Botulinum toxin acts by interrupting the message between nerve and muscle. This results in temporary paralysis of the muscles of facial expression when used in the face. Such injections are mostly used for the upper third of the face to treat forehead lines, frown lines between the eyebrows and crow's feet. This can enhance the facial beauty of the patient if done with skill and precision. Over treatment can result in a frozen appearance and occasionally malposition of the eyebrow and eyelid.
The consultation with the specialist is critical in understanding the patient's concerns and whether injection therapy will help. Botulinum toxin injections affect the dynamic lines of the face. Repeated injections may soften the lines at rest but not fully. The best place to start treatment is between the eyebrows, to prevent the dynamic frown lines. The degree of paralysis can be varied according to need. The risk of eyebrow or eyelid malposition is small. The effect can take up to seven days to fully evolve. Review within that period by the specialist is recommended to determine whether the patient's expectations were met. Crows feet would be the next zone to be treated, followed by the forehead.
Botulinum toxin injections treat the muscles of the forehead and those around the eyes. The effect takes up to 7 days to evolve and should last for 3-4 months. The risks are small but must be fully discussed during the consultation with the specialist.