Botulinum toxin is produced by a specific type of bacteria. In higher amounts, it can be poisonous. However, only small, weaker doses of botulinum toxin are used to reduce facial wrinkles.
When botulinum toxin is injected, it blocks certain nerve signals that make muscles contract. The muscles relax, reducing unwanted wrinkles. This effect lasts about 3–6 months. After that, the muscles move again and wrinkles come back.
Crows’ feet before botulinum toxin injection
When you have botulinum toxin injected, your doctor may first rub an anesthetic cream on the area to numb it. Then he or she will inject the medicine into specific facial muscles. This only takes a few minutes, and can be done right in the doctor’s office. You will be able to continue your daily activities right afterwards.
About 3 days after the injection, you should notice some muscles starting to relax. After 1 week, you likely will see fewer facial wrinkles and lines. This effect wears off in about 3–6 months.
There are two types of wrinkles: dynamic wrinkles and very fine lines and wrinkles.
Dynamic wrinkles are caused by facial muscles that move when you smile, laugh, and squint. These are often around the lips, on the forehead and between the eyebrows. They are also the “crows’ feet” at the corner of your eyelids. Everyone is born with dynamic wrinkles. As you age, these wrinkles get deeper and easier to see. Botulinum toxin can be used to make these dynamic wrinkles less noticeable.
Very fine lines and wrinkles are formed when collagen in the skin starts to thin. Collagen is protein just beneath and within deep skin layers. Aging and sun damage cause collagen thinning. It makes the skin on your face stretch and sag, creating fine wrinkles. Botulinum toxin does not erase fine lines and wrinkles. However, there are other ways to reduce their appearance.
Botulinum toxin type A injections are the most common cosmetic procedure performed in the United States. There were 4.3 million procedures performed in 2015 accounting for 42 percent of all cosmetic procedures in that year, based on the Cosmetic Surgery National Data Bank Statistics from the American Society for Aesthetic Plastic Surgery, (ASAPS). According to a 2016 study published in the Aesthetic Surgery Journal, the official publication of ASAPS, patient satisfaction with their overall facial appearance increased by 28 percent with injections to the so-called “11s” (the glabellar rhytids, which are the lines that appear between the brows as we age).
The satisfaction rate was determined based on participating patients’ completion of the FACE-Q survey, a newly developed and validated patient-reported outcome instrument that can be used for measuring a patient’s own perceptions of cosmetic facial procedures. The survey consists of 63 questions asking patients to evaluate their overall appearance, age appearance, and the appearance of cheeks, nasolabial folds, lower face and jawline, chin and neck.
Dr. Daniel C. Mills, president of ASAPS states, “The results of this study are not surprising and validate what we’ve suspected for quite some time. I see an ever-increasing influx of patients in my practice in Laguna Beach, California requesting botulinum toxin type A injections to the area between the brows and other areas on the face, like the crow’s feet and forehead as a preventative anti-aging or pre-aging measure from patients in their 20s up to their 70s. It’s a quick nonsurgical fix that packs a powerful punch. This new study reaffirms the efficacy of botulinum toxin type A and the satisfaction it brings to patients.”
The study’s authors examined 57 female patients who completed the FACE-Q survey. After the baseline survey, the patients received injections of one brand of botulinum toxin type A, (Botox, Dysport or Xeomin) in the region between the brows. Two weeks post-injection, the patients completed the FACE-Q survey again. The percentage changes in patient responses from the first to second surveys were assessed to determine how the injections affected patient satisfaction with their facial appearance.
Patients stated that they believe they look an average of 5.6 years younger post-injection with any of the botulinum toxin type A products. The average age of the 57 patients with pre- and post-neurotoxin FACE-Q responses was 49.6 years (range of 32-75 years old).
“This indicates that patients’ satisfaction with their overall facial appearance was statistically significantly greater after receiving the injections, and certainly accounts for the continued success of neurotoxin popularity to reduce the signs of aging,” states Dr. Ivona Percec, the study’s senior author.
To view the complete study, visit the Aesthetic Surgery Journal website, academic.oup.com/asj.
The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body. ASAPS is comprised of more than 2,600 plastic surgeons; active members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and nonsurgical aesthetic procedures. International active members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict code of ethics and must meet stringent membership requirements.
Courtesy of The American Society for Aesthetic Plastic Surgery