Botulinum toxin

Botulinum toxin has long been known in medicine. It is made from the bacteria Clostridium botulinum and, in effect, this is a protein which, depending on the quantity, can enfeeble or fully deactivate various muscles or can stop perspiration.  At molecular level, it blocks the impulses sent by the nervous fibre, respectively, to the muscle or the sweat gland.


In aesthetic medicine, Botulinum toxin is applied in insignificant quantities and is completely safe, although the word toxin sounds terrifying to many.  Where it is used for smoothing the expression lines in the upper half of the face, the effect occurs in 48-72 hours, where it is most expressed in 2 weeks. Its effect continues for several months, where with the time muscles gradually restore their activity and, on average, it is desirable that you repeat the procedure in 6 months.  The toxin affects best the wrinkles on the forehead, between the eyebrows (the anger wrinkle) and those around the eyes. In addition, it affects some of the wrinkles around the mouth, neck and loosens the chin.


How is this procedure performed?


Botulinum toxin must be introduced by a qualified dermatologist or a plastic surgeon. Very fine needles are used and there is very slight discomfort during its injection. This can be further mitigated with preliminary cooling of the treated area.


What happens after botulinum toxin application?


Like any procedure related to injection, one can sometimes have a slight reddening, oedema and small haematoma. All of these will fade away in several hours to several days.  The risk grows if you have taken aspirin or other blood-thinning medications in the days before the manipulation. Rarely, if the musculature is stronger, one can have headaches in the first few days.  


Results longevity?


Wrinkles do not even out right away but, rather, in 2-3 days. The effect stays for 3-7 months, depending on the depth of the wrinkles and the quantity set.


How often could the procedure be applied?


It is recommended that the interval between the applications is at least 3 months. The observation of these intervals is a guarantee for better efficiency and lasting results of the application in the years. Otherwise, you run the risk, albeit small, to form antibodies against the toxin and it can virtually stop acting on you.


Who should not apply this procedure?


Patients with nervous muscular and auto-immune diseases (multiple sclerosis, myasthenia gravis).  People taking the following groups of medications: Aminoglycoside antibiotics, calcium blockers, quinine, penicillamine. Pregnant and breast-feeding women.


Does one run the risk of eyelid flop?


The flop of either or both eyelids is, in reality, the most serious side effect which can occur following the placement of botulinum toxin.  Its frequency is below 1% and largely depends on the experience and proper assessment of the dose and sites of application by the physician. It is also important that the patient does not go to bed for 3-4 hours after such a procedure.  Luckily, eyelid flop is completely reversible and it restores gradually for several weeks.  There are also special eye drops that help for faster recovery.


Botulinum toxin products registered for use in Bulgaria are:


Dysport®  of Ipsen of the UK (since 2003)

Vistabel®  of US company Allergan (since 2009)

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