Application of botulinum toxin

Prevencia vzniku mimických vrások a rýchle odstránenie už vzniknutých vrások

Application of botulinum toxin is together with application of hyaluronic acid the most often using method not only at our clinic but also in the world. Despite of longtime experience in application of this substance clients often have negative attitude to this method, their first reaction mostly is: "I am afraid, it's a toxin".

But ladies and gentleman, let's be honest, how many toxins are used in medicine? Consider just Purple foxglove - Digitalis purpurea, whose extract is used in healing heart disease; also Nightshade - Belladonna, which is used for mydriasis in ophthalmology and as a sedative; or penicillin which is basically a product of molds.

Botulinum toxin used in medicine is totally safe with minimum side and undesirable effects and to be honest so far we haven't had a client with adverse reaction after application of botulinum toxin.

History of the discovery of this toxin falls to the Napoleonic wars when a small epidemic occured that caused the death of many soldiers. It was assumed that it was food poisoning, especially after eating smoked sausage - that's why we call it botulinum toxin - sausage poison (botulum - Latin sausage).

In 1897 it was for the first time isolated the bacterium Clostridium botullinium, and in 1949 was discovered the actual effect of botulinum toxin and that it blocks the transmission of nerve impulses to the muscle plate, thus the nervous system does not give instructions to the muscle movement, causing partial paralysis of the muscle.

Cosmetic effect of botulinum toxin was for the first time described by American plastic surgeon Dr. Clarck and in 1992 was discovered also it's effect for wrinkles in eye area. In ophthalmology was botulinum toxin used several years ago for removing ticks and patients described disappearance wrinkles as an adverse reaction - side effect of the substance.

In 2002 was botulinum toxin type A (BOTOX) approved by US Food and Drug Administration (FDA) to temporarily improve the appearance of moderate-to-severe lines without using scalpel and surgery procedures.

 

When is the right age to start with the application of botulinum toxin?

The exact age limit doesn't exist. At trainings and courses it's said that botulinum toxin can be applied from the age of 17. Maybe you consider it too soon but in this age a bad habit is created - wrinkling forehead between the eyebrows which can lead to creation of first wrinkle. A similar phenomenon cen be observed in short-sighted people who do not wear glasses and

But in this age of young people there is a bad habit - wrinkling forehead between the eyebrows, which can begin to create the first wrinkle, a similar phenomenon can be observed even in short-sighted people who do not use glasses and sharpen their eyesight by nictating and thus wrinkling forehead.

Our youngest clients are about 23 years old and their need for application of BOTOX results not only from the creation of first wrinkle but also from the observation of their mothers who have line between eyebrows significant already at their wedding photo. The upper age limit for applying BOTOX is about 50 years old, in older age wrinkles are already fixed, we observe so-called broken skin, which cannot be affected by this method. In older age there is also a risk of "falling eyelids" because patients often compensate flabby overhanging eyelids by raising a forehead. If this move is blocked by BOTOX eyelids "fall" and face gets a "tired look" - this is also a signal for plastic surgery of upper eyelids.

Based on these experience we can sum up that Botulinum toxin is an excellent prevention against the appearance of wrinkles and it ideally should be applied in the age of 30-50.

 

Where is botulinum toxin applied and for what it is used in aesthetic dermatology?

Botulinum toxin is applied on face especially in the glabellar lines area - line between the eyebrows ("anger wrinkle"), forehead area - horizontal lines caused by raising forehead ("wonder wrinkle") and eye area - wrinkles by the outer corners of the eyes.

It also can be applied at the sides of the nose created by wrinkling nose, then for removing wrinkles at the upper lip (we don't recommend this application because it often completely blocks move of the upper lip and unables pouting lips when drinking or kissing - it also calls a "Sicilian lip" as it's said that Sicilians don't move upper lip when speaking).

Recently is botulinum toxin also used in the form of MEZOBOTOX which is threefold diluted botulinum toxin than the normal application. This method applies the substance into small surface lines for instance in cheeks, chin and neck and the result is relaxed skin without lines.

 

Botulinum toxin and excessive sweating.

Excessive sweating in armpits, palms and feet is a serious problem especially for social active people. These people mostly already tried to use everything - antiperspirants, various pharmacy products, herbs, even a psychotherapy. Non of these helped - they come among other people, start to realize that they don't want to sweat, start to be nervous followed by excessive sweating.

In these cases the application of botulinum toxin is an ideal solution. It completely stops sweating in the area of application and this effect lasts 6-9 months.

 

How it botulinum toxin applied?

The procedure is very simple and short, there are clients who come to apply botulinum toxing during their lunch break. It is applied by thin needle so patient almost doesn't feel it. The number of incisions depends on location where BOTOX is applied. The anger wrinkle needs 4-6 incisions, horizontal forehead wrinkles 5-7 and lines in the eye area 3-5 incisions at each corner.

Moderate swelling, redness or slight bruising may occur for several minutes after the procedure. It can be covered with correction fluid and disappear within a few days. The actual effect starts after 48-72 hours and fully develops within 2-3 weeks.

After the first application the effect of paralysing facial muscles lasts circa 3-4 months. By repeating the application is the effect prolonged to 9-12 months.

 

What I can and cannot do after the application of botulinum toxin?

Each client is after the procedure informed about certain facts. After the procedure, you should not lie down in a horizontal position for 4-6 hours, it is not recommended to drink alcohol for two days, to perform excessive physical activity, to visit sauna, to lean forward, to touch the treated area...

It is recommended to move the treated muscles as much as possible - wrinkling forehead, frowning and smiling, for the best effect.

 

When it is not recommended to realize the procedure?

One of the contraindications is especially pregnancy and lactation so if the client cannot absolutely exclude the pregnancy, we recommend to use the pregnancy test (for these cases we have them at our clinic).

