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Botox (Botulinum)

Forehead wrinkles, frown lines and crow’s feet as well as fine lines and wrinkles on the sides of the eyes are caused by unconscious permanent tension in the mimic muscles. The injection of botulinum leads to relaxation of the mimic muscles by reducing the activity of the affected muscles. Wrinkles and wrinkles are smoothed out. You will look much fresher after a short time. Botulinum treatment can also improve migraines.


Botox treatment for migraines

Botox or botulinum toxin A is now also used very successfully for chronic migraines. Injections into certain neck and head muscles can make a very good contribution to preventing migraine attacks. We would be happy to inform you about the possibilities in a personal consultation.

Botox treatment for hyperhidrosis

Botulinum is also excellent for treating excessive sweating (hyperhidrosis). We have been using this method successfully for many years. The effect begins after just a few days!

Botulinum is injected into the appropriate muscles with a very fine cannula. A permanent tension in the muscles is thus released very effectively, which leads to the tightening of the wrinkles and fine lines there. The onset of action comes about 3-5 days after treatment and lasts about six months after primary treatment.

The duration of action can be extended by up to a year with repeated applications. In this way, a further deepening and new formation of wrinkles is prevented at the same time.

After the treatment, there may be slight swelling and possibly also redness at the injection site, which usually disappears the next day.

Frequently asked questions about botulinum toxin

1. What actually is Botox?

Botox is the trade name of the first preparation with botulinum toxin. Botulinum toxin (BTX) itself is a naturally occurring bacterial protein made by bacteria called Clostridium botulinum. For decades, BTX (a distinction is made between type A and type B) has been used successfully and safely to treat various nerve and muscle diseases. Botulinum toxin type A (BTX-A) has been used in aesthetic medicine for around 15 years. BTX inhibits the transmission of excitation from nerve cells to muscles, which reduces muscle activity for 3-6 months and gently smoothes out wrinkles. There are now several comparable BTX preparations on the market that have been approved as a drug for correcting wrinkles caused by facial expressions. Nowadays one no longer speaks of “poison” or “toxin”, the term botulinum has become common in dermatological usage.

2. Can botulinum have a negative effect on the entire system of the organism?

BTX-A has been used for over 30 years and in relatively high doses to treat pathological muscle cramps (spasms). From these experiences it is known that the drug does not cause any long-term side effects. Microscopic examinations were able to show that no permanent changes to the nerves or muscles result after the botulinum effect has worn off.

3. Which wrinkles can be treated?

BTX-A works particularly well on wrinkles caused by unconscious muscle tension. The best-known example of this is the so-called “frown line”. The classic area of application for BTX-A are wrinkles in the forehead area and around the eyes caused by facial expressions. There are also areas of application around the mouth to smooth out small wrinkles. However, the safe use of BTX-A always belongs in the hands of experienced doctors.

4. How does the wrinkle smoothing work and how often or at what intervals does it have to be repeated?

First of all, in a joint detailed discussion, it is determined what the patient would like to have treated and to what extent this can be represented with BTX-A. There are also other treatment methods for wrinkle smoothing, some of which are used in combination. But back to the topic: Knowing the anatomy and the course of the corresponding mimic muscles, BTX-A is injected exactly into the desired area with a thin needle. This leads to a relaxation of the corresponding muscle and a smoothing or reduction of mimic wrinkles. This effect lasts between 3-6 months. After that, another treatment can be carried out.

5. Does it hurt?

When injecting with the very thin needle, you may feel a needle prick. The injection of BTX-A itself can also be felt as a short, small pressure with perhaps a little burning. Before the treatment, the area in question can be effectively pre-treated with an anesthetic cream, so that the treatment can be carried out almost painlessly. In general, however, the procedure is not really painful.

6. When is one "gesellschaftsfähig% 22 again after the treatment?

You are socially acceptable again immediately after the treatment. There may be brief reddening at the puncture site, but this will subside after a few minutes. Small bruises rarely occur, which disappear after a few days and can be covered cosmetically without any problems during this time.

7. What complications can occur with botulinum treatment?

Treatment with BTX-A always belongs in the hands of experienced doctors! Long-term undesirable side effects are not known to date. There is also no poisoning from accidental injections. The drug has a large therapeutic range, ie the smallest dose changes have almost no effect on the entire organism. However, the patients should be correctly informed about possible temporary side effects in an informed consent discussion. These include: bruising, drooping of the upper eyelid, headache, swelling around the eyes, blurred vision, itching, rash, skin redness and hypersensitivity. However, these temporary side effects are very rare when injected correctly by the experienced doctor. A follow-up appointment within the next 14 days is recommended to assess the outcome of the treatment.

8. You keep reading about Botox migrating into the brain...! Is there something to it?

There were press releases in this regard, where correspondingly high concentrations could be measured in a high-dose mouse experiment. But this attempt was made with a multiple of a normal dose! Applied to humans, the BTX-A would have to be injected “by the liter” so to speak…

9. Can sensory disturbances such as numbness occur in the treated area?

A feeling of numbness shortly after the injection of BTX-A may be possible, but then only lasts for a few days. There is no numbness in the sense that it lasts for about half a year during the Botox effect.

10. What must be considered after the treatment? And what's the worst that can happen if you don't stick to it?

Cooling of the region is recommended immediately after treatment with BTX-A. Rubbing or massaging the treated areas should be avoided. On the day of treatment, the patient should take it easy, in particular not do any sports and avoid cosmetic treatments and lymphatic drainage.

