Written by Dr Alison Colville, Medical Director at The Avery Clinic, Leamington Spa, Warwickshire
More often than not, we don't want to shout to the world what treatments we have had done, but we DO want results. So how do we get that balance of a natural but effective result?
Here we take a look at some of the ways we can help you achieve that sweet spot...
How does Botulinum Toxin work?
'Bo(h)tox' is a nickname for all anti-wrinkle injections containing Botulinum Toxin Type A. When injected into a muscle, this substance temporarily blocks the nerve endings in that particular area and therefore stops any movement there. This allows the overlying skin to appear smoother and prevents wrinkling of the skin with certain facial expressions.
Some muscles of the face work in opposition to one another, pulling in directions. Therefore, we can relax one muscle but leave the other to allow for an area of the face e.g. the eyebrow, to move in a certain direction.
Can botulinum toxin give natural results?
Absolutely yes! With a good knowledge of the anatomy of the muscles of facial expression, we can target certain muscles and even certain areas of those muscles in order to manipulate how they move. For example, we can use a low dose in multiple areas of a the forehead to allow for some movement but reducing it enough that the skin doesn't fully wrinkle up into obvious folds.
How can we avoid a 'frozen' look?
Choosing the correct dose to inject is very important. Before treatment, each person's individual musculature should be closely observed to assess how much product might be needed in each area. With basic training, practitioners are taught a set pattern of injection points and a set dose to use. Although this is usually a safe way to practice, and will give the average person a good result, it will not meet the needs of everyone and can sometimes cause an overtreated look - the 'frozen' look.
It is a good idea to start with small doses and then review the result at 2 weeks when the effects will have fully set in. At this appointment, we can 'top-up' with any extra treatment needed to ensure a great result.
The 'secret' areas for anti-wrinkle injections:
Most of us know that you can relax the muscles in the forehead, the frown lines and improve crow's feet, but did you know there are many other areas of the face that we can treat with anti-wrinkle injections to reduce signs of ageing and/or change the shape of the face subtly. Here are a few examples:
Chin dimpling - Often we don't notice this effect as it tends to show when we we are talking. By treating with small amounts of botulinum toxin to the chin muscle, we can smooth out the skin (with the added bonus of foundation staying perfectly in place all day....)
Gummy smile - For those who would prefer to show less gum when they smile, we can treat the muscle that lifts the top lip to allow it to drop ever so slightly. A favourite with many celebrities for that 'perfect smile'
Smoker's lines - AKA peri-oral lines. Whether you smoke or not, most of us will develop these vertical lines around our mouth at some point from puckering of the mouth. A small dose of toxin around the mouth can prevent puckering and allow for these lines to soften
The 'lip flip' - as an alternative to lip filler, by relaxing the muscles around the mouth, we can allow the lip to open up slightly to create more surface area to the lip and therefore appearing slightly bigger
Bunny lines - these are wrinkles on either side of your upper nose which appear when you scrunch your nose (like a bunny!). These can be relaxed easily with a little toxin to the area giving a smoother nose
Downturned smile - As we age the corners of our mouth pull downwards making us appear sad (with an upside down smile) - we can relax the muscle that pulls downwards allowing for the mouth corners to naturally be supported in a more upwards position resulting in a generally happier expression at rest
Eyebrow lift -- The shape of the eyebrow can be altered with careful placement of toxin to create either a more arched look, or a lifted eyebrow tail
Do I have to have botulinum toxin injections to the whole upper face?
No! Although the most common request is for anti-wrinkle treatment to 'three areas' being the forehead, frown lines and crow's feet, tailoring a treatment for your specific concerns is vital.
Often, the main concern might be just one area e.g. crow's feet, and therefore we can spare other areas to allow for full movement or dose low enough to retain a good amount in expression elsewhere. Each of us has different amounts of muscle and even asymmetrical faces and therefore you will go on a journey with your practitioner to find out what the best dose and areas for treatment are for you.
What if I don't like the results of a botulinum toxin treatment?
Your practitioner should offer you a review after 2 weeks to assess your treatment results and be able to tweak if needed for a stronger result, or relaxing other opposing muscles of the face if the result is too strong. As long as we use low doses, we usually avoid drastic changes in the shape of the face but unfortunately, as each person's face is different, we can only use our experience to predict how it will respond.
The good news is that the activation of the muscles will slowly wear off over a 3 month period and return to normal so if the result is not as you hoped, then you can be sure that it is not permanent!
What is 'baby bo(h)tox'?
A popular term being used at the moment is 'baby bo(h)tox'. Essentially, this is just using low doses of toxin to allow for some relaxation of the muscles of facial expression, but maintaining some movement so it is less obvious. This isn't a new technique!
It is less popular nowadays that people want complete relaxation of the facial muscles and much more of a drive for a natural result. Thankfully, whether you like it being called 'baby bo(h)tox' or not, we can achieve a varying degree of relaxation by simply injecting less. However, the downside to this is that the result doesn't last as long. With smaller doses, you will likely need treatment more frequently, perhaps every 6 weeks rather than 12 weeks.
Choosing the right practitioner:
In order to get the right result for you, choose your practitioner wisely. Understanding the anatomy of the muscles of the face, how they move together, how to dose properly, and how to correct any unwanted results is vital. Ensuring they have a background in medical training e.g. a doctor, dentist or a nurse will reassure you that they are properly regulated by a governing body and therefore more likely to be able to practice safely and effectively.
Interested in natural results with injectable treatments? Book in for a free consultation with Dr Alison and talk through the various treatments that might be able to help you.
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