will vary from person to person. In addition, cosmetic denervation may be less effective past the age 65. The Botox effect will be apparent 3-4 days after the injection and will last up to 2-3 months. It can be repeated should one wish to. It will still be possible to frown in the Glabella area even if more difficult. Everything will return to normal within 2-3 months.