Botox

Botox

BOTOX – Efficacy and Safety

Botox is a brand name and registered trademark by Allergan Inc for botulinum neurotoxin, a protein neuromodulator produced by the bacterium Clostridium botulinum.  It is commonly known as a muscle relaxant (or muscle paralysis) and is used in medical conditions as well as aesthetic indications such as to relax wrinkles. Botox is also used to treat non- muscle related conditions such as excessive sweating and scars

Medical uses of Botox

  • Crossed eyes (strabismus)
  • Eyelid spasms (blepharospasm)
  • Neurological movement disorder (cervical dystonia)
  • Spasticity
  • Overactive bladder
  • Achalasia – problem in throat which makes swallowing difficult

Aesthetic uses of Botox

  • Botox to treat facial wrinkles : forehead lines, crow’s feet, frown lines, marionette lines, bar codes on upper lips, chin crease
  • Botox for brow lift
  • Botox for facial slimming
  • Botox to treat temporal-mandibular joint(TMJ) disorders and associated jaw tension and pain: Relieves the soreness and discomfort and jaw tension
  • Botox to treat excessive sweating in the underarms and palms
  • Botox to treat migraine
  • Botox is used after surgery to reduce scar formation and also as part of the treatment for scars and keloids
  • Botox lift
  • Microbotox of skin to minimise pores and reduce oiliness
  • Botox for body slimming: to create a long and slim neck and shoulder line, to slim arm and calf muscles
  • Botox for salivary glands
  • Botox for neck contouring
  • Botox to relax neck wrinkles and platysma bands

BOTOX – Mechanism of action

  • Botox acts on the muscle end plate to prevent the release of the neurotransmitter acetylcholine from the nerve endings to the neuromuscular junction ( muscle end plate) This results in paralysis of the muscle
  • Botox acts on the sympathetic nerves and skin to reduce pore size, skin oiliness and to tighten the skin
  • Botox acts on the salivary glands and sweat glands to reduce secretion of saliva or sweat and glandular size

Botox Procedure

  • The Botox powder is reconstituted with normal saline
  • The reconstituted Botox is injected into the muscles or skin or the target tissue
  • You may feel tiny pinprick sensation. Usually no anaesthesia is required
  • You will start to see effects within a day or two with maximal effect seen in 2 weeks. In some, effect is seen at 4 weeks when muscle atrophy starts to show

BOTOX – Side-effects and complications

Botulinum toxin is very toxic but Botox is manufactured to contain very minute amounts of toxin, making it safe and effective in therapeutic and aesthetic dosages. However as in any drug, side-effects may occur but they are not common.

Early side-effects of Botox injection

  • Injection site reactions such as pain, stinging, burning, swelling, bruises
  • Mild localised headaches

Uncommon side-effects of Botox injection

  • Numbness, paraesthesia and twitching
  • Flu-like symptoms
  • Mild nausea and occasionally vomiting
  • Stomach upset
  • Mild malaise and feeling unwell
  • Myalgia
  • General weakness after treatment of neck muscles(cervical dystonia)

Serious side-effects of Botox injection

  • Immediate hypersensitivity presenting as hives, shortness of breath
  • Allergy to the protein, lactose, sodium succinate in the botox

Complications of Botox injection related to treatment technique

  • Eyebrow asymmetry
  • Quizzical or “spock” eyebrow
  • Excessive elevation of brow
  • Droopy eyebrow (brow ptosis)
  • Lack of expression
  • Droopy eyelids (eyelid ptosis)
  • Upper eyelid swelling
  • Eye complications like double vision, reduced tearing
  • Difficulty swallowing, speaking
  • Asymmetric smile