Botulinum toxin cannot be applied by auto-immune diseases.

 

What else should we add?

Dear ladies and gentlemen, botulinum toxin is an excellent and time-honored method, which don't need to be afraid of. Do not believe the dubious articles that botulinum toxin is addictive like a drug. Yes, it is a habit but in positive meaning.

Just try once and you will understand how awesome is to look in the mirror and not to see the anger wrinkle when not frowning, how pleasant is to be able to have a haircut without bangs that covers the forehead wrinkles and how wonderful is to wear a silk blouse or tight T-shirt without having to be afraid of sweat maps in the armpits.

Kde sa na tvári aplikuje botulotoxín?

- do oblasti glabely – vráska medzi obočím, tzv. vráska hnevu
- v oblasti čela – horizontálne vrásky na čele, tzv. vrásky údivu
- do vrások pri vonkajších kútikoch očí, tzv. stračie nôžky. Pozitívnym efektom pri aplikácii do hornej časti čela je nadvihnutie vonkajších strán obočia
- do vrások vzniknutých po stranách nosa, ktoré vznikajú pri krčení nosa
- odstránenie vrások na hornej pere. Naša klinika sa však snaží aplikáciu do tejto oblasti nerealizovať často, z dôvodu vzniku úplného znehybnenia hornej pery, čoho následkom je znemožnenie špúlenia pery pri bežných úkonoch, akými sú pitie nápojov z pohára alebo bozkávanie. Účinne sa dajú tieto vrásky odstrániť kyselinou hyalurónovou.

V poslednom období sa botulotoxín využíva aj vo forme Mezobotoxu – čo je trojnásobne zriedený botulotoxín. Pri tejto metóde sa roztok aplikuje do jemných povrchových vrások - napríklad na lícach, brade a krku. Výsledkom je zrelaxovaná koža bez vrások.

Kedy je ten správny vek začať s aplikáciou botulotoxínu?

Neexistuje presná veková hranica. Botulotoxín sa dá aplikovať už od 17-tich rokov. V tomto veku môže vznikať u mladých ľudí zlozvyk – krčenie čela medzi obočím, čím dochádza k vzniku prvých vrások. Horná veková hranica, keď botulotoxín ešte má efekt, je cca 50 rokov. Vo vyššom veku sú už vrásky fixované, pozorujeme tzv. polámanú kožu, ktorá sa už aplikáciou botulotoxínu nedá odstrániť.

 

Ako prebieha aplikácia botulotoxínu?

Samotný zákrok je veľmi jednoduchý a prebieha rýchlo. Botulotoxín sa aplikuje tenkou ihlou – inzulínkou, preto vpichy takmer necítite. Počet vpichov závisí od lokality, do ktorej je botox aplikovaný – počet sa pohybuje medzi 3 - 7 vpichmi. Po vpichoch môže niekoľko minút pretrvávať mierne zdurenie či začervenanie, prípadne drobná modrina, ktorá sa dá prekryť korektorom a do niekoľkých dní vymizne. Samotný efekt nastupuje po 48 - 72 hodinách a plne sa rozvinie do 2 - 3 týždňov.
Po prvej aplikácii efekt znehybnenia mimických svalov pretrváva cca 3 - 4 mesiace, pri opakovaných aplikáciách sa efekt botulotoxínu predlžuje až na 9 - 12 mesiacov.

Dĺžka trvania zákroku je približne 10 minút.

Čo môžem a čo nemôžem robiť po aplikácii botulotoxínu?

Po zákroku by ste si nemali 4 - 6 hodín ľahnúť do vodorovnej polohy a nepredkláňať sa, neodporúča sa dva dni piť alkohol, vykonávať nadmernú fyzickú aktivitu – napríklad cvičiť a ísť do sauny. Dôležité je aj nedotýkať sa ošetrenej oblasti.
Zároveň sa odporúča čo najviac pohybovať ošetrenými svalmi – krčiť čelo, mračiť sa a usmievať sa. Tým bude efekt účinnejší.

Kedy sa neodporúča realizovať tento zákrok?

Kontraindikáciou je predovšetkým tehotenstvo, ktoré musí byť absolútne vylúčené, tiež dojčenie a autoimúnne ochorenia.

Botulotoxín v dermatológii

Napriek dlhoročným skúsenostiam s danou látkou sa často stretávame s negatívnym postojom k tejto metóde, klientky majú strach a obavy, že ide o jed.

Botulotoxín používaný v medicíne je absolútne bezpečný a má minimum nežiaducich účinkov

Kozmetický efekt botulotoxínu bol prvýkrát popísaný americkým plastickým chirurgom Dr. Clarckom. V roku 1992 bol prvýkrát opísaný aj jeho efekt na vrásky v oblasti očí. V očnom lekárstve sa totiž botulotoxín používal už dávnejšie na odstránenie tikov a ako „nežiaduci účinok“ – ako vedľajší efekt popisovali pacienti aj vymiznutie vrások v mieste aplikácie tejto látky.

V roku 2002 bol botulotoxín typu A (BOTOX) schválený americkým úradom na kontrolu liečiv FDA na dočasné vylepšenie vzhľadu bez použitia skalpela a operačných prístupov.

SME ŠKOLIACE STREDISKO V APLIKÁCII BOTULOTOXÍNU.

Aplikácia botulotoxínu

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Before & After

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Prices

botulotoxin application between eyebrow (glabella)from 68 to 102,- €
botulotoxin application to the foreheadfrom 80 to 102,- €
botulotoxin application to the crows feet102,- €
botulotoxin application to the mouth corners34,- €
botulotoxin application to the neck area- Nefertiti effectfrom 80 to 170,- €

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