The application of botulinum toxin is now an integral part of the daily practice of modern dermatologists and serves as a unique tool for addressing certain medical and aesthetic concerns. Botulinum toxin type A is produced by the bacterium Clostridium botulinum and is available in two formulations: Botox (Allergan) and Dysport (Ipsen). It works by temporarily inactivating striated muscle fibers through its action at the neuromuscular junctions. Both products are approved by the FDA as well as the corresponding regulatory agencies in the EU.
In most cases, wrinkles form as a result of changes in the skin’s architecture, with a gradual replacement of elastin fibers by collagen fibers, under the influence of various factors such as exposure to ultraviolet radiation, smoking, sleep, daily habits, the patient’s constitution, and the activity of facial muscles through expressions.
As previously mentioned, botulinum toxin acts on the presynaptic membranes of postganglionic cholinergic nerve fibers, inhibiting the release of acetylcholine at the neuromuscular junction. This leads to temporary, reversible muscle weakness and the desired therapeutic effect. The onset of action is typically observed 3–4 days after injection, with results peaking around the 2nd to 3rd week. The duration of the treatment's effectiveness depends on the severity of the wrinkle-related aesthetic issue, the dynamic strength of the muscles, and the degree of the patient's facial expressiveness. The application is fully individualized, with the dose and injection sites tailored to the muscle activity, size, age, and gender. Muscle function gradually returns, usually within 4–6 months.
Botulinum toxin has been used for over 15 years in aesthetic dermatology to correct hyperdynamic expression lines in the glabella (frown lines), forehead, periorbital area (crow’s feet), expression lines at the nasal base, and to correct facial asymmetries. The strictly medical applications include improvement of hyperhidrosis in the axillae, palms, and soles, as well as treatment for certain types of migraines, blepharospasm, torticollis, and cervical dystonia.
Botulinum toxin is contraindicated in: Individuals with neuromuscular disorders (Myasthenia Gravis, Eaton-Lambert syndrome) Those with an allergy to any of the product's components or in the presence of inflammation at the injection site
In patients taking medications that affect the neuromuscular junction by enhancing the effect of botulinum toxin (e.g. aminoglycosides, penicillamine, quinine, calcium channel blockers) During pregnancy and breastfeeding.
When Botox®/Dysport® is administered correctly by a well-trained dermatologist in a specialized medical setting that meets all necessary standards, the likelihood of side effects is minimized.
Common side effects observed after the procedure include bruising at the injection sites and minor extravasation of the product. Some patients may also experience headaches for 1–2 days, while in rare cases, temporary eyelid drooping (ptosis) has been reported, which typically resolves within 10–15 days.
For these reasons, and to perfect the aesthetic outcome of the Botox/Dysport treatment, a follow-up evaluation is performed in our clinic approximately 15–20 days after the procedure by our physician, Dr. S. Theocharis.
It is important to note that the goal of proper botulinum toxin administration is not to completely immobilize facial movement, but rather to reduce involuntary or habitual facial movements that lead to the formation of specific wrinkles.
The initiation of Botox/Dysport treatment is determined by a specialized dermatologist according to the individual needs of each patient and, of course, after obtaining a complete medical history. The primary goal is to prevent the transformation of dynamic wrinkles (those that appear during facial expressions) into static ones (visible at rest), rather than intervening when treatment is not deemed necessary. Our aim is always to achieve a natural-looking result.
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Yes, injectable Botox/Dysport treatment is generally considered safe when performed by experienced and professional dermatologists in a clinically secure environment. Botox has been used for decades in medical applications, and its safety has been documented in millions of patients worldwide.
Try to exercise the facial muscles for 2–3 hours after the treatment (e.g., frowning, raising eyebrows, smiling). This helps the toxin take effect faster and distribute evenly across the muscles. Although this technique is helpful, forgetting to do it will not significantly affect the final result.
Do not rub the treated areas for the next 24 hours.
Do not apply makeup for 4 hours after the treatment.
Do not lie down for 2–4 hours after the treatment.
Avoid strenuous exercise for 2 days following the treatment.
Avoid hot showers, blow dryers, excessive sun exposure, massage, sauna, or hammam for the next 2 days.
Avoid additional facial treatments such as laser therapy, chemical peels, or dermabrasion for 1 month.
For optimal and lasting results, the procedure should be repeated every 6 months, according to international medical standards.