Botox - Botulinum Toxin 101
Article written by Jessica Tapia, MD
Although it may be a generic term, Botox® is a specific brand of wrinkle relaxant that prevents and diminishes the appearance of wrinkles.
This treatment has become one of the most popular cosmetic procedures worldwide, including Mexico.
Botox (Botulinum Toxin) is a neurotoxin derived from the bacterium Clostridium botulinum and is widely used to smooth wrinkles and expression lines through temporary muscle paralysis. Its use in aesthetic medicine has become popular due to its effectiveness and fast results.
Beneath the skin, Botox works by targeting specific facial muscles (those that cause wrinkles to form), causing them to contract less with use. This selective action allows natural results to be obtained without affecting the natural expressions of the face.
The safety and efficacy of Botox are well established, making it one of the most sought-after treatments for fine lines and wrinkles. And with results lasting three to four months, it is an excellent long-term solution.
What is Botox made of and how does it work?
Botulinum toxin, the main component of Botox, comes from the bacterium Clostridium botulinum. There are seven types of this toxin, identified as A through G, with types A, B and F being the most potent. For medical and cosmetic uses, types A and B are preferred, especially type A, also known as Onabotulinumtoxin A, which is the one used in the Botox® brand.
Botox works by interrupting communication between nerves and muscles in specific areas.
By inhibiting the release of acetylcholine, a neurotransmitter responsible for muscle contraction, Botox reduces expression lines by relaxing the muscles that contribute to wrinkle formation. This mechanism of action allows Botox to be effective in reducing dynamic wrinkles, which are those caused by repetitive muscle movements.
The effect of Botox is gradual. Patients do not see an immediate change after injection, but rather the results develop over several days. This contributes to a more natural look and avoids drastic changes in appearance.
Is Botox safe?
The safety of Botox has been extensively studied and documented. The FDA approved Botox treatment between the eyebrows in 2002, crow's feet in 2013 and forehead lines in 2017. In Mexico, its use is regulated by COFEPRIS.
Since the inception of botox, no long-term adverse effects have been reported and no systemic safety issues have been associated with FDA-approved use. It is considered a drug with a wide margin of safety when administered by trained medical specialists.
Where is it applied?
In the upper third of the face, Botox is used to treat wrinkles in three main areas:
Frontal muscle: "worry lines" on the forehead. These are the horizontal lines that appear when the eyebrows are raised.
Procerus and corrugator muscles: the "onces" between the eyebrows. These are the vertical lines that appear when frowning.
Orbicularis oculi muscle: "crow's feet" on the outer parts of the eyes. These are the lines that form when smiling or squinting.
In addition to these areas, Botox can also be used on the lower face to treat lines around the mouth.
In Mexico, Botox treatment must be performed in a medical office that complies with the sanitary requirements established by COFEPRIS. The procedure must be performed by a medical specialist with experience in aesthetic medicine to ensure the safety and efficacy of the treatment.
How is it applied?
The Botox application process begins with an assessment consultation. Your doctor will evaluate your face, discuss your concerns and goals, and develop a personalized treatment plan.
Before injecting Botox, your specialist may apply a topical anesthetic or local cold to prepare the area to be treated and minimize discomfort. Some patients describe the sensation of the injection as a small prick or a momentary pressure sensation.
During the session, a very fine needle is used to inject the botulinum toxin precisely into the facial muscles. Your physician will determine the exact amount of Botox needed for each area, based on the strength of the muscles and the degree of correction desired.
The procedure is usually completed in less than 20 minutes.
What is the post-treatment care?
After treatment, follow these recommendations to optimize results and minimize possible side effects:
Avoid strenuous physical activity during the first 24 hours to prevent dispersion of the product.
Avoid exposure to extreme heat (such as saunas or steam baths) for the same period.
Do not consume alcohol in the first 24 hours, as it may increase the risk of bruising.
Do not rub or massage the treated areas for the next 24 hours to prevent the product from moving to unwanted areas.
Keep the head elevated for the first 4 hours after treatment.
Practice gentle facial movements on the treated areas to help the absorption of the product.
It is normal to experience slight redness or small bumps at the injection sites immediately after treatment. These effects usually disappear within a few hours.
How long do the effects of Botox last?
Patients begin to notice results 4 to 5 days after treatment, with final results visible at around 14 days. This gradual onset of action contributes to a more natural look and allows the face to adapt to the changes in a subtle manner.
The effects of Botox can last approximately 3 to 6 months, with a progressive decrease in effectiveness beginning after the first 6 to 8 weeks. The exact duration may vary depending on individual factors such as metabolism, muscle strength, and the area treated.
To maintain results, follow-up treatments are recommended every 3 to 4 months. Over time, some patients notice that they need treatments less frequently as the muscles "train" to relax.
What are the possible side effects?
As for side effects, most are mild and transient. The most common include:
Pain, swelling or bruising at the injection site
Mild headache
In rare cases, more noticeable side effects may occur such as:
Drooping eyelids
Uneven eyebrows
Asymmetrical smile
These more serious side effects are usually the result of migration of the product to unwanted areas and are generally temporary, resolving as the effect of the Botox diminishes.
In extremely rare cases, the effect of Botox may extend beyond the treatment area, causing muscle weakness. For this reason, inform your doctor immediately if you experience unusual symptoms after treatment.
What other uses does botulinum toxin have?
Although Botox is widely known for its cosmetic applications, it has a variety of therapeutic uses that have revolutionized the treatment of various medical conditions.
These include:
Chronic migraines: Botulinum toxin has been shown to be effective in preventing migraines in patients suffering from frequent headaches. It is administered by a series of injections in the forehead, temples, back of the neck and shoulders every three months.
Hyperhidrosis or excessive sweating: Botulinum toxin can block the nerve signals that stimulate the sweat glands, significantly reducing sweating, especially in the armpits and palms.
Muscle spasms: In conditions such as cervical dystonia (neck spasms), blepharospasm (eyelid spasms) and strabismus (crossed eyes), botulinum toxin can help relax the affected muscles.
Bruxism: Injection of botulinum toxin into the masseter muscles can relieve nocturnal teeth grinding and reduce associated pain.
What is suitable for me?
We could talk about this all day; we honestly could! If you're considering diminishing those wrinkles and fine lines, we would love to have you in for a consultation.
