Between the eyebrows
The vertical lines that appear when frowning. This is the area where the aesthetic use of the toxin began.
Dr. Gustavo Suárez · Aesthetic medicine
Botoxor botulinum toxin.
Botulinum toxin, known as Botox, is a medicine that temporarily relaxes the muscle into which it is injected. It softens lines caused by facial expressions. It does not add volume.
Request a consultation What is botulinum toxin?The treatment
A medicine
that acts on the muscle.
Botulinum toxin is a medicine that blocks the signal from the nerve to the muscle into which it is injected. Contraction of that muscle is temporarily reduced, softening the wrinkle that formed when it moved. The effect is always temporary.
It acts on dynamic wrinkles, those that appear when frowning, raising the eyebrows or smiling. When a wrinkle is also visible with the face at rest, the sources describe the possibility of adding a filler. As it is a medicine, it is administered by a doctor.
Where it is administered
Each area
depends on a different muscle.
The aesthetic use of the toxin began between the eyebrows and extended to the upper half of the face. Each area involves different muscles and is therefore assessed separately.
Forehead
The horizontal lines that appear when raising the eyebrows. The muscle that creates them also lifts the eyebrow, so treating the forehead requires consideration of eyebrow position.
Crow's feet
The lines at the sides of the eyes when smiling. The aim is to soften them without removing the expression: eliminating them completely gives an artificial appearance.
Other areas
Applications outside the upper third have been described, but not all are authorised indications. Authorised indications depend on the specific medicine and are listed in its summary of product characteristics, available through the AEMPS (Spanish Agency of Medicines and Medical Devices). The proposed indication is explained during the consultation. Serious complications are exceptional and, following the medical assessment, are explained individually according to each patient's characteristics.
The scope
What it does
and what it does not do.
The toxin and fillers are often confused, but they do different things. The toxin works on muscle; filler works on volume.
What it does
- Temporarily relaxes the muscle into which it is injected.
- Softens lines caused by facial expressions.
- Modulates facial expression, which depends on the activity of these muscles.
What it does not do
- It does not add volume. That is the role of dermal fillers.
- A wrinkle that is also visible at rest may need a filler as an adjunct.
- It does not aim to erase every wrinkle or eliminate facial expression.
- It is not permanent: over time, the muscle regains movement and the wrinkle returns.
The anatomy
The facial muscles do not move in the same way in everyone. Understanding this variation is the basis for injecting the toxin effectively and with fewer unwanted effects.
This is the conclusion of an article published in 2015 in Plastic and Reconstructive Surgery on facial muscles as targets for neuromodulators. Dr. Suárez is among its authors.
View the publication
The assessment
What is reviewed
before recommending treatment.
The clinic assesses the treatment area and tissue characteristics before recommending treatment. The consultation reviews what you hope to achieve, your health, allergies, medication and any previous treatment with toxin or fillers.
It is helpful to bring a list of medications and supplements: anticoagulants, anti-inflammatory medicines and some herbal preparations increase the risk of bruising. During the examination, the face is assessed and measured, and photographs may be taken.
Preparing for the initial consultationAfterwards
Care and
unwanted effects.
After the injection
To reduce redness, swelling or bruising, it is recommended to avoid rubbing or pressing the area, remain upright and avoid physical exertion for the number of hours advised by the doctor.
Unwanted effects
The most common are pain, swelling, redness or bruising at the injection site, headache and flu-like symptoms. Temporary drooping of the eyelid or brow, eye irritation and asymmetry of the brows or smile may also occur.
Serious complications are exceptional. During the consultation, after the medical assessment, these are explained individually according to each patient's characteristics.
When it is not administered and when to seek help
The indication depends on the medicine and its conditions of use. Allergies, infection in the area, neuromuscular diseases, swallowing difficulties and previous treatments must be reported. Some situations contraindicate treatment and others require specific precautions. Its aesthetic use is not recommended during pregnancy or breastfeeding.
Seek immediate medical attention if you develop difficulty swallowing, breathing or speaking, vision problems or weakness in an untreated area.
Before deciding
Frequently asked
questions.
Questions about the effects, risks and suitability of botulinum toxin.
What is Botox and what is it used for?
Botox is the common name by which botulinum toxin is known, a medicine that temporarily relaxes the muscle into which it is injected. In aesthetic medicine, it is used to soften lines caused by facial expressions, mainly frown lines, forehead lines and crow's feet.
Botox or hyaluronic acid?
They do not do the same thing. The toxin relaxes the muscle and acts on wrinkles that depend on facial movement. Hyaluronic acid is a filler and adds volume. When a wrinkle is also visible at rest, their combined use is described. Which is appropriate, if either, is determined by the assessment.
What are the risks of using Botox?
The most common unwanted effects are local and temporary: pain, swelling or bruising at the injection site, and headache. The eyelid or brow may temporarily droop, or asymmetry may occur. AEMPS also warns of an uncommon but serious risk: the effect spreading beyond the treated area, causing difficulty swallowing, breathing or speaking. If these symptoms occur, seek medical attention immediately. During the consultation, following medical assessment, these effects are explained individually according to each patient's characteristics.
Who should not have Botox in their face?
The indication depends on the medicine and its conditions of use. Allergies, infection in the area, neuromuscular diseases, swallowing difficulties and previous treatments must be reported. Some situations contraindicate treatment and others require specific precautions. Its aesthetic use is not recommended during pregnancy or breastfeeding.
How long does the effect of Botox last?
The effect is temporary: after a time, the muscle regains movement and the wrinkle returns. How often it should be repeated depends on each person and is established during the consultation, together with the aims and limitations of treatment.
What is the best age to have Botox?
There is no suitable age for everyone. The assessment examines lines caused by facial expressions and situations in which treatment is not indicated.
Related procedures
Other treatments
in aesthetic medicine.
Dermal fillers
Injectable products that add volume and soften lines and folds. Most, such as hyaluronic acid, are temporary.
Hyaluronidase
An enzyme that dissolves hyaluronic acid. It is mainly used to dissolve a previously administered hyaluronic acid filler.
Polynucleotides
Purified DNA fragments injected to improve skin quality. They are not used to correct volume.