What is botox?

What exactly is botox?

When talking about botox, we essentially mean the brand name for botulinum toxin type A, which is derived from the bacterium Clostridium Botulinum. The form is injectable. Is the world’s most popular, minimally invasive medical cosmetic treatment in women and men, since according to data from the American Society of Plastic Surgery, the US only made 6 million applications for aesthetic reasons and spent about $ 1 billion in 2013.


When was botox used for the first time?

When, in 1968, neurologists, orthopedic surgeons and ophthalmologists were seeking new and more effective treatments for various neuromuscular diseases that plagued their patients, botox was first used with impressive results. Its use expanded to other disciplines and indications. It is used with excellent results to date.

Application & results

Where exactly is botox is applied and why?

The most common muscle groups to which it applies are:

  • pyramidal, responsible for wrinkles between the eyebrows
  • circular eyelid, responsible for wrinkles on the “goose foot”
  • frontal muscles, responsible for horizontal wrinkles of the forehead


How difficult it is to implement and who does it not apply to?

This is a minor surgery, harmless, since the amount of the drug used is substantially negligible and, of course, absolutely controllable. The use could probably be contraindicated in patients with myopathy, neuropathy or other serious neurological diseases. In such a case the doctor should be informed.

How long does it take to apply and who choose it?

Treating facial wrinkles with botox is done by a specialist, a plastic surgeon, dermatologist or ophthalmologist and lasts from 10 to 20 minutes, depending on the situation. The drug is injected into the wrinkle with a tiny insulin needle just half a millimeter thick.

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When do results appear and how long do they last?

Onset of action starts after three days to three weeks following the injection. The duration of action of the drug is dependent on the body, the indication, dosage and method of administration. Generally, however, the duration of the effects is from 4 to 6 months and sometimes more.

Frequently asked questions

Does this procedure leave any scars and if so, when do they disappear?

After the application, the patient can return to work as the signs usually resolve in less than 30 minutes. The signs are a little irritation, like a mosquito bite. Also, the patient is advised not to lie down for at least 3 hours after surgery for effective action of the drug.

What ages are the most appropriate for treatment with botox?

The appropriate age with the best results is after 30, wherein the treatment provides visible and physically impressive results, not excluding younger ages if there is an appropriate indication.


Are there any possible side effects?

The side effects are very rare. Such side effects are due to the movement of the liquid in adjacent muscles resulting in the unwanted temporary halt. But even such a rare side effect is 100% reversible and transient.


Is there a case if occurrence of antibodies that will reduce the drug’s effectiveness?

Antibodies to botulinum toxin may occur, resulting in decreased efficacy of the drug the next time it will be used. This of course may only occur in very long use and large amounts of medicament. It is worth noting here that in cases of lower limb spasticity in infants younger than 2 years, allocated quantities touching ten times than in the cases for wrinkles, again we have serious production of antibodies or other hazards.

Instructions after treatment

Useful info & tips:

  • try to exercise your facial muscles, for 20 to 30 minutes after treatment (e.g., frowning, lifting the eyebrows). This helps the drug to act faster through muscle. Although this technique will help, it does not mean that if you forget it there will be a negative impact on the final result
  • do not try to rub the areas where the treatment was applied, for the next 24 hours
  • do not use make – up for 4 hours after treatment
  • do not lie down and do not exercise vigorously for 3-4 hours after treatment
  • avoid hot showers, the hairdryer and excessive exposure to the sun, for the next two days
  • be sure that small speckles or redness will disappear completely within a few hours


Better results:

Treatment results may appear after 2 weeks. They are not permanent. They usually last for 3-4 months. If you follow the appointments for treatment with the frequency that your doctor will suggest, the results will last even longer. At the Institute of
Ophthalmology and Microsurgery Ophthalmica, the goal is that patients are fully satisfied with the result. So we see our patients between the 3rd and 4th month. The best clinical results are achieved within this period. If you allow the drug to be completely deactivated (6+ months), and then go back to your doctor, it will be difficult for them to see how various muscles responded to the treatment.


It is worth noting that the treatment is performed with a special technique that identifies the injections in the particular muscular structure of each patient. For this reason it is necessary for the doctor to see you before you activate the muscles again. The doctor should see you at the exact time when the muscle just starts to turn on, but before fully activated. This way it is possible to personalize the injection will have the best effect on your face.

