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2023-02-03

Botulinum Toxin (Toxin)

Toxin is one of my favourite treatments to do; I take a very individualised approach to each face. I often treat new patients in stages, giving a lower dose and having them come back after two weeks to see how their face has responded and which areas require a little more help. I carefully chart these treatments to get the optimal result and treatment plan for their future visits.

My goal is not to produce a motionless face but, rather, to achieve a refreshed relaxed appearance. When a person looks angry, tired, or worried, they send out negative signals to the people they encounter. In return, those people subconsciously engage with them on that level. I aim to eradicate these negative signals and produce a more youthful, relaxed, and smooth result.

Toxin is a protein made from the bacteria Clostridium botulinum. It was first approved by the US FDA in 1989 to treat eye conditions such as strabismus (squinting). Now, it has the approval to treat conditions from head to toe, such as: chronic headaches, hyperhidrosis, limb spasticity, cervical dystonia, strabismus, blepharospasm, and neurogenic detrusor overactivity.

“But it’s toxic!” I hear some people say. Well, I’ve also heard that Daddy long-legs spiders are the most poisonous spiders in the world. (Can we just take a moment to appreciate the scientist who came up with this name for these spiders.) While there is no scientific evidence to support the Daddy long-legs myth, Clostridium botulinum is a neurotoxin and at very high doses, such as the Botulism food poisoning outbreak in the 10th century, can be toxic. This is why it is available in tiny units (100 times less the toxic dose) and only administered by carefully trained and licensed medical professionals.

OnabotulinumtoxinA is carefully made from a protein of this bacteria and works by interfering with the release of acetylcholine, the main neurotransmitter at the neuromuscular junction. So in essence, it blocks the lock-and-key space between the nerve and muscle - restricting the message to make the muscle move.

The body naturally overcomes this inhibition of muscle contraction and it generally takes around 3 - 12 months depending on various factors.

Commonly we treat areas like the forehead, between the eyebrow, and crows feet. New research has shown that it is ideal to treat all areas simultaneously rather than separately to get value for money. This is because the way the body overcomes the blockage of the signalling happens faster if you treat areas separately.

The latest research has also revealed that the way the forehead contracts is very different to what was previously believed and thus there are newer more effective techniques for treating this area - that I am thrilled to be able to offer my patients.

Some people are unaware that Toxin is also one of the possible treatment options for chronic headaches, hyperhidrosis (excessive sweating), bruxism (jaw clenching/grinding of teeth), and platysmal bands (visible bands of the neck from ageing).

Myths:
1) Having Toxin will leave you with a frozen face
 - There are various techniques available to achieve different results and it is possible to achieve a natural relaxed appearance with carefully placed Toxin.
2) No one knows the long term effects
 - Toxin has been thoroughly studied since the 1980’s and thus has a long and well established safety history.
3) If you stop Toxin treatments your wrinkles will get worse
 - If you decide to stop getting Toxin treatments the muscles in your face will contract and could lead to the natural lines and wrinkles you’d get with ageing.
4) Toxin goes to distant parts in the body
 - There is no current scientific research documented supporting this claim.
5) Toxin is only for older people
 - Toxin is approved by the FDA from the age of 18
6) Botox is addictive
 - Botox has no addictive properties
7) Toxin is painful
 - The needle is tiny and not injected deeply, thus relatively painless.

There are a few possible side effects documents in the research such as; bruising especially if a patient is taking Aspirin, vitamin E or Non-steroidal Anti-Inflammatories, so it is recommended - if possible and not medically contraindicated - a patient refrain from taking these two weeks prior to treatment. Rare complications can include feeling flu-like symptoms, and eyelid ptosis (weakness of the eyelid), and even Dr. Spock eyebrows. So, it is important to go to a very well trained medical doctor and also make sure to follow the recommendations:

Precare
To reduce the risk of bruising or bleeding at the injection point:
One week prior to Toxin treatment, we advise you to avoid using alcohol, garlic, lidocaine, aspirin, or any other non-steroidal anti-inflammatory drugs for pain, swelling and / or fever, such as medications containing diclofenac, mefenamic acid, indometacin or ibuprofen - ask your doctor before stopping chronic medication.

Make sure to inform your aesthetic doctor of your medical history and any current problems, as well as details of any allergies or medication you are taking.

Postcare
The aesthetic effects of Toxin last for an average of 3-4 months but will vary depending on the condition of the skin, area treated, amount of product injected, injection technique and lifestyle factors such as sun exposure and smoking. Results of the treatment may take up to 14 days to take full effect.

After treatment:
●  For 4 hours - do not lie down or do strenuous exercise and similar activities, nor should you do anything that will increase the blood flow to the injection area.
●  For 12 hours - avoid extreme facial expressions, alcohol consumption, and applying make-up.
●  For 24 hours -  do not rub or massage the treated areas as this could influence the effect of the product.
●  For 2 weeks - avoid direct sun exposure, UV light, freezing temperatures and saunas.

I have full aesthetic consultations where I’d do an aesthetic assessment and together we design a treatment plan that best addresses your main concerns.

If you have any questions please feel free to get in touch.