|What is Botulinum Toxin?It is a natural purified protein produced by anaerobic bacteria, the so called Clostridium botulinum. There are seven different serotypes A, B, C, D, E, F and G, types A, B and F have beneficial effects in humans, being the variant type A, the longest in duration.The Botulinum Toxin is able to block the transmission of impulses which activate the muscular fibers and the sweat glands by inhibiting the release of acetylcholine, the intermediary responsible for transmitting.For years has been used in medicine to correct abnormal muscle contractions of the muscles of the eyes, neck and extremities (strabismus, blepharospasm, dystonia, spasmsticity), and is already more than 15 years ago that is used in cosmetic dermatology.
How does it work?
Temporarily paralyzing the muscles that cause with their contraction the so call facial wrinkles, giving the face a relaxed look. It will not remove deep wrinkles already formed that can be corrected later by other methods once achieved the relaxation of the area.
What are its effects?
Botulinum toxin attenuates the facial expression lines and delays the appearance of those, having therefore an important prophylactic effect, to prevent with its use, the formation of future facial wrinkles, especially in young people. After treatment, peripheral skin is smooth and unwrinkled, while the untreated facial muscles contract normally, allowing the facial expression not to be altered, remaining completely relaxed and natural, also making the facial gaze more open and youthful.
How long will the effect last for?
The effect is not immediate, it starts after 48-72 hours and the maximum effect occurs between the 7th to 14th days. The relaxation effect is very natural and does not detract the facial expression; it lasts between 3 and 5 months and can be reapply when necessary
Does it produce habituation?
There are no studies showing that the body creates defenses against botulinum toxin, making it ineffective, or even used in large quantities, which is not the case in cosmetic dermatology. On the contrary, on some people the effects can last over six months if repeatedly treatment has been made, which is explained by the lack of repeated exercise on the treated complex muscle.
What special care should follow before and after treatment?
No special preparation is needed, but it is advisable not to take anticoagulants 24 hours before, such as ibuprofen, aspirin etc. to avoid bruising. The treatment is very quick and does not altered the patient’s daily life, who simply must avoid sunbathing the first few hours, use a high sunscreen, not to massage the injection site, or to make sudden movements.
Is it safe? What are the side effects?
This technique is absolutely safe as it used in minimal doses and it is harmless. Misapplied can produce side effects such as “the surprise look”; drooping eyelids, that they are like the intended effects, that is, temporary and reversible. It has interaction with aminoglycoside antibiotics.
It may cause discomfort such as burning and pain at the injection site, mild and temporary headaches, temporary eyelid ptosis (drooping or falling of the upper or lowereyelid). It could also take place the appearance of a small hematoma in the injection zone, which can be corrected with makeup and lasts for a few days.
|Who does this?It should be perform by specialist with a thorough knowledge of human anatomy, experience and proper training. Dr. Rafael Spagnuolo by his training and his experience in surgery posses a perfect knowledge of the facial muscles, which added to his further specific training and experience in the appliance of this substance, make it the appropriate professional in the used-placing of these methods, eradicating the possibility of any side effects resulting from misapplication.
Can be combined with other cosmetic dermatology treatments?
Patients treated with botulinum toxin can benefit greatly from the combination with other treatments such as fillings, that way, if we treat frown lines with botulinum toxin and then we fill them, the result will be more satisfying and with longer lasting effects.It can also be combined with peeling, mesotherapy etc… It is not recommended a subsequent combination with radiofrequency as the results would be less durable.
Botulinum toxin in treating hiperhidrosis
Hyperhidrosis is an exaggerated and unnecessary increased of sweating, especially the axillaes, hands and feet, being the hands, the most troublesome for the sufferer.
The sweat, serves to regulate body temperature, it is regulated by the nervous system, and when sometimes operating improperly sends exaggerated stimulations to the sweat glands causing excessive sweating in some body parts.
The botulinum toxin treatment, blocks the nerve relationship and prevents the nervous-sweat gland production and it can be used in the axillae, palms, soles and under the breasts area.
Botulinum toxin produces an inhibitory effect on the secretor eccrine cells, which are innervated by cholinergic neurons and reduces the production of sweat.
Before placement a test is performed the so called “Minor Test”, a tests using iodine- starch to define the area to be treated.
Once the hyperhidrotic area is defined a 50-200 units of Botulinum Toxin is injected intradermally. The dose is divided into 10-30 injections at a depth of 3.5 mm, with a very small needle (used in mesotherapy), at spaced points of approximately 2 centimeters, sufficient to cover the affected area. The injection is usually well tolerated without anesthesia. For other areas can be used anesthesia or local cold.
The anhydrotic effect can be seen in the following 24-72 hours and usually is very pleasing.
Although apocrine glands are innervated by adrenergic fibers and therefore would not be affected by the botulinum toxin, treatment with this component has made a huge improvement on the body odor (bromhidrosis). The mechanism of action of this effect might be due to a reduction of the wet environment, favoring bacterial proliferation responsible for the sweat decomposition which it will hardly exists following treatment with Botulinum Toxin.
The possible discomfort it is reduced to feel pain of the puncture and the risk of infection from any injection. Minimum precautions such as disinfecting with alcohol three or four times a day in the following two days are sufficient.
The effects last longer in time on the armpits and may last up to 10-12 months, palms up to 5 months.
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