By the doctor Olivier Claude
What exactly is Botox®?
It is a protein manufactured using biotechnology, starting with an inactive bacterial strain. This is also the case for many other medicines. It has been used for more than forty years in various medical specialities (ophthalmology, paediatrics, urology, etc.). It reduces any excessive and unfavourable muscle contractions in the face by adapting the exchanges between the motor nerves and the muscles. Its action is limited over time and generally lasts between 4 and 6 months.
What are the benefits of Botox®?
Over the years, regardless of how we feel, the face expresses more negative emotions. It can look more tired, sad or stern. The treatment must be used in a gentle way that is appropriate for each patient in order to restore the more positive emotions. This objective is achieved by selectively reducing the contraction of the muscles that pull the tissues downwards. This way we balance out the muscles’ action by strengthening the elevator muscles, which opens up the eye area and makes it easier to portray positive emotions.
It has also been proven that botulinum protein injections improve the skin quality.
What areas of the face can it be used on?
Injections are generally carried out into the upper part of the face. They treat the glabellar lines between the eyebrows, which make the person look stern and angry, forehead wrinkles that make them look tired and sometimes surprised, and crow’s feet wrinkles. But all of the facial muscles are interconnected. It is therefore important to treat the muscles in the lower face too, such as the ones that lower the corners of the mouth, the DAO. By treating them, we can reduce the “inversed smiley” look, which portrays sadness. The superficial muscles of the neck are also injected during the same session. This improves the definition of the jawline and reduces the vertical cords in the neck, which optimises the submental angle.
From what age should we start and how often?
In general, patients start around age 30-35, generally due to glabellar lines between the eyebrows. They make a person look very stern whenever they are concentrated or paying attention to something or someone. More and more patients are starting treatment around age 30 in order to prevent the first signs of aging. It might be compared to starting Pilates classes in order to take preventative action to treat the body. We thus optimise the function of the muscle balances for the present and the future: it is both a treatment and a prevention.
Can we achieve a natural look and avoid looking “frozen”?
Yes, of course. Our objective is to achieve a natural-looking appearance, and this is even more important nowadays, what with wearing a mask during the pandemic. The upper part of the face is often the only visible part and must therefore remain expressive. We must analyse the face at rest and in movement, while the person pulls different faces and expres- sions. The treatment plan is personalised and adapted to each patient’s wishes and requirements. The aim is to regulate the muscle activity, as opposed to blocking it. The doses are adapted to each treatment by adapting the concentrations, volumes and number of injections made into each treatment zone. This avoids freezing the face and allows us to achieve natural-looking and balanced results.
How is Botox® prepared?
Botulinum protein is stored in the fridge at 4°C. It is a small amount of powder that needs mixing with saline solution. This fiddly step is carried out prior to every use. Different concentrations are used according to the patient and the desired effect. This way, the same dose injected can be 2 or even 4 times stronger than another, depending on this activation stage.
Can they complement hyaluronic acid injections?
Yes, botulinum protein and hyaluronic acid injections work in synergy with one another. Facial aging is a multifactorial process, and we must use treatments suitable for each of its components. Ideally, hyaluronic acid injections, using personalised “MD codes”, should be carried out first in order to restore the facial support. This allows us to rest the face, which is no longer obliged to use its muscles in an excessive and anarchic way. Hyaluronic acid, when injected deeply, can restore the face’s support and strengthen the lever arm of the elevator muscles. It really modulates the muscles and acts collectively with the botulinum toxin to promote positive facial expressions.
We use the minimum dose of each tool in order to create a synergy and avoid the side effects of the different treatments. It is the same in any field of medicine. The aim is to put forward the best version of ourselves and prepare our faces for the years ahead.
Plastic and Aesthetic Surgeon – Paris.
Qualified in Plastic, Reconstructive and Aesthetic Surgery.
D.E.S.C. medical specialisation diploma in Plastic and Aesthetic Surgery.
Graduated from the French College of Plastic Reconstructive and Aesthetic Surgery.
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