Botulinum toxin
(Bocouture®, Botox®, Vistabel®, Azzalure®, Dysport®, Xeomin®)
Botulinum toxin type A, also known under the brand name Botox®, has a firm place in aesthetic medicine and is one of the most popular measures when it comes to smoothing wrinkles caused by facial expressions and slowing down skin ageing. Over the years, however, a variety of other treatment options have emerged using botulinum toxin type A. As botulinum toxin is a prescription drug, it can only be used by doctors.
Botulinum toxin type A, also known under the brand name Botox®, has a firm place in aesthetic medicine and is one of the most popular measures when it comes to smoothing wrinkles caused by facial expressions and slowing down skin ageing. Over the years, however, a variety of other treatment options have emerged using botulinum toxin type A. As botulinum toxin is a prescription drug, it can only be used by doctors.
Brief overview of treatment with Botox:
Duration of treatment:
15-45 minutes
Anaesthesia:
as a rule none
Follow-up treatment:
not special
Load restrictions:
none - 1 day
How does botulinum toxin work?
It acts like a muscle brake that weakens or even completely slows down the transmission of the command to contract from the nerve to the muscle - depending on the dose and desired effect. Depending on the dosage, the product selected and the individual metabolism, it breaks down again exactly where it was introduced over the course of four to six months.
What result can I expect?
The effect of the botulinum treatment begins after approx. one week and is largely complete after approx. 14 days. For a lasting effect, the treatment should initially be carried out every six months. Over time, the intervals can also be extended, as a muscle that can no longer "train" is weakened in the long term. The result: significantly fewer mimic wrinkles develop or do not develop at all.
Is anaesthesia necessary?
No anaesthetic is generally required for botulinum injections.
When will I be fit for work again?
Immediately after treatment. You should only avoid sport and physically strenuous work for the next 24 hours. Apart from the puncture, no pain is to be expected.
Botulinum has been used successfully for decades to treat neurological disorders. It is also successfully used to treat hyperhidrosis, abnormally increased sweating, severe teeth grinding (bruxism) and migraines.
What can be treated with botulinum toxin?
Botulinum toxin is used here:
- Smoothing of expression lines: Frown lines, crow's feet, forehead wrinkles
- Strawberry chin
- Lipflip
- Gummysmile/toothy smile
- Corner of the mouth
- Browlift
- Mesobotox
- Oily scalp
- Facial slimming
- Bruxism/teeth grinding
- Hyperhidrosis (armpits/hands)
- Migraine
Smoothing of expression lines: Frown lines, crow's feet, forehead wrinkles
Whether we are laughing, frowning thoughtfully or speaking - our facial muscles are constantly in motion. Some parts of the face are tensed more often than others: When concentrating on work, for example, we often unconsciously draw our eyebrows together. In the long term, this results in the so-called frown or frown lines (glabellar lines), which give the face a grim expression. But transverse forehead wrinkles, crow's feet or drooping corners of the mouth and lip wrinkles can also be treated with botulinum.
What is done during an injection with botulinum toxin?
After testing the individual muscle activity and strength of the muscle responsible for the contraction, the botulinum is injected with small punctures in such a way that the muscle activity in the desired area decreases and the mimic wrinkles are levelled out.
Lipflip - lip augmentation with botulinum toxin
Anyone interested in lip augmentation first thinks of the filler hyaluronic acid. Botulinum does not appear to be suitable for a volumising, plumping effect due to its muscle-relaxing effect. Nevertheless, treatment with this medication is effective if the right technique is used. The so-called lip flip.
What is done during lip augmentation with Botox?
The botulinum toxin is injected specifically into the edge of the upper lip in order to achieve the eponymous flip. This flip means that the upper lip turns slightly outwards or upwards. This makes the lip appear fuller, which is why the method is particularly interesting for women and men who dislike their very narrow upper lip. Botulinum toxin is not normally injected into the lower lip with this method. However, for reasons of harmony and to maintain individual facial expressions, minimal treatment of the lower lip is still advisable in some cases. However, if you want an even more visible effect, you can also combine the lip flip with a hyaluronic acid injection. However, this should not be done on the same day.
Filler as an alternative to botulinum toxin
Hyaluronic acid fillers are particularly popular for lip treatments as they offer a wide range of treatment options. It can be used to:
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Widen narrow lips
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Filling and shaping flat lips
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lift the hanging corners of the mouth
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Smoothing fine upper lip wrinkles
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Gummysmile / Gum smile
A smile with beautiful teeth is considered attractive, but if there is too much gum, this is known as a gummy smile. Many sufferers feel uncomfortable with this and even avoid smiling. Here, too, botulinum can ensure that the upper lip no longer rises so much, making it possible to smile with significantly less gum showing.
How is the treatment carried out?
A smile with beautiful teeth is considered attractive, but if there is too much gum, this is known as a gummy smile. Many sufferers feel uncomfortable with this and even avoid smiling. Here, too, botulinum can ensure that the upper lip no longer rises so much, making it possible to smile with significantly less gum showing.
