Botulinum toxin

Origin and how it works

It was first used for migraine, and around 1987 some people also looked smoother where it had been placed, which is how cosmetic use began.

A muscle contracts when a nerve releases acetylcholine. The toxin reduces that release, so the treated muscle eases. It is used in very small amounts. Powder is mixed with saline to the units on the vial, then injected into the muscle.

It also has medical uses, such as squint, migraine, heavy sweating and bladder symptoms, and has been studied in more than 20 conditions.

Areas the clinic treats

Small muscles such as the forehead and the eye area are treated with the aim of softer lines and crow’s feet. The jaw muscle takes a larger dose, with the aim of a narrower V-shaped line. The menu also includes the nasal ala, neck, underarm sweating, calves and the contour of the back.

The clinic uses both Korean and US products, and also offers lifting programmes for the neck and back. The doctor chooses the product, the units and the number of points.

How the injection is done

The vial is under vacuum. The doctor mixes saline to the labelled units and injects with the smallest needle along the muscle, in several points so the muscle is covered. Dose and needle count follow the person’s muscle.

Before

Little special preparation is required. Collagen, vitamins or alcohol in the previous two weeks can make a needle mark bruise or bleed more easily.

It is not used in pregnancy or while breastfeeding, or after an allergy to the drug or its ingredients. Tell the doctor about conditions and medicines.

After

• Do not lie flat for the first 3 hours, so the dose is less likely to seep into a neighbouring muscle. Facial muscles sit close together. Spread in the first 3 days can leave the face looking uneven.
• Avoid heat on the area: hot water, steam, sauna, or a hairdryer aimed at the injection points.
• Washing and cream are fine. Do not rub, massage or scrub.
• Avoid alcohol. The clinic notes that regular drinkers seem to clear the toxin sooner, and that heat and alcohol shorten the effect over time.
• Leave laser for 2 weeks.

When a change shows, and how long it is described as lasting

According to Dr. Kony, lines start to change in about 7–10 days and are judged fully at about 1 month. Larger muscles, such as the jaw and calves, start at about 2 weeks and are judged at about 1 month.

Some people notice an onset within 24–72 hours, and in uncommon cases it can take up to 14 days. Follow the review your doctor sets rather than judging from the first day.

The Korean product discussed at the clinic is described as lasting up to about 6 months, while lines may start to return at 3–4 months. A higher dose can leave a stiff, mask-like face, so the dose is kept lower and the effect can be shorter. Dry skin, rubbing and heat bring lines back sooner. Frequent gum or tough chewing brings the jaw muscle back sooner.

About reactions

Most people tolerate the injection well. An unusual short-lived response is uncommon, and that about 1 in 100 people receiving type A may form antibodies that make a later treatment less effective. Side effects can occur, as with any procedure, and the doctor will explain them before treatment.

Questions