Medical Cosmetic Service

Wrinkle relaxing injections - Patient Information Sheet

What is botulinum toxin?

Botulinum toxin is a bacterium that blocks the release of acetylcholine, the substance responsible for transmitting electrical impulses that elicit muscle contraction. In medicine, botulinum toxin is injected directly into hyperactive muscles. It has been safely and effectively used for treatment of strabismus (cross-eye) and blepharospasm (lid spasm) since the early Eighties.

How does botulinum toxin work?

Hyperactivity of the facial expression muscles often results in the development of deep frown lines, forehead lines and/or crow's feet. Injecting botulinum toxin into the affected area temporarily paralyzes the underlying muscles responsible for wrinkling, giving the face a more relaxed and pleasant appearance. The wrinkles become smoother or disappear altogether. Botulinum toxin therapy cannot replace wrinkle correction methods such as collagen implantation, laser peeling or autologous fat transplantation when these are necessary.

When and for how long does botulinum toxin work?

The initial effects of treatment become visible within 48 to 72 hours. The maximum effect is reached in about 1 to 2 weeks. Your facial expression will become more relaxed, but by no means mask-like. The overall result is very natural. The effect of treatment generally lasts for 3 to 6 months. Re-treatment is then required.

Potential adverse effects (side effects)

Botulinum toxin injection is generally a safe and effective treatment method. Nevertheless, certain side effects can occur but, like the intended treatment effects, they are mostly reversible. At your appointment you will be informed about the potential side effects of botulinum toxin therapy, contraindications to therapy and potential drug interactions.

Potential side effects:

• Bruising or swelling at the injection site
• Slight feeling of nausea
• Tiredness, pain in the arms and legs
• Temporary drooping of the eyebrow or upper eyelid
• Brief visual disturbances
• Dryness of the eyes
• Skin rash
• Itching
• Allergic reactions (albumin)
• Dry mouth
• Muscle atrophy
• Muscle recruitment, i.e. compensatory fine wrinkles appearing in other sites

Contraindications:

• Pregnancy
• Breast feeding
• Myasthenia gravis
• Lambert-Eaton syndrome
• Bell's palsy
• Blood coagulation disorders

Cautions:

• Aspirin
• Anti-inflammatory drugs
• Vitamin E
• Gingko Biloba
• St John's Wort

Drug Interactions:

Drug interactions can occur when botulinum toxin is used concomitantly with other medications. Since these medications can alter the effects of botulinum toxin, you must ensure that your doctor is aware of any current medications you are taking, especially aminoglycoside antibiotics (e.g. gentamicin, amikacin, neomycin, netilmicin, tobramycin).