BOTOX INJECTIONS: TREATMENT WITH BOTULINUM TOXIN

What is Botox?

Botox, the commercial name for the botulinum toxin that is its active ingredient, is the most widely used aesthetic treatment in the world. Initially used for medical indications (neurology, ophthalmology....), botox is now widely used in medicine and cosmetic surgery. This substance, which comes in powder form, temporarily reduces the contraction of the targeted muscles.

Contents

Highlights

Botox in Geneva

Botulinum toxin is used to reduce wrinkles and fine lines of the face by relaxing the muscles responsible for the appearance of these imperfections.
L'hyaluronic acid and botulinum toxin are the two anti-ageing treatment par excellence. The essentials in aesthetic medicine for treating the ageing of the skin.

This product is best known for treating frown lines, crow's feet and forehead wrinkles, but there are many other indications, including the treatment of perspiration and bruxism.

Is Botox for men possible?

Botulinum toxin is a beauty treatment widely used by men and women to reduce the signs of ageing.
Bien que les motivations puissent varier, les résultats souhaités sont similaires : une apparence plus jeune, reposée et naturelle. Chez les femmes, le Botox est couramment utilisé pour lisser les rides du front, les pattes d’oie et les rides glabellaires. Les hommes, quant à eux, recherchent souvent un 

traitement pour adoucir les rides sans bloquer complètement leurs expressions  et leur apparence masculine. Le Botox permet aux deux sexes de maintenir une apparence fraîche et dynamique avec des résultats subtils mais visibles. Le traitement est personnalisé et réponds aux besoins spécifiques de chaque patients.

botox action mechanism diagram

How does Botox work on wrinkles?

In the face, the muscles are intimately linked to the skin. Every time the muscle contracts, the skin follows. This causes wrinkles to appear, first dynamically (expression lines), then statically (rest lines).
Botox works by preventing the release of acetylcholine, the signal needed for muscle contraction, at the nerve endings. The muscle can no longer contract, the skin relaxes and wrinkles disappear.

Its action is both aesthetic and functional.

  • Treatment of expression lines and rest lines caused by muscle contraction.
  •  Treatment of hyperhidrosis.
  • Repositioning anatomical structures: lifting the tip of the nose, raising the eyebrows.
  • Medical treatment by neurologists and ophthalmologists: spastic paralysis, blepharospasm.

Does botox give a frozen or natural appearance?

Botox injections can give a natural result or freeze the person, depending on the patient's wishes and the medical technique used.
Some patients prefer to be completely blocked, American-style, although the natural result is the most popular.
On the doctor's side, errors can be made at the time of injection in terms of diluting the product, locating the points injected and the quantities used for each point. This lack of technical control is responsible for :

  • a frozen appearance.
  • excessive expression blocking.
  • product diffusion, which has many consequences: blocking of the smile, drooping eyebrows, drooping eyelids, etc.

What is the difference between botox and hyaluronic acid?

L'hyaluronic acid is a gel used to fill hollows, give volume or lift. It has no effect on the muscles, which continue to contract after the injection. The result is immediate.
Botox is a powder that is reconstituted with physiological serum so that it can be injected. Botulinum toxin can only correct wrinkles caused by muscle contraction.
The result begins to be visible two days after the injection and is definitive seven days later.

For wrinkles of muscular origin, the first-line treatment is botox. If the wrinkle persists, hyaluronic acid can be injected to make it disappear.

At what age should I start botox injections?

It all depends on the problem to be treated. Excessive sweating, for example, can be treated even at the age of 18.
The laboratory advises against using botox before the age of 18 and after the age of 65.
In the field of aesthetics, the indication is the appearance of static wrinkles. The age at which they appear varies from person to person and is linked to the individual's expressiveness.
If we intervene too late, the skin will show cracks that can be improved but not erased.
The best indication for botox is prevention. It is important not to wait for wrinkles to appear, but to intervene before they do.

The botox boom: botox in figures

Botox is the most widely used aesthetic medical treatment in the world. In second place are hyaluronic acid injections and in third place laser hair removal.

In 2012 in the USA, almost 3.3 million people received it: 2.9 million women and 340,000 men.

In Europe, its annual growth rate was 8.9% over the period 2019-2025.

When should botox injections be used?

Botox meets various aesthetic needs.

photo botox frown lines

The treatment of vertical wrinkles between the eyebrows relaxes the eyes.

photo botox crow's feet wrinkles

Wrinkles in the corner of the eye are effectively treated and the eyes look more open.

photo botox forehead wrinkles

Horizontal wrinkles on the forehead should be treated naturally so as not to freeze the patient.

photo botox jaw

This treatment is only effective if the masseter muscle is strong. A wide jaw due to an imposing bone structure is not an indication.

photo botox eyebrow lift

The eyebrows are raised by blocking the two eyebrow depressor muscles, which are also responsible for frown lines and crow's feet.

photo botox nose tip lift

Botox nose tip lift
The tip of the nose is raised by injecting botox into the lower nasal septum muscle.

photo botox excessive perspiration

Botox is the treatment of choice.

