Botox has been available for medical purposes ever since the mid 1980′s, but it was not until the mid 1990′s that it has been used for cosmetic medical treatments. Since then people have come to realize its fantastic potential for turning back the clock. It can literally take years off your appearance, softening lines and wrinkles that you might have thought were now a permanent feature of your face.
But Botox needs to be respected. You need to choose a provider who is properly trained and regulated. It’s a powerful drug and it can be used in a way that produces a balanced and harmonious look. But if used in the wrong places it can cause problems. These can range from cosmetic problems like an eyelid droop, to functional problems like not being able to form a proper seal around your spoon or fork when you eat, or not being able to swallow your food. These types of problems can arise from incorrect administration of Botox, which might mean too a high a dose for your particular muscles, or incorrect site of injection, or both.
The safest and best places to use Botox for cosmetic purposes are on the forehead, between the eyebrows and at the sides of the eyes. This will soften lines and wrinkles, and if given correctly, can also produce a subtle eyebrow lift. In these areas there is more leeway (particularly on the forehead and between the eyebrows) in terms of the dosage or injection points. Plenty of research has been done about using Botox on the forehead to define the correct average dose range and the optimal points for the injections. Botox for “crow’s feet” lines that extend out from the corners of the eyes can also be very effective.
Care needs to be taken about injecting Botox around the corners of the eyes because if it is given too low down on your face it can affect the cheek muscles that hold up the side of the mouth. If these are affected by the Botox on both sides you could end up with down-turned corners of your mouth and difficulty smiling. A rather sad, sallow expression. On the other hand, if only one side of your mouth is affected you could end up with an asymmetrical facial appearance, rather like after a stroke or Bell’s palsy. Fortunately with Botox none of these adverse events are permanent and the effect will wear off within three to six months.
Moving down the face another effective area for Botox treatment is the top lip, where fine vertical lines can develop. Here the margin for error is much less, and a lot of expertise and experience is required to get a good response and at the same time minimize the risk of lip incontinence. Particular care needs to taken when treating people who use their mouth muscles for the work, notably musicians. Loss of the fine motor coordination that they need from their lips might mean loss of their livelihood.
Some people have Masseter muscle hypertrophy, giving rise to a square-faced appearance. Injection of Botox here can produce subtle but worthwhile improvements if your appearance.
Botox can also be used in the chin area to reduce dimpling, and also to lift the corners of the mouth. This can be very effective but again a precise knowledge of the local muscle anatomy is required to avoid problems with lower lip weakness from incorrect injection.
Finally, Botox has been used in the neck to treat Platysmal bands. These are vertical bands that stretch up to the chin. Care needs to be taken with the dosage and injection site to avoid inadvertently affecting the muscles that are used to swallow.