Neurotoxin Neurosis

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Unless you have been living under a rock for the past decade, you have probably heard of Botox. The good, the bad, and the ugly of it all. Whether you yourself have received the toxin that so many are raving about, or know someone who has, many are treating it with as much importance as their daily skin regimen, retinols, and sunscreen. Individuals are ditching the stigma around the product and choosing to venture into the great world of aesthetic procedures; choosing to try neurotoxins for themselves. So how exactly does it work? Why do you need it and when? And Why are there so many different brands? Let’s dive a little deeper into the aesthetic world of neurotoxins to find out.



First, no one NEEDS an aesthetic procedure, but many choose to look better and feel better with a thorough aesthetic consultation. When patients arrive into my chair, they usually already have some working knowledge of what neurotoxins do and how they are administered. Living in an era of TikTok, Instagram, Youtube, Realself, and Facebook warrants us the unique opportunity to peek into the lives of random strangers. Many of them document their aesthetic journey, before, during, and after to give appeal and less reproach surrounding cosmetic procedures. So how do you know if Botox is the right choice for you? My rule of thumb may not be what most practitioners choose to believe, but I try to keep it real with my patients by offering unsolicited, honest feedback. When a patient has fine to mild rhythms (wrinkles) that are static (seen at rest) it is usually time to start thinking about Tox. If a patient has moderate to severe rhytids, it’s usually best to consider a more invasive procedure like moderate to deep resurfacing procedures. These more invasive procedures help to stimulate collagen production and remove top layers of the epidermal (most superficial skin layer) and reveal healthier, younger looking skin. After that, then we consider adding a neurotoxin, like Botox, as a preventative measure to keep the skin tight and smooth.
So now that we know when to begin thinking about Botox, the next question “so how does it actually work?” Some individuals believe that botox “freezes”, “paralyzes”, or destroys the muscle function, but that's not quite true. Botox is produced from a toxin, specifically the bacteria Clostridium botulinum, which after injection diffuses into the tissue and prevents the release of acetylcholine causing relaxation of the muscles (Satriyasa, 2019). The relaxation of the muscle, in turn, reduced wrinkles due to excess movement of the face. Botox can be used on any muscle, but it is up to your injector to determine if and where Botox placement can help with your aesthetic concerns. Not only can Botox be used for wrinkles, but many find it useful for acne, hyperhidrosis, vascular abnormalities, and lifting of the brows (Satriyasa, 2019). Botox is dosed per unit, and usually distributed in 50 and 100 unit vials. Doses are individually dependent and rely upon mutual aesthetic goals between provider and patient. Lethal doses are very rare for cosmetic purposes; lethal doses are usually found at 40 units/kg/body weight (Satriyasa, 2019). Side effects are minimal and usually involve injection site redness and swelling as well as a possible dull headache, but is usually patient specific and can be treated with systemic analgesics like Tylenol. Ptosis (dropping of the eyelids) can also occur if the neurotoxin migrates or the injection technique is not followed appropriately. All side effects, however, are minimal and gradually resolve before the toxin dissipates within the muscle (Satriyasa, 2019).



Neurotoxins overall are a perfect option when considering an anti aging regimen and prevention of facial wrinkles. Each brand of toxin has its own unique strain of Clostridium botulinum but they all have the same effect on the muscles. They do, however, range in longevity, onset of action (how quickly it begins to work), dose, and FDA clearance for usage. It’s best when considering neurotoxin use to explore injectors in your area for experience and reviews to decide where you might find your injector. Each injector may come with different training, expertise, and personal philosophies on aesthetic procedures and finding your perfect match is also an essential tool to consider. If you are interested in finding out more, visit us for a consultation where we would be happy to introduce you to the world of neurotoxins.



SOURCE: Satriyasa, B. (2019). Botulinum toxin (Botox) a for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clinical Cosmetic and Investigational Dermatology, (12), 223-228. Doi: 10.2147/CCID.S202919.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.