Botulinum Toxin

Botulinum toxin injections block muscle action selectively, which softens or eliminates dynamic wrinkles: the vertical lines between the eyebrows, crow's feet at the outer corners of the eyes, and horizontal forehead lines. Small doses are also used around the mouth.

Dynamic wrinkles are the ones that appear when the face moves. Lines that are visible at complete rest are static wrinkles, and they generally need resurfacing or filler rather than muscle relaxation. Knowing which kind you have is the difference between a treatment that works and one that disappoints.

Injections are also used to enhance the results of other treatments, including laser resurfacing, by reducing the muscle movement that works against healing skin.

What to expect

There may be minimal swelling or bruising after injection. Usually there is very little external evidence of treatment and normal activity continues the same day.

The medication takes effect over the following one to two weeks, as muscle action in the treated area diminishes. Effects on dynamic wrinkles typically last three to four months and sometimes up to six, with individual thresholds for repeat treatment varying widely.

Dry eye or a droopy eyelid are uncommon in the absence of pre-existing symptoms. Double vision, or difficulty opening and closing the eyes, warrants prompt contact with the treating clinician. Generalised weakness or difficulty breathing is rare with the small doses used around the eyes, but is a reason to seek medical attention immediately.