Botulinum toxin is used to soften expression lines caused by the contraction of the facial mimic muscles, such as frown lines (between the eyebrows), forehead lines and crow’s feet.
Botulinum toxin is a prescription-only medicine, authorised in Italy also for the aesthetic treatment of upper-face lines. It must be prescribed and injected by a doctor: the choice of product and dose is up to the doctor, based on the assessment of each patient.
It causes a temporary block of the contraction of only the muscles where it is injected, reducing the lines produced by facial expressions.
Facial expression is preserved: the lines that come with smiling (crow’s feet), the frowning, worried look (frown lines) or the “surprised” look (forehead lines) are smoothed, giving a more relaxed, rested and fresh look.
The effect lasts on average about 4 months, with some variation from person to person; for this reason the treatment is usually repeated 2 or 3 times a year. When performed by an experienced doctor, risks and complications are rare and temporary.
The main problems come from products of uncertain origin and from treatments performed by non-medical staff.
Combined with fillers of the cheeks and of the area around the mouth, botulinum toxin allows a harmonious treatment of the whole face.
Botulinum toxin is used therapeutically by neurologists and ophthalmologists. Ophthalmologists were among the first to use it, to treat conditions such as blepharospasm and strabismus.
In aesthetic medicine it is injected in very high dilutions and at low doses: a few micro-injections reduce, within a few days, the contraction of the mimic muscles around the eyes and therefore the lines around the eyes.
The lines that respond best are frown lines, forehead lines and crow’s feet.
The treatment is performed in the clinic and the patient can go back to work straight afterwards, usually with no visible marks.
To rejuvenate the eye area, botulinum toxin is an effective technique and also a support to surgery, because it helps the results last longer.
The eyes are the first thing we notice in a person, in real life or on a screen. A fresh look conveys energy and vitality, in men and women alike.
The face, and the eyes in particular, matters in our personal and professional life. We can age well at any age, and taking care of the eye area can improve how we feel and how we present ourselves to others.
Aesthetic medicine plays an important role because it offers treatments with minimal recovery time and limited risks.
The treatment plan is assessed and tailored to each patient, based on their features and requests. First of all we establish whether the patient is a good candidate for botulinum toxin; we examine the mimic muscles involved in the contraction and agree the treatment plan with the patient.
I observe the patient at rest (with a still face) and in motion (with active expressions) to assess expressions, asymmetries and line formation. Then I take some measurements and mark the points where I plan to place the product. Usually 12-15 micro-injections are made in the selected areas. Patients can wear make-up straight away and go back to their social or professional activities as soon as they leave the clinic.
No anaesthesia is needed, because the treatment is well tolerated: only the skin is numbed with a specific cream or with cold. The treatment consists of a few tiny injections, each lasting a fraction of a second, made with very fine needles into the muscle to be treated. The whole treatment takes about 10 minutes and the patient can go back to their activities immediately, usually with no visible marks.
The effects start to show after 48-72 hours and peak at about two weeks, when the patient is normally seen again for a check-up. The effect lasts on average about 4 months and the treatment can be repeated 2-3 times a year.
Will people see that I had something done? Will I look fake? Will I keep my expressions?
A well-performed treatment should look natural and the doctor’s hand should be invisible. The result is a fresh, relaxed and rested look, but a normal one.
Facial expression is preserved: my patients include people who work with their facial expressions, such as stage actors and opera singers.
Today there is no need to choose between a natural look with increasingly visible lines and a “frozen”, motionless face. Micro botulinum toxin is a technique of preparation and injection of botulinum toxin that uses very diluted micro-doses, injected superficially where the mimic muscles insert into the skin.
The aim is not to block the function of the muscle, but to reduce the lines that form on the skin. The technique can also be used in the lower face, for lines around the lips, chin and neck.
Botulinum toxin remains one of the most effective medical treatments for the eye area and, with this technique, it can be extended to other areas of the face. The result depends largely on the doctor’s experience: this is why it is important to see a specialist.
Botulinum toxin is a medicine obtained from a bacterial toxin, just as some antibiotics are derived from moulds. It has been used in medicine for over 30 years and, at aesthetic doses, side effects are rare and usually temporary: the best known is a temporary drooping of the upper eyelid (ptosis), which resolves within a few weeks.
The main precaution is that the treatment is performed by a doctor with specific aesthetic training, ideally an expert in the eye area, in a medical clinic and with products of certain origin.
In Italy, injecting botulinum toxin is a medical act: be wary of treatments performed by non-medical staff or outside a healthcare facility. Complications are mainly related to products of uncertain quality and to the inexperience of whoever administers them.
The first effects are visible after 48-72 hours and the full result is reached in about two weeks.
On average about 4 months, with differences from person to person. To maintain the result, the treatment is usually repeated 2-3 times a year.
A well-performed treatment smooths lines without blocking expression: the face looks rested, not “frozen”. The result depends on the initial assessment and on the doctor’s experience.
They are rare and temporary: slight redness at the injection points and, rarely, a temporary drooping of the eyelid that resolves within a few weeks.
Only a doctor, in a medical clinic. Knowledge of the anatomy of the eye area is important for a natural and safe result.
Botulinum toxin can be combined with other non-surgical treatments of the eye area, such as hyaluronic acid fillers and the G-Point Lift, or with surgery, such as the endoscopic forehead and brow lift. For a personal assessment, see our clinics in Genoa and Milan.
See also:
Advances in the use of botulinum neurotoxins in facial esthetics. J Cosmet Dermatol. 2012 Mar;11(1):42-50. doi: 10.1111/j.1473-2165.2011.00593.x.