Why won't botox work on me?

Several factors may be responsible for this disadvantage.

  • Product quality: if the Botox used is not of good quality or has been poorly preserved, its effectiveness may be reduced.
  • Injection technique: an incorrect technique may result in inappropriate diffusion of the product or an insufficient quantity of product in the targeted areas.
  • Insufficient dosage.
  • Individual metabolism: some people metabolise Botox more quickly than others.
  • Frequency of treatment: frequent use of Botox can lead to resistance to the product. The minimum time between injections is three months.
  • Lifestyle: certain factors such as smoking, excessive sun exposure and stress can influence the duration of the Botox effect.
  • Injection area: certain areas of the face may require different quantities or specific techniques to achieve the desired results.


It is therefore important to consult a qualified and experienced doctor for Botox injections.

How is a Botox injection carried out?

The face is analysed at rest and dynamically. The examination is important for identifying muscular balances, spotting any asymmetries and identifying certain technical adjustments to be made according to the patient's anatomy.
There are different brands of botox. Dr Romano uses Azzalure from the Galderma laboratory, a toxin which, according to studies, is the longest-lasting.
The principle of the treatment is muscle blocking: the muscle, not the wrinkle, is injected. Very precise points adapted to the patient's anatomy are injected.
The injection is rapid. A very fine needle is used. No anaesthetic is required, the injection is virtually painless, and the product contains no anaesthetic (unlike hyaluronic acid). A warming sensation is felt when it is administered.

photo of botox session

What precautions should be taken after a botox injection?

Patients are made aware of the importance of following certain instructions in order to avoid complications.

On the day of the injection, you should avoid touching the injected points, shampooing or tilting your head.
For two days following the injection, you should avoid all sporting activities, eyelash and eyebrow care and hair dyeing.
For a week, you should avoid saunas, steam rooms, UV booths, massages and facial steams.

How can Botox results be reversed?

photo how to remove botox
  • Patience: the best way to make the results of botulinum toxin disappear is to wait. The effects of Botox are temporary and fade naturally over time, generally between three and six months. The exact duration depends on the dose injected, the area treated and the patient's metabolism.
  • Massage: although controversial and not always recommended, some practitioners recommend lightly massaging the treated areas in an attempt to redistribute the botulinum toxin. However, this must be done under professional supervision to avoid possible complications. Dr Romano is not in favour of this method.
  • Muscle stimulation: gentle facial exercises and repeated muscle contractions can help accelerate the breakdown of botulinum toxin by stimulating muscle reactivation. Results vary.
  • Medical consultation : If the effects of botulinum toxin are bothersome or lead to aesthetic or functional complications, consult your practitioner. Although there is no solution to immediately reverse the effects, a professional can provide personalised advice and manage any side effects.
  • Complementary treatments: in some cases, other cosmetic procedures may be considered to reduce the undesirable results of botulinum toxin. For example, hyaluronic acid injections. Unfortunately, this is not always possible.

Contraindications of Botox

The contraindications are :

  • Pregnancy and breastfeeding.
  • Neuromuscular or neurological pathologies, such as myasthenia gravis.
  • Known allergy to botulinum toxin type A or egg (some brands contain albumin).
  • An infection or sore at the injection site.
  • Combination with aminoside antibiotics is not recommended, as they increase the effect of the toxin.

What are the disadvantages of botox?

Side effects last between one and seven days.

  • Headaches.
  • Dry eyes.
  • Ptosis (drooping) of the eyebrow or upper eyelid: this complication is due to a technical error or failure to observe post-injection precautions.
  • Asymmetry: an asymmetry present before the injection cannot be completely corrected.
  • Nausea, dizziness, flu-like symptoms.
  • Difficulty swallowing or abnormal lip movements for injections into the fine lines of the lips (an injection that Dr Romano advises against).

Normal follow-up

The classic suites are :

  • Small swellings at the injected points, lasting about ten minutes.
  • Local redness at the injection site, lasting no longer than a week.

Botox results: before / after Botox injections

Botox rejuvenates the face: wrinkles disappear, the eyes look open and rested.
The result is adapted to the patient's wishes. Some patients prefer the complete disappearance of wrinkles to the natural result, others want the eyes to be more open, others want to retain a little mobility in all the muscles (the actors for example)...
Dr Romano always respects the patient's choice, but she strongly recommends a natural result.

The effects begin to be visible two days after the injection and are definitive seven days later.

How long do botox results last?

