Botulinum Toxin Use For Wrinkle Blocking and Other Uses Is On The Rise
Dr. John Burroughs has been injecting botulinum toxin neuromodulators since 1997. He is a recognized “Botox” expert and has even published book chapters on his techniques and taught at national aesthetic meeting symposia. He also published a study helping patients with a severely debilitating eyelid spasm disorder showing a technique to help these patients open their eyes better when they suffer benign essential blepharospasm and pseudo-apraxia of eyelid opening.
Dr. Burroughs and others in the aesthetics community have noted that non-invasive rejuvenation is on the rise, and Botox and other botulinum toxin Type A injections are very popular showing an over 750% jump since 2000, and nearly 7M injections performed in 2015 alone. The most popular formulations are the A serotypes to include Xeomin (Merz), Dysport (Galderma), and Botox (Allergan). The toxin is isolated from the clostridium botulinum bacteria. This is the same organism that can cause botulism, but when given in the pure form and in carefully controlled small amounts it does not pose a significant risk to patients.
How Does Botulinum Toxin work?
The toxin is injected in very tiny amounts into the muscles that directly cause the undesired wrinkles, expressions, or facial positions (e.g., brows). The botulinum toxin acts as a neuromodulator causing temporary and very targeted “micro-damage” to the nerve muscle junctions blocking the contractions of the muscles. These aren’t wrinkle fillers or volumizers like the dermal fillers are (e.g., Restylane, Belotero, Juvederm, Radiesse). Over time and with repeated and regular dosing the areas treated can relax and change the desired areas of the face to a more relaxed, less wrinkled, and more “welcoming” appearance. Similar to how a metal paperclip or bobby pin weakens over time if it is bent too many times, this same analogy compares to how the botulinum toxins help the facial shape and appearance. Most patients are responsive to these injections and allergic reactions exceedingly rare.
How Should The Injections Be Done?
The toxins come packaged safely as a powder in medical-grade bottles. They are then typically reconstituted with preserved saline, which improves the comfort of the injections. It was first approved cosmetically for the frown lines between the brows caused by the corrugator and procerus muscles. Many “off-label” uses are now done widely by aesthetic practitioners to help the smile lines around the eyes, the brow positions, forehead lines, and even for facial slimming. The injections are done through very tiny needles and though they can feel sharp, there are distraction techniques such as pinching, tapping, and rubbing of the skin that make the injections very well tolerated.
When Do The Results Start and How Long Does It Last?
Most patients, according to Dr. Burroughs, see results begin at 2-3 days and reaching maximal improvement at 2-3 weeks. Most patients get 3-4 months of improvement when dosed and injected appropriately. The forehead can actually last up to 4-6 months because the muscles are thinner. Male and “thicker” muscled patients require higher dosages. Age can also play a factor, but Dr. Burroughs has treated patients from their upper teens into their 90’s with good success.
Is It Safe Over Time?
Dr. Burroughs has never seen any long-term complications, and there are patients that have been getting botulinum injections at pretty high dosages for medical conditions since the 80’s without suffering adverse issues. In fact, over time, the results can last longer as the targeted muscles can atrophy a bit such that the wrinke lines and undesired expressions improve with time and regular injections. This is because the dynamic lines don’t have time to reform because the muscles have been consistently relaxed through regular interval injections before the effect entirely wears off.
What Are Some Of The Risks?
The injections can cause temporary redness, swelling, and bruising. Very rarely drooping of the eyelid, double vision, or asymmetric results can happen. Experienced injectors see this less owing to their cumulative experience of treating thousands of different individuals and facial desires and goals. Avoidance of blood thinners (e.g. aspirin or NSAIDS like Motrin) even alcoholic beverages a week prior to injections can lessen the risks of unwanted spread of the toxin.
What Is The Best Botulinum Toxin?
Dr. Burroughs has used all three of the major toxins. He likes Xeomin by Merz the best as the company actively offers excellent discounts to patients, and he finds the dosing to Botox by Allergan to be equivalent. Additionally, multiple comparative studies have shown when Xeomin is reconstituted and injected properly to have equivalent effect to Botox. Dysport is unique that it gives a somewhat wider spread of effect, which can be beneficial on the forehead, but perhaps riskier in other areas of the face like the eyelids.
Can The Botulinum Toxins Be Given At The Same Time As Dermal Fillers?
Absolutely yes! It is very popular at Springs Aesthetics to get wrinkle blocker and fillers simultaneously as they work well together and provide different and longer lasting results when done simultaneously. They can also be done in conjunction with other procedures and if given enough in advance be helpful for surgical results. They are great when done in conjunction with chemical peels and with fractionated skin resurfacing (Fractora).
Will I Look Natural?
When the injections are done properly you will indeed look natural and better. Over dosing can cause your face to look frozen and possibly untrustworthy, so this can be avoided by giving smaller doses over a larger number of sites and not excessively treating. Fortunately, and although very rare, if you don’t like the look it will wear off over a few months. Most patients love their appearance so much after wrinkle blocker injections that they want to keep it up. It works that well.
Summary
The wrinkle blockers are extremely popular because of their outstanding results and no downtime. They even have benefits beyond wrinkles to include help with excessive sweating and even depression. Trust your face to a trusted and expert injector. Dr. Burroughs trains and teaches others on his techniques and a video showing a live injection session can be seen here. If you are tired of wrinkles or others saying you look tired, sad, or “bitchy” then join the millions of others that have given the wrinkle blockers a chance. Give us a call at Springs Aesthetics for a consultation to see if a wrinkle blocker injection will help you.
John R. Burroughs, M.D.
Oculofacial Plastic Surgeon
Medical Director Springs Aesthetics
Colorado Springs, CO
719-473-8801