Botulinum Toxin: treatments beyond Aesthetic Medicine

Botulinum toxin is a neurotoxin produced by a microorganism. Its main peculiarity is that it paralyzes the muscles temporarily, which has led to its many applications in medicine.

In Aesthetic Medicine, this material is used to eliminate expression wrinkles. Specifically, those that appear on the face as a result of the muscles of the face are inserted into the skin and, by contracting, fold it, causing a wrinkle. If we block the muscle, the wrinkle does not appear, which makes the face look more relaxed. Among the expression wrinkles, the most frequently treated are those known as “crow’s feet” in the eyes, those between the eyebrows, which give an “angry” look, and those on the forehead.

At the Rosa Pulgar Clinic they use botulinum toxin to improve facial expression, not to suppress it. With this, they get the muscles to continue working, but in a less intense way, which gives a softer expression eliminating the permanent angry face, without freezing the face.

Many patients come to the clinic and do not want to undergo the toxin treatment because they have in their minds the image of static and inexpressive faces. And indeed, that is not ideal. That is why we propose to relax and not to block the expression, so that our patients continue to be themselves but with a less tense appearance, that they look better, but that it is not noticeable that they have been retouched.

When is it advisable to start treatment with botulinum toxin?

Starting treatment with botulinum toxin depends on each case. There are people whose muscles contract very strongly, which wrinkles a lot of the skin. This may mean that at an early age, crow’s feet wrinkles already appear. In such cases, the toxin can be used as a preventive treatment, because if the muscle does not contract or contracts with less force, the wrinkle does not appear. That is why many people begin treatment in their thirties.

What is the difference between botulinum toxin and hyaluronic acid?

Botulinum toxin and hyaluronic acid are two completely different things, although they can sometimes be confused. Both are treatments that have been used in Aesthetic Medicine for a long time to improve the face, but they serve different purposes.

The toxin, as we have already mentioned, is used to treat expression wrinkles, the “dynamic” wrinkles produced by the muscles when pulling the skin. Hyaluronic acid (HA), however, is a natural component of the skin and has other applications.

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Depending on how it is formulated, hyaluronic acid is used as a skin moisturizer, to improve the appearance of the skin and/or to recover or improve the volumes of the tissues that form the face. In addition, it is a hydrophilic substance, so it absorbs a large volume of water. If we inject it into the dermis by mesotherapy, it produces an increase of water in the skin, a real hydration of the skin.

Other formulations of this material are used to eliminate small wrinkles, define the lips or slightly increase their volume. Other types of HA are denser and are used to replace the loss of bone and fatty tissue caused by the facial aging process. As we age, bone loses volume and so does facial fat. The result is that the overlying skin loses the structures that support it and sags, with the consequences we are all familiar with, static wrinkles. Hyaluronic acid can restore lost bone and fat volumes, give new support to the skin and make the face appear rejuvenated while respecting the natural volumes that the person had when he/she was a little younger.

What other applications does botulinum toxin have in Aesthetic Medicine?

Botulinum toxin has more and more applications in medicine and, especially, in Aesthetic Medicine. It is not only used to treat wrinkles but also to treat hyperhidrosis, understood as excessive sweating in the armpits, palms of the hands and feet. This is done by micro-injections of botulinum toxin in the area to be treated, which prevents the sweat glands from excreting excessive sweat. The treatment is very satisfactory for the patient although it has a temporary character, due to the action of the toxin.

Another indication is the masseter muscle, which forms the mandibular angle on the side of the face. Some people suffer from bruxism, that is, they grind their teeth when they sleep. In addition to the actual dental treatment of this problem, botulinum toxin is sometimes injected into this muscle in order to weaken the muscle and, by losing power, reduce the negative effects of bruxism in the mouth. In addition, the face is refined, since in these people the hypertrophy of this muscle results in an excessively wide face in the lateral area.