Muscle Relaxing Injections (Botulinum toxin)
Botox (botulinum toxin) is the naturally occurring substance which stops the normal contraction of muscles. It is used in plastic surgery to treat wrinkles on the face by preventing contraction of the underlying muscles. It is also used by plastic surgeons for the treatment of hyperhidrosis (excessive sweating) of the armpits, palms and groins.
Why do patients ask for botulinum toxin injections?
With the passage of time, strong contraction of the muscles underneath the skin of the face (muscles of facial expression) causes the overlying skin to wrinkle. Patients are unhappy with an appearance of constant frowning or tiredness. They are also concerned about the deep creases in the forehead, between the eyebrows and lines around the eyes (crowsfeet). Patients who suffer from hyperhidrosis are very embarrassed by their condition. They are unable to wear light coloured clothes as rings of sweat show up in a very short period of time. They often carry spare sets of clothes to work and have to shower two to three times a day because they are self-conscious about body odour. They cannot shake hands and are unable to write as the paper smudges due to excessive sweating.
Are there any reasons for patients not to have Botox injections?
Patients who are pregnant, who are on blood thinning medications such as warfarin or aspirin or suffer from myasthenia gravis should not have Botox.
What does the treatment involve?
Botox injections are administered as an outpatient procedure. The surgeon marks the areas to be injected. Botox is injected with a very fine needle in carefully regulated doses into the muscles that are responsible for the formation of creases and wrinkles. Patients with hyperhidrosis of the armpits can also be injected in the outpatient department. Occasionally a white anaesthetic cream is applied to the skin one to two hours before the injection to decrease the discomfort of the injection. Patients with hyperhidrosis of the palms and soles of the feet usually have these injected with Botox under general anaesthetic.
What normally happens after the injection?
The areas that have been injected can be slightly bruised or swollen. The swelling and bruising usually resolves within a week. The effect of the Botox is not visible until one to three weeks after the injection and lasts for approximately four to six months. Patients who want a sustained effect need to have a repeat injection when the effect of Botox wears off.
How long will I need off work?
Most patients are able to return to work within a day. On occasions there maybe some significant swelling or bruising at the site of injection. This may affect your ability to meet with clients or to attend important social occasions.
What are the complications of Botox injections?
Very rarely patients can have an allergic reaction to Botox or the effect of Botox maybe visible in a wider area than intended. This can result in an exaggerated result was relative immobility of the forehead or slight drooping of the brow or of the upper eyelid. However this effect is completely reversible within some weeks of the injection.