The result is not definitive and lasts between four and six months.

What are the effects of Botox over time?

Botox, or botulinum toxin type A, is widely used to reduce wrinkles and improve the appearance of the face. Here is a summary of its effects over time.

Immediate effects (0 to 7 days)
1 to 3 days: the first effects begin to appear. The muscles treated begin to relax and wrinkles start to fade.
7 days: the result is optimal, with a significant reduction in wrinkles and smoother skin.

Short-term notes (1 to 3 months)
1 to 2 months: the results are at their peak, with a free touch-up carried out one to three weeks after the initial injection to perfect the result. The skin looks younger and wrinkles are significantly reduced.
3 months: the effects begin to fade slowly, the muscles start to work again, but the wrinkles do not reappear.

Medium-term effects (3 to 6 months)
3 to 4 months: a visible reduction in the effectiveness of Botox is often observed. Some wrinkles may reappear.
4 to 6 months: The effects of Botox continue to fade. The muscles have almost completely returned to their normal function and wrinkles reappear.

Long-term effects (6 months or more)
6 months and beyond: Botox is fully metabolised by the body. The muscles regain full activity and the wrinkles disappear completely. However, after several injection sessions, some wrinkles may appear less pronounced due to the temporary weakening of the muscles.

Cumulative effects
Repeat injections: by repeating the injections every six months, the muscles gradually weaken, resulting in a more lasting reduction in wrinkles.
Prevention: regular Botox injections prevent the formation of new wrinkles.

Long-term adverse effects
Botox tolerance Some people can develop a tolerance to Botox, and these patients require higher doses to obtain the same results.
Weakening muscles with Botox This is quite positive if the injections have been carried out correctly. Otherwise, a weakening of the forehead muscle in the lower part of the forehead, for example, can lead to a permanent drooping of the eyebrows.
Botox resistance Botulinum toxin: some people can develop antibodies against botulinum toxin, making the treatment less effective or ineffective. This is often due to injections being given too close together. Resistance is rare.

How much does a Botox injection cost?

The price of botulinum toxin injections depends on a number of factors, including the area to be treated, the quantity of product required and the expertise of the practitioner. In the USA, the price of the area to be treated is calculated per unit, with an average cost of between CHF 10 and 15 per unit. In Switzerland, the price is calculated in terms of the area treated.

It is important to consult a qualified practitioner for a precise, personalised estimate and, above all, to be sure of obtaining a natural result without complications.

Type of consultation General rates
Botox upper face
WOMAN
one zone: CHF 300
two zones: CHF 450
three zones: CHF 600

MEN
one zone: CHF 350
two zones: CHF 500
three zones: CHF 650
Botox masseter/bruxism
CHF 500 for the 1st bottle
CHF 350 for each additional bottle
one to three vials are required
Botox perspiration
CHF 500 for the 1st bottle
CHF 350 for each additional bottle
One to three vials are needed

Opinion on Botox for wrinkle filling

Opinions on Botox are overwhelmingly positive, both from patients and doctors.
Patients praise Botox's ability to smooth fine lines and wrinkles, resulting in a more youthful, rested appearance. Patients appreciate the subtlety of the treatment which, if carried out by an experienced practitioner, allows natural expressions to be retained while reducing the signs of ageing.
Results are visible quickly, with an optimal effect after just one week. What's more, Botox is renowned for its safety and efficacy, with effects that last for six months. The rapid recovery and minimal side effects add to patient satisfaction, making Botox the solution of choice for those looking to treat the signs of ageing on the face.

Is Botox dangerous?

Botox (botulinum toxin type A) is a widely used cosmetic treatment approved by health authorities in many countries, including the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Botox is considered safe when administered by a qualified doctor.

Botulinum toxin has been discovered and studied since the early 19th century. Initially identified as a cause of food poisoning, it became an important medical and cosmetic tool in the 20th century. Botulinum toxin is now widely used to treat a variety of medical and cosmetic conditions.

Botox is often used to reduce wrinkles and fine lines on the face, particularly those on the forehead, crow's feet and between the eyebrows. It can give a more youthful, rested appearance when administered correctly by a qualified doctor. However, it is essential to consult a doctor to assess whether Botox is right for you.

Botox smoothes wrinkles and fine lines and opens up the eyes, giving the face a more youthful, rested appearance.

It is generally advisable to wait at least 24 hours before washing your face after a Botox injection. This allows the product to set properly and reduces the risk of the Botox spreading to other muscles.

Yes, Botox is very effective in temporarily reducing or eliminating forehead wrinkles. Results may vary depending on the depth of the wrinkles and individual reaction.

Botox delays ageing by preventing the formation of new wrinkles and the worsening of existing ones.

