Botulinum toxin
Operation Description
Botulinum toxin is a purified neurotoxin that reduces the activity of the muscle into which it is injected. In aesthetic medicine, it is used in multiple facial and jaw regions, with various goals – smoothing wrinkles, relieving muscular tension, and contouring the face, all while preserving natural facial expressions.
It is most commonly applied in the upper third of the face, where it works by reducing excessive activity of the muscles responsible for wrinkle formation – the frontalis muscle (forehead), the glabellar muscles (between the eyebrows), and the orbicularis oculi muscles (around the eyes). Rather than completely immobilizing these areas, proper dosage allows the face to appear smooth and relaxed, while maintaining spontaneous and lively expression.
Additionally, there is a less common but highly effective application of the toxin in the nasal region, for individuals who develop fine horizontal lines on the sides of the nose when smiling – known as a "bunny smile." Bunny smile occurs due to repetitive contraction of muscles in the upper mid-face, especially the nasalis muscle. Botulinum toxin in this region calms the muscle that causes these fine lines during smiling, gradually softening them. The effect is subtle but visible – the face retains its natural expressiveness, but without the tiny lines that can disrupt the softness of a smile. The goal is not to completely paralyze the area, but to achieve controlled relaxation while maintaining facial mobility.
Another important region where botulinum toxin is used is the lower third of the face, particularly the masseter muscle. When the product is injected into the masseter, it gradually relaxes and reduces the muscle's volume. Visually, the lower face becomes slimmer and softer; subjectively, patients often feel relief in the jaw, reduced nighttime teeth grinding, and relaxation in a previously tense area. Over time, the muscle adjusts to a lower level of contraction, which can further prolong the effects with repeated treatments.
Candidates
Botulinum toxin treatment is recommended for individuals:
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who have pronounced wrinkles on the forehead, between the eyebrows, or around the eyes,
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who notice fine lines on the sides of the nose when smiling,
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with strong upper-face mimicry,
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who wish to prevent the deepening of facial lines,
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with a prominent jawline due to enlarged masseter muscles,
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who experience pain or tension in the jaw,
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diagnosed with bruxism or who grind their teeth at night,
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who desire a softer, more oval lower-face shape.
The treatment is not performed on pregnant or breastfeeding individuals, those with neurological disorders, or anyone with active infections or inflammation of the skin in the treated area.
Preparation
No special preparation is needed for botulinum toxin treatment. During the consultation, the physician carefully evaluates facial expressions at rest and in motion to identify areas of greatest muscle activity and determine the appropriate amount of product. In the forehead and eye region, attention is given to brow position, natural mobility, and expressions during speech or smiling. In masseter treatments, the doctor assesses facial shape, symmetry, and muscle tension. An individualized treatment plan is formulated based on these assessments.
Operation time
The treated area is first cleaned and disinfected, and a topical anesthetic may be applied if needed. Botulinum toxin is injected using an extremely fine needle, in small amounts and into precisely determined points – whether it's the forehead, nose, or masseter. The procedure typically lasts between 10 and 15 minutes and causes no pain, only a mild sensation of stinging or pricking.
Recovery
Most patients can return to their daily activities immediately after treatment. Temporary reactions such as redness, mild swelling, or tenderness at injection sites may occur. It is recommended to keep the face upright for a few hours post-treatment and avoid touching the treated area. For the next 24 hours, avoid makeup, aggressive skincare products, sun exposure, heat, intense physical activity, and saunas. In the case of masseter treatment, facial massage should also be avoided.
Safety precautions
Botulinum toxin is a treatment that demands high precision, especially in delicate areas such as the nose or around the eyes. When performed by an experienced physician, the risk of complications is minimal. Undesirable effects such as excessive muscle relaxation, temporary asymmetry, or heaviness are rare when proper dosage and technique are used. It is essential that the treatment is carried out by a medical professional with in-depth knowledge of facial anatomy and experience with botulinum toxin.