Botulinum toxin causes muscle weakness. It exists in different forms such as botox, dysport or xeomin. The result takes 7 to 14 days to fully show and resolves gradually over the next 4 to 6 months. It is very wise to reevaluate the patient after the 10 days’ mark in case they need a touch up but not before that unless there is a clear asymmetry which is rare in experienced hands.

The effects of botulinum toxin cannot be reversed; however most of the adverse effects can be fixed. First, you need to see a specialist who knows the face anatomy by heart. Since Botulinum toxin weakens the muscle, for you to reverse that effect, you need to relax another group of muscles which are pulling in the opposite direction.
The most commonly seen adverse effects are brow ptosis, asymmetry in the forehead, surprised look, asymmetric smile, and persistent arched lines over the lateral eyebrows.

Bunny lines (the horizontal or diagonal wrinkles we get on the side of the nose when we smile or scrunch up our nose.) can be a sign of aging. These creases are caused by the activity of the underlying procerus muscle.These lines occur with years of smiling and with aging, they can also be caused by poor botox injections elsewhere or in those who have received too much botox injections in the forehead or glabella region. When these targeted muscles become paralyzed, the muscles on either side of the nose overcompensate. This often contributes to unwanted bunny lines.

An experienced injector, however, understands the risks of creating too little movement in facial muscles and inadvertently causing lines or wrinkles in other areas of the face.

Botox is also FDA approved to treat migraine headache.
Migraine is a very common illness, it can greatly affect your daily life and leave you in distress. In case you failed to respond to regular migraine treatment, botox can help relieve your pain.
For you to be a good candidate, you need to have a chronic migraine headache, or a headache for at least 15 days per month, or you have failed to respond to at least 2 migraine medications.

Botox or dysport can also be used to decrease sweating.

Before Botox

Do not apply make up: before injecting botox, your physician will clean your skin.

Stop taking any blood thinning medications :

• Aspirin
• Ibuprofen, NSAIDs
• Vitamin E
• Fish oil or Omega-3s
• Ginko Bilboa
• Ginseng

Ask questions: how many units are injected in every site? How long will it last?

After Botox

For 24 hours do not:

• Take blood thinning medications
• Lay down for the first 4 hours
• Drink lots of alcohol
• Touch, or massage the injected area
• Exercise
• Get a facial or chemical peel

Botox resistance

It is very common to hear some patients complain that botox is not working as it used to do. Although it is very rare, but still it can happen. The most common cause of botox immunity or resistance, is excess in dosage. The normal body reaction to this, is to produce antibodies. This happens when patients get botox injections frequently and they don’t respect the 6 months’ interval between injections.

On the other hand, you may be receiving a diluted dose of botox injection. A simple blood test can detect the presence of antibodies and solve the matter.

This is why, it is very important to have your botox injections done by an experienced and highly trained doctor, to avoid uncertain outcomes.

Most of the times, doing the injections at 6 months interval or switching to another brand of botulinum toxin will help. If this doesn’t help, there are different options to get rid of wrinkles such as lasers, chemical peels or fillers.

Dr. Abi Akl is an expert in injectables. During your consultation, he will guide you through all the available options of facial rejuvenation and together will decide on the best treatment for your case. There is no one size fits all procedure, each case is customized to meet your goal.

If you are interested in botulinum toxin injections, schedule a virtual or clinical appointment or call our office.