There is no cream that can completely replace Botox. However, certain creams containing peptides, retinol or hyaluronic acid can help improve the appearance of the skin and reduce the appearance of wrinkles.

Argireline is a peptide that mimics the action of botox.

The laboratory advises against the use of Botox after the age of 65. When Botox is stopped, the temporary effects (reduction of wrinkles) will gradually disappear after 3 to 6 months and the muscles will resume their normal activity. Wrinkles and fine lines will then gradually reappear.

There is no 'natural Botox' identical to synthetic Botox. However, some natural products, such as serums based on peptides or plant extracts, can offer anti-ageing effects by stimulating collagen production and improving skin elasticity.

Botox can temporarily change the appearance of the face by smoothing fine lines and wrinkles, but it does not change the structure of the face. When injections are carried out by a qualified doctor, the face retains its natural appearance.

A drooping eyelid after a Botox injection can occur if the Botox accidentally diffuses into the levator muscle of the upper eyelid. This complication is rare and temporary, usually resolving within a few weeks.

Drooping eyebrows, caused by the forehead being completely blocked, can give the false impression of a drooping eyelid.

Botox can be beneficial for those who wish to reduce the appearance of wrinkles and fine lines and open up their eyes.

Azzalure.

Yes, Botox can be combined with other aesthetic treatments such as fillers, peels and laser treatments. Some of these treatments cannot be carried out on the same day.

Botox injections are generally well tolerated and pain is minimal. An anaesthetic cream may be applied before the procedure.

Botox injections do not have an immediate effect because the blocking of muscle receptors (acetylcholine receptors, which are the target of botulinum toxin) is only possible once they are free.
That's why Botox® doesn't work straight away: you have to wait for these receptors to be released before you see a visible effect.

It takes approximately 3 to 4 hours to fall asleep after the injection. It is often said that on the first night after the injection, it is advisable to sleep with your head slightly elevated, but this is not necessary. 

Botulinum toxin injections are mainly used to reduce wrinkles and fine lines by relaxing the facial muscles responsible for expressions. The result is a smoother, younger-looking face without the need for surgery. Results are visible within a few days and last for several months.

The choice between Botox and hyaluronic acid depends on the indications. Botox is indicated for smoothing expression lines caused by muscle movements, such as forehead wrinkles and crow's feet. Hyaluronic acid, on the other hand, is a filler used to add volume, fill in deep wrinkles and hydrate the skin. The two treatments can be complementary and are often used together for a complete rejuvenation of the face.

Unfortunately, there is no method of reversing the effect of Botox. The effects of Botox are temporary and diminish naturally over time, generally between four and six months. 

Botulinum toxin itself does not generally cause fatigue. However, some people may feel slightly tired after the injection, but these symptoms are temporary.

It is advisable to avoid steam rooms, saunas and baths for at least two days after a Botox injection. Excessive heat can increase the risk of botox spreading and bruising.

Yes, this is a frequent side effect, but it is generally mild and temporary.

A Botox injection session generally lasts between ten and twenty minutes. The injection itself lasts barely a minute.

Yes, you can fly after a Botox injection.

Botox can be used preventively before the age of 30 to reduce the appearance of expression lines.

Botox is indicated for curative purposes when the first static wrinkles appear.
It is important to consult a qualified practitioner to determine whether Botox is appropriate for you.

There is no specific antidote. Once injected, there is no substance capable of neutralising its action.

Yes, botox delays skin ageing and slows the appearance of muscle-induced wrinkles.

Botulinum toxin injections are not recommended for the lower part of the face. In fact, the benefits obtained at this level are low, while the risks of diffusion are high, which can cause speech defects or breathing difficulties.

Botox slows down the ageing of the skin, but only acts on wrinkles. The other components of skin ageing will not be treated.

Botox is contraindicated in pregnant or breastfeeding women, in cases of known allergy to botulinum toxin or any of the product's ingredients, and in patients with neuromuscular disorders. It is important to consult a qualified practitioner to rule out these contraindications.

Botulinum toxin injections delay ageing. However, botox can make you look older if the injections don't work and your face looks stiff.

The patient is seen again one to three weeks after the initial injection for a free touch-up to correct any asymmetry or anomalies and perfect the result.
Subsequent injections should be repeated every four to six months to maintain the result.

  • Choosing a good practitioner.
  • Follow the post-injection recommendations.
  • Plan regular injections every six months.
  • Have a good skincare routine.
  • Adopt a healthy lifestyle and manage stress in particular.
  • Combination of treatments: dermal fillers and laser.  

Botox is particularly effective in treating expression lines, such as forehead wrinkles, crow's feet and frown lines. By relaxing the muscles responsible for these folds, Botox smoothes the skin and visibly reduces wrinkles. The result is natural and harmonious. It's a fast, long-lasting solution for reducing the signs of ageing.

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