Myths and reality

Myths and reality about botox:

  • Botox is actually a protein known since 1897 as a product of the bacterium clostridium botulinum. The exact mechanism of action was discovered in 1949, when it was found that transiently inhibits the secretion of acetylcholine (a neurotransmitter) from the nerve endings of the motor neuron, thereby reducing excessive muscle contractions. Thirty years later it was first implemented therapeutically for the treatment of strabismus and blepharospasm, and then it was approved (FDA) in a variety of medical disorders. Besides ophthalmological indications, neurological conditions such as migraines, persisting facial spasms, gastrointestinal, orthopedic, urological and gynecological diseases are mentioned indicatively.
  • Botox became known and it was discussed because of its use in cosmetic dermatology for reducing wrinkles of the glabellar, initially. Currently, it is applied around the upper portion of the face (forehead, eyes, nose) to reduce wrinkles caused by repeated dynamic muscle movements. In 2002 it was formally approved for cosmetic use in facial wrinkles, and began to be used in other dermatological diseases such as primary axillary hyperhidrosis and hyperhidrosis of the palms and soles
  • It is true that botox derives from the botulinum toxin, the effect of which is responsible for botulism, a serious disease that one gains from eating improperly preserved and canned sausage
  • but it is a great myth that botulinum toxin type A contained in botox in the form of purified toxin is harmful and dangerous to the human body. Clinical studies conducted in the last 14 years of the use of botox in cosmetic medicine attest that the side effects of botox are few and only transient, with more frequent, a mild headache and heaviness on the forehead after application that subside soon and decrease after repeated applications of the substance on the face
  • it is noteworthy that although to date several million injections have been performed for cosmetic reasons, serious side effects from its use in cosmetic medicine have never been observed. This is evidenced by studies conducted in large numbers of patients, according to which the most frequent adverse events were mild pain, redness or bruising at the injection site, and ptosis who was experienced transiently by a small number of patients, associated with improper application or dosage of the drug
  • it is heard that botox can alter and distort the facial features or “freeze” the expressions. This is another myth. Botox reduces muscle contractions that move the skin, resulting in fine lines that soften. When the dosage is correct and the appropriate anatomical landmarks, the expressions and facial features are not altered, but emerged, as the face looks more relaxed and refreshed
  • it is true that the duration of action of botox is transient, fully reversible. So yes, it should be repeated
  • it is a myth, the belief that after many applications the effectiveness of botox is reduced
  • there is no limit to the number of treatments that someone can do. In contrast, a study in a large number of patients, published in 2011 in the valid scientific journal American Society of Dermatologic Surgery, timely and consistent repeat treatment every 4-5 months results in greater wrinkle reduction, greater patient satisfaction and longer duration of the result, which in some cases can be up to 6-7 months
  • a myth is the notion that if someone decides, for some reason, to discontinue treatment will accelerate the aging process and deteriorate the image of their face. After its action, the person will simply, gradually return to its original, pre-treatment condition, as the muscles begin to move normally again
  • the safe time period for re-treatment is at least 4 months
  • it is a myth that the need for botox treatment is determined by age. There are persons with overactive muscles with intense expressiveness that need botox from the age of 20 to 25 years, while hypotonic persons may not develop wrinkles before the age of 30-35 years. Therefore the situation of the person and not age determine the need for the implementation of treatment
  • early initiation of treatment is proactive in the appearance and installation of wrinkles and maintains the youthful face for many years. Preventive application at ages 20-30 are often referred to as “baby botox” and keeps gaining ground
  • it is not true that botox is the magic solution that will completely eliminate wrinkles at any age. When wrinkles are quite prominent, they have settled and become permanent or if there is skin slackening coexist , botox, over a more relaxed view, will not completely erase the wrinkles. In such cases, a combination with other methods, such as filling with hyaluronic acid will be required
  • it is true that the application of botox cosmetic dermatology procedure is quite simple, brief and the person can return to their daily activities immediately
  • botox is an extremely sensitive substance to high temperatures. The results are reduced to improper maintenance, improper drug dissolution and retention thereof dissolved for some time before use
  • botox is an expensive medicine. Therefore the cost of treatment is relatively high. Choosing cheap solutions and “bidding” is dangerous, as in such cases the origin and quality of the drug is uncertain, the dissolution – diluting it not correct and the result, at best, is poor and of short duration. When we choose a medical treatment, the main criterion should be the experience of the doctor and the safety of treatment. In a non-original preparation there are serious and incalculable risks to our health
  • botox is a drug used in medicine for over 35 years with a number of clinical studies to demonstrate its efficacy and safety