11. Can an allergic reaction to botulinum occur after treatment?

In the manufacture of BTX-A, highly purified human albumin is used, which has been approved for use in human medicines. The patient should be informed about the possibility of an allergic reaction, but these are extremely rare.

12. How often can the treatment be repeated after the effect has worn off?

After the BTX effect has worn off, it can of course be repeated. This point in time should be determined individually with the doctor treating you. The ideal time is shortly after regaining the appropriate movement of facial expressions. But in any case, an improvement in effectiveness after repeated use of BTX-A is known.

13. Can Botox become ineffective with repeated use and how long does it last, or does it change with regular treatment?

In the repeated injection treatment of some nervous diseases, very large amounts of BTX are injected. This can lead to the formation of blocking antibodies, which impede the effectiveness of BTX. When treating mimic wrinkles, we work with very low doses, so this phenomenon is rather unlikely.

14. Is Botolinum also used during pregnancy/when breastfeeding?

No, BTX-A should not be injected during pregnancy or breastfeeding, as there is not enough experience with many other medications.

15. Can a botulinum treatment also help with migraines and headaches?

BTX-A can also be used successfully to treat migraines. Many patients report an improvement in their symptoms shortly after treatment. In more than half of all patients with frequent attacks, attacks of pain and tension headaches are mutually reinforcing. In such cases, botulinum breaks this vicious circle. But BTX can also be used for chronic neck or back pain. However, this is not the domain of dermatologists.

16. Pain can also be treated with botulinum, what kind of pain is this?

That’s true, but it’s not the dermatologist’s domain. For example, you can weaken a chewing muscle so that the nocturnal grinding of teeth and the associated pain in the jaw joint disappear. However, this should be carried out by an experienced oral and maxillofacial surgeon. This also goes beyond the intention of an aesthetic-dermatological treatment.

17. When is botulinum treatment not recommended?

Botulinum should not be injected if certain nerve or muscle diseases are present, if there are acute infections in the treatment area, if there is a strong tendency to bleed or if you are taking blood-thinning medication or certain antibiotics.

18. How does it feel when you memorize certain facial expressions for years (literally) and suddenly nothing works anymore?

Surprisingly, you don’t miss it when you suddenly can’t frown anymore or when you no longer have strong wrinkles around your eyes when you laugh…

19. Doesn't botulinum turn patients into mask-faced zombies? The best examples are stars and starlets from the USA – has too much been done here, or has something been done wrong here? Many people have these terrifying images in their minds. Could that be the reason why there is panic precisely because of this?

Incorrectly placed or overdosed injections of BTX-A for wrinkle treatment can actually lead to an unnatural facial expression, a “mask face”. For this reason, treatment with botulinum should only be carried out by experienced doctors. The injection should be individually tailored to the patient with precise knowledge of the anatomy of the facial muscles. This ensures that a naturally beautiful result is achieved. In the USA, however, a different ideal of beauty prevails with regard to aesthetic interventions: you should see that something has been done, in contrast to us: you should look good, but nobody should know that help has been taken!

20. What other medicinal uses are there for botulinum? Are there actually creams with botox ingredients?

The “Botox creams” do not contain botulinum, but the active ingredient Argireline. This is a Botox-like protein that, like Botox, prevents the release of acetylcholine. For galenic reasons, the original botulinum would not be incorporated into a cream, as this would destroy the substance. However, the “Botox cream” cannot replace a BTX-A injection, but one area of application for these creams is, for example, small creases around the eyes. If necessary, the results of botulinum toxin injections can also be extended here. However, no dynamic wrinkles can be treated directly, since the substance cannot penetrate as far as the muscles.

21. What does science know about the long-term side effects?

Long-term undesirable side effects of BTX-A are not known.
BTX-A has been used for over 30 years and in relatively high doses to treat pathological muscle cramps (spasms). From these experiences it is known that the drug does not cause any long-term side effects. Microscopic examinations were able to show that no permanent changes to the nerves or muscles result after the botulinum effect has worn off.

22. What costs can be expected for the treatment?

Depending on the area treated, the treatment costs from 300 euros (e.g. for an isolated smoothing of a “tender” frown line) to 450 euros for a complete package for forehead/frown lines and eyes. Such a package is then often combined with other procedures such as hyaluronic acid for deeper wrinkles, which are not only caused by facial expressions. This is priced in a similar way.

23. Can you help to extend the duration of the effect?

No, you cannot influence that. The loss of effectiveness or the regaining of muscle movement depends on how quickly the nerve ending sprouts again microscopically. This varies from person to person and cannot be predicted.

24. How is the drug assessed from a medical point of view?

With BTX-A, a highly effective drug is available which enables effective, safe and gentle treatment of wrinkles. In the hands of an experienced therapist, very good results can be achieved with few side effects. In addition, BTX-A can be combined with a number of other modern, non-invasive methods of wrinkle treatment, such as treatment with hyaluronic acid. Thus, the optimal result can be achieved individually for each patient.

25. Statements

On the one hand, the desired treatment and the feasibility of the treatment must match. Unfulfillable wishes lead to dissatisfaction on both sides when trying to treat them anyway.

Second, we have our own philosophy of treatment: we want to accentuate and moderately enhance a beautiful face. We have various options available for this, which we coordinate individually. This means that you don’t see a good treatment, but the patient simply looks more rested and relaxed. Anyone who wants to radically transform their face is definitely out of place with us.

Thirdly, it is great fun to see the patient at the check-up appointment and to share their happiness about the treatment result! BTX A does not make you happy, but you feel more attractive and significantly happier, which has a positive effect on your environment.