Almost everyone has heard of BOTOX®, the magical treatment that fades or eliminates lines and wrinkles from the face, smoothing it out and creating a more youthful look overall. As a minimally-invasive and highly-effective treatment that only requires injections into the face, it is extremely popular among actors and the general population alike. In addition to its use for cosmetic purposes, BOTOX® is also used to treat a wide variety of medical conditions such as excessive sweating, headaches, and spastic movement disorders. However, most people don’t have any idea how exactly this powerful agent works to smooth lines and treat other medical conditions. We’re here to help.
A Closer Look at BOTOX®
Some people are wary of BOTOX® because it has “tox” in it. That’s understandable, but it’s nothing to be worried about. BOTOX® is basically a purified protein solution that acts to relax the muscles in the face that are responsible for causing certain types of wrinkles. It is completely safe for cosmetic and medical use because the tiny dose applied only acts locally; you cannot contract botulism from getting BOTOX® injections.
A Note About Wrinkles and Lines
When people make facial expressions, like laughing, smiling, frowning, lifting the eyebrows and so forth, a layer of muscles underneath the skin pulls at the skin and move the face into these various expressions. Young people have very elastic and springy skin that simply bounces back to its original state after producing facial expressions, but as people begin to age, the skin starts to become less elastic because the production of a protein called elastin declines; it also becomes drier and thinner due to lower levels of production of collagen and hyaluronic acid. These aging processes generally begin during the early twenties and are accelerated by exposure to sunlight and cigarette smoke. Thus, the skin stops springing back after each facial expression and instead starts to stay in the position it is frequently being pulled into by facial muscles, and a wrinkle is formed.
How BOTOX® Can Help
After isolation and characterization of the main ingredient in BOTOX®, someone had the bright idea to use it cosmetically to temporarily relax the muscles. If the muscles that are pulling the skin into wrinkles could be harmlessly stopped from doing so, the muscles would relax and the skin would smooth out. After extensive clinical testing, this was found to be the case. Carefully injecting a tiny amount of BOTOX® into a muscle that is pulling the skin into a wrinkle stops the process, resulting in a visibly smoother and more youthful appearance. It in particular works extremely well for lines and creases that form between the eyebrows, on the forehead, and around the eyes (crow’s feet). It can even be used to smooth out wrinkles on other areas of the face.
One exciting application is the prevention of wrinkles; instead of waiting for wrinkles to form, BOTOX® could be applied to areas commonly affected by wrinkles in order to keep the skin as smooth and flawless as possible for as long as possible. This use may allow people to delay or completely avoid the need for further treatments like fillers, skin resurfacing, and facelifts at older ages. However, it all depends on the unique case.
BOTOX® is also used to treat other medical conditions where relaxation of particular muscles is beneficial. For example, chronic muscle contractions of the scalp can trigger chronic headache syndromes that can be effectively treated with BOTOX®. Other conditions that involve abnormal spasms of muscles like hemifacial spasms, cervical dystonia, overactive bladder, and excessive sweating can also be effectively treated with these injections.
How Does It Work?
In order for a muscle to contract, it first has to receive a signal from a neuron. Neurons connect to muscles at places called the neuromuscular junctions and release chemicals to the muscles. These chemicals can either lead to contraction or inhibition of muscle contraction. The most common chemical used by motor neurons to induce contraction of muscles is called acetylcholine. When the presynaptic motor neuron is stimulated by upstream neurons to trigger muscle contraction, vesicles inside the neuron that contain high concentrations of acetylcholine fuse with the neuron’s cell wall, thus releasing the contents of the vesicles to the muscles.
BOTOX® binds to receptors on the presynaptic motor neurons and is then absorbed into the interior of the neuron. Once inside the neuron, the product is cleaved to release its active component called the light chain. The light chain binds to various proteins, blocking them from inducing the fusion of vesicles containing acetylcholine with the neuron’s cell membrane, and thus no signal can be sent to stimulate the muscles to contract. The effect is not permanent; the body breaks down the product over time, and the neuron and muscle return to their previously normal state with no permanent damage. It takes multiple days to completely relax the muscle, and the period of relaxation usually lasts for multiple months before another treatment is necessary.
Medical-grade BOTOX® is purified and made in a laboratory. In addition to BOTOX®, there are other brands of similar solutions available that differ slightly from BOTOX®. The various brands may have distinctive advantages and disadvantages in various situations. For example, another brand called Dysport is available as a liquid that can be stored at room temperature for long periods of time; however, it has a lower potency than BOTOX® and thus a larger volume is needed for each injection, which may increase the risk of the solution migrating to non-targeted muscles. In addition, it may have a higher risk of inducing the formation of neutralizing antibodies. A third brand, which is not currently in widespread use, is called XEOMIN®. It is a completely pure preparation of the toxin with all other bacterial proteins removed.
How is It Administered?
The process always starts with an initial consultation, during which we can learn about your cosmetic goals and evaluate your case. We want to make sure BOTOX® is right and safe for you and your needs.
For the actual treatment, the injection is placed directly into the targeted muscle, and multiple injections at different locations may be necessary. For cosmetic purposes, usually a skilled professional can simply identify the necessary sites of treatment by observation.
Patients are typically advised to not exercise strenuously for a day or two and to not massage or rub the sites of injection for a set amount of time after the injections. These precautions are intended to avoid any risks. You should be happy to know that over many years of very large numbers of patients being treated with BOTOX® for various conditions, no serious complications have ever been reported.
Who is a Good Candidate for Treatment?
BOTOX® is best for adults who are dealing with dynamic wrinkles. These are the types of wrinkles that the solution was designed to treat, and they are the ones that form due to the making of facial expressions over the years. They are typically found:
- On the area around the eyes (crow’s feet)
- In between the eyebrows
- On the forehead
Good candidates for this popular treatment tend to have the following in common:
- Good overall health
- Realistic expectations regarding the treatment and results
- Signs of aging that are not too advanced to be treated with the injections
Men Can Benefit!
Some people don’t realize that BOTOX® can work for both men and women who are dealing with dynamic wrinkles. Gone are the days when only older women used this treatment. These days, more and more men, including younger males, are coming to our office to either prevent or address their wrinkles.
If you are considering BOTOX® treatments for cosmetic purposes, consider making an appointment at Tru-Male Medical to discuss whether it is right for you. Our office is conveniently located in Oak Brook, and we happily serve clients throughout the surrounding areas. Contact us today to book your consultation and get started!