Ageing shows up on the skin in the form of wrinkles and fine lines. While creases are a natural part of growing older, some people try to conceal them with cosmetic intervention.
Preventative Botox, for example, is done to prevent the formation of lines and wrinkles. Among the commonest cosmetic procedures across the world, Botox injections prevent muscles from contracting, thereby softening the lines caused by repeated muscle contractions.
Dr Shireen Furtado, senior consultant, medical and cosmetic dermatology, Aster CMI Hospital, Bangalore, recalls the case of a woman she treated a couple of years ago.
The woman, a chronic smoker in her late 50s, had started noticing lines around her mouth because of the overuse of the puckering muscles while smoking. Her lipstick would bleed into the lines.
“In 2020, she got Botox injections around her mouth, which helped reduce these lines,” says Dr Furtado “She follows ups every six months, where the injection is repeated.”
Types of wrinkles
Dr Furtado says there are two types of wrinkles:
- Dynamic wrinkles: These appear due to muscle contraction while emoting — like when laughing, smiling, squinting and frowning. They include smile lines, frown lines, crow’s feet (lines on the corner of the eyes) and forehead lines.
- Static wrinkles: These occur due to the gradual loss of elasticity and collagen in the skin. Factors like UV exposure, smoking and poor nutrition can cause static wrinkles. Plus, dynamic wrinkles can turn into static wrinkles over time.
What are Botox injections?
“Botox is an injectable form of botulinum toxin, which is a protein derived from the bacterium Clostridium botulinum,” says Dr Furtado. “It is a neuromodulator that, on injecting into the muscles, reduces the activity of the muscles,” says Dr Furtado.
According to Dr Piyali Chatterjee, consultant, dermatology and cosmetology, Manipal Hospitals, Salt Lake, Kolkata, Botox reduces the expression lines which occur due to continuous use of the muscles, which leads to collagen loss in those areas and folding of the skin.
“Botox also has medical uses and is used for treating chronic migraines and muscle spasms,” adds Dr Chatterjee
According to Dr Furtado, people also opt for preventative Botox, where one gets the injections before formation of these lines. Preventative Botox is popular among people whose professions involve a lot of emoting and use of facial expressions.
How does Botox work?
“Botox works at the junction of the nerves and muscles,” says Dr Chatterjee. “It blocks the nerve signals that direct the muscle to contract, thereby reducing the wrinkles that result from these contractions. The effect of these injections wears off in a few months as new nerves start forming. As a result, the junctions that were inactivated gradually get activated again.”
Also, doctors advise that people must exercise caution before getting a Botox treatment done in a beauty salon, where medical supervision cannot be guaranteed.
How long do Botox injections last?
Explaining the procedure, Dr Furtado says that once the target areas are decided, they are marked to be injected. Sometimes, a numbing cream is applied prior to the injection to prevent pain. The injections are given about 40 minutes later.
“The effects wear off within three to four months,” says Dr Furtado. “Factors like being in a high-stress job, which can result in using the facial muscles a lot, can cause the injections to wear off quicker. The person can come for touch-up sessions where the Botox is reinjected.”
Dr Furtado advises against exercising for 24 hours after receiving Botox injections as it may reduce their effectiveness.
“The injections are skilfully placed on the targeted muscles,” says Dr Furtado. “Rigorous physical activity and the resultant sweating and blood flow can cause the Botox to migrate to other areas.” She also discourages massaging, putting pressure on the treated area or wearing tight headbands.
Dr Furtado adds that the injections take effect gradually over one or two weeks — when a tightening of the target muscles can be noticed. The person may not observe any change in the initial few days of the treatment.
How safe are Botox injections?
According to Dr Chatterjee, Botox injections have minimal side-effects if given by a trained professional.
“Misplacement of the injections or overdose of the product can cause complications like paralysis of the muscles, uneven smile and corners of the lips moving up,” says Dr Chatterjee.
Dr Karan Shetty, consultant plastic surgeon, Sagar Hospital, Bangalore, adds that the toxin itself doesn’t have side-effects. Adverse side-effects can arise if the procedure isn’t done by a skilled practitioner or if a low-quality product is used.
“One of the side-effects that can happen is a drooping of eyebrows and eyelids due to the wrong placement of the product,” says Dr Shetty. This could happen, for instance, when the Botox meant to reduce forehead lines is placed below the designated area.
“It resolves by itself within a few months, when the effect of the injection wears off,” adds Dr Shetty.
One well-known instance of a cosmetic treatment causing adverse reaction involved Bollywood actor Koena Mitra, who was left with swollen cheekbones after plastic surgery.
Dr Furtado says some people may see minor bruising at the site of injection. “Refrain from getting the injections right before an event,” she adds. “Do it at least a month in advance, so that the injection sets in and the minor bruises are settled.”
- Botox is the cosmetic form of botulinum toxin, a protein derived from the bacterium Clostridium botulinum.
- It is a neuromodulator that temporarily blocks nerve signals to the muscles, preventing them from contracting.
- Dynamic wrinkles are formed while emoting and become static wrinkles with time.
- Preventative Botox is done to prevent lines and wrinkles from forming.
- Avoid rigorous exercise, massaging and rubbing up to 24 hours after Botox.
- The cosmetic effects of the injections last for up to four months.