Corner of the mouth
The treatment of drooping corners of the mouth is a complex matter, as it depends on the muscular structure on the one hand and the anatomy of the lips on the other. Drooping corners of the mouth are caused by adhesions of the tissue to the musculature and continue to develop during the ageing process. This can be treated well by "braking" the responsible muscles with botulinum toxin.
How are drooping corners of the mouth treated?
Botulinum toxin is injected into the muscles responsible for drooping corners of the mouth. This relaxes the muscles and the corners of the mouth move upwards again.
Filler to fill drooping corners of the mouth and marionette lines
In addition to treatment with botulium toxin, this area can also be treated with hyaluronic acid fillers in addition or on its own. This also includes marionette lines or "Merkel lines", which often develop as a continuation of the lowered corners of the mouth during the ageing process.
Browlift with botulinum toxin
Brow movement is a complex interplay of numerous muscles. Knowledge of the anatomy is therefore of the utmost importance for the targeted treatment of brow movement in order to avoid, among other things, a lowering of the brow (brow ptosis). What is important in botulinum therapy of the brow is always a customised result that suits the face. Patients who can actively lift their brows are particularly suitable for botulinum therapy. Even if the treatment results in asymmetry in brow height, the low brow can be treated and the symmetry restored.
How can botulinum toxin be used here?
The "ideal" brow shape is achieved with a very simple rule: divide the brow into thirds. This can be easily done using three auxiliary lines. The beginning of the eyebrow is marked by a vertical line directly above the wing of the nose, the so-called curvature or apex is obtained by a connecting line between the wing of the nose, pupil and brow. The end of the brow is determined by a connecting point between the nostril and the lateral corner of the eye. By braking the responsible muscles (brow depressors), the forehead muscle takes over and the eyebrow rises slightly upwards.
Browlift - these treatments are also possible:
The "ideal" brow shape is achieved with a very simple rule: divide the brow into thirds. This can be easily done using three auxiliary lines. The beginning of the eyebrow is marked by a vertical line directly above the wing of the nose, the so-called curvature or apex is obtained by a connecting line between the wing of the nose, pupil and brow. The end of the brow is determined by a connecting point between the nostril and the lateral corner of the eye. By braking the responsible muscles (brow depressors), the forehead muscle takes over and the eyebrow rises slightly upwards.
Mesobotox - face, neck, décolleté
Mesobotox combines the relaxing effect of botulinum with stimulating mesotherapy to create an ideal anti-ageing method. The result is significantly smoother skin and a finer complexion. This special superficial injection technique of botulinum toxin has its origins in Asia. This is because rejuvenation measures in the superficial skin area are particularly in demand there.
How is the face, neck or décolleté treated?
With mesobotox, botulinum toxin is diluted to a very high concentration and placed superficially over the entire face, neck and décolleté area using very fine needle pricks. The botulinum toxin relaxes the micro-muscles in the surface of the skin and smoothes the overlying skin. This reduces creases, crow's feet and wrinkles, refines pores and evens out neck and décolleté wrinkles. Unlike conventional botulinum treatment, which paralyses the muscle itself, treatment with the Mesobotox method involves injecting the active ingredient into the epidermis/skin surface. This is done using a microneedle and multiple injections.
Are there alternatives for a finer complexion?
At the Montanari practice, we offer numerous methods in addition to Mesobotox to refine the skin's appearance and minimise pores:
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- Microneedling
- Double Tite (RF-Needling in combination with mesotherapy)
- Profhilo® / Skinbooster
- Radiesse®/ Biostimulator
- PRP / vampire lifting
- Polynucleotides / Biostimulator
- Hydra4Face
Facial slimming with botulinum toxin
A youthful, beautiful face is characterised above all by volume in the areas of the cheekbone and outer cheekbones. A classically "beautiful" face is structured like a triangle standing on its apex. The wide base is determined by the cheekbone region and narrows towards the cheeks and jaw. A visually overly wide jaw region can be caused by genetic predisposition, by a shift in volume due to gravity and the loss of supporting structures from the cheek region downwards, the so-called sagging cheeks, or by a widening of an overly strong muscle, e.g. due to teeth grinding (bruxism). In this case, a botulinum toxin injection leads to a targeted weakening of the chewing muscle and thus to a slimming of the lower third of the face.
How can facial slimming be achieved?
The botulinum is injected directly into the chewing muscle with three to four punctures. The medication ensures that the chewing muscle is slowed down and can no longer contract as strongly, which means that it is no longer trained as strongly and slowly breaks down muscle substance and the face slims down in the lower part of the face. (-> see also bruxism/teeth grinding)
What result can be expected?
The effect of botulinum treatment begins after approx. one week and is largely complete after approx. 14 days. You have to be patient for up to four weeks before the reduction in the masseter muscle becomes visible. For a lasting effect, the treatment should initially be carried out every six months.
Liposuction and fat removal injections as an alternative?
If the cause of a face that appears too wide is too much fat in the cheek and neck area or a double chin rather than too much masseter muscle, classic liposuction is preferable. In contrast to treatment of the masseter muscle, fat reduction by liposuction results in a permanent thinning of the fat in the lower cheek area. By reducing the sagging cheeks, the lower jawline is also sharpened again. For those who shy away from surgery, Dr Montanari's practice offers fat removal injections as an alternative.