What is Botox?
Botox is a brand name for a substance called Botulinum Neurotoxin type A. Botulinum neurotoxins are a substance produced naturally by clostridial bacteria. It is historically a well-documented source of food-poisoning.
For use in medicine and cosmetics, it is purified and isolated in a complex series of steps that is highly regulated by government agencies in most countries.
Tiny quantities are injected directly into the target muscle, where it is not absorbed systemically, i.e. it doesn’t enter into the bloodstream or spread throughout the body.
The substance binds to the nerve endings within the muscle and (in very simple terms) prevents the muscle from contracting. Eventually the nerve endings recover and normal muscular function is restored. There is no evidence of permanent changes to the muscle with regular botox use, but there is suggestion that the effects last longer with more frequent injections, because the nerve terminals take longer to recover.
Safe Uses of Botox
In Aesthetics, Botox is mainly used to relax muscles that cause lines or wrinkles when contracted (dynamic lines), in other words, lines that aren’t there when the underlying muscle is fully relaxed. It isn’t effective against permanent wrinkles that aren’t caused by contracting muscles.
Aestethic uses of Botox in the Upper Face: Lines of the forehead (frontalis), brow (glabella), crows feet (lateral orbit), nose,
Aesthetic uses of Botox in the Lower Face: smokers lines of the lips (orbicularis oris), gummy smile (Levator labii superioris alaeque nasi), masseter hypertrophy, platysmal bands, and improvements of the perioral region
Botox in Other Body Parts: Excessive sweating (Hyperhidrosis), Calf slimming (popular in East Asia), Writer’s Cramps.
Other Medical uses:
- Pain in conditions such as chronic migraines, cervical dystonia, postherpetic neuralgia, complex regional pain syndrome,
- Dentistry: Temporomandibular disorders, bruxism, jaw clenching,
- Eye conditions such as strabismus (crossed eyes) and blepharospasm (abnormal muscle spasms of the eyelids).
Why do you see mask-like botox faces?
These individuals have likely taken it too far by either
- Using too high doses
- Injected too many regions/muscle groups of the face at once
- Combined it with too many other treatments such as fillers in the face or lips
altogether causing an unnatural and rigid mask-like effect. However, the majority of botox receivers attain a much more natural look, and the chances are you know many people that have received botox but you wouldn’t know it.
A responsible medical practitioner shouldn’t do any of the above. Ask to see their work before you commit to a botox practioner.
Safe and Approved Brands of Botox
The most famous and widely used is Botox® by Allergan. Other well-known examples of safe and approved brands are: Dysport®, Myobloc®, Xeomin®, Boccouture®.
Avoid “cheap” and unregulated botox products at all costs. These are often imported from other countries where regulation is lax, and it is with these types of products that dangerous things happen. I have personally seen poorly labelled vials of “Botulinum Toxin” from unclear sources in China, with no indication of strength or potency. Anyone using these is being highly dangerous and irresponsible.
So, is Botox Bad for You?
To summarise, botox in itself and the use of it is not bad for you. When done correctly, procedure is safe, and the doses regularly used in the above mentioned regions are safe. But it’s dangerous to buy cheap unapproved “botox” products where the manufacturing process and the purity of the product isn’t regulated.
References
Nayyar P, Kumar P, Nayyar PV, Singh A. BOTOX: Broadening the Horizon of Dentistry. Journal of Clinical and Diagnostic Research : JCDR. 2014;8(12):ZE25-ZE29. doi:10.7860/JCDR/2014/11624.5341.
Benedetto, Anthony. Botulinum Toxin in Clinical Aesthetic Practice. Journal of Cosmetic and Laser Therapy. 2nd ed., Informa Healthcare, 2011.
Dr. Anjani Knöbel 