Due to constant activity of the mimic muscles, wrinkles can appear in the overlying skin over the course of a lifetime, for example frown lines above the nose, forehead wrinkles or laugh lines at the corners of the eyes (known as crow's feet).

Since Botox (botulinum) reduces muscle contraction by blocking the messenger substance required for this purpose, botulinum injections into the muscles in question lead to a dose-dependent relaxation. As a result of the muscle relaxation, wrinkles also smooth out or disappear completely if they were not yet too deeply ingrained. Botox (botulinum) is rapidly degraded after injection, and its effect lasts for several months, depending on the amount injected and the patient.

For which wrinkles is Botox (Botulinum) particularly suitable?

Due to its mechanism of action (muscle relaxation), Botox (Botulinum) is particularly effective for wrinkles caused by frequent, usually unconscious muscle pull, such as forehead wrinkles (often caused by concentrated gazing) or wrinkles caused by facial expressions (laugh lines).

The classic area of application for Botox (botulinum) are wrinkles of the upper third of the face, i.e. around the eyes and on the forehead.

However, Botox (botulinum) can also smooth disturbing wrinkles on the sides of the bridge of the nose (called "bunny lines") or cobblestone-like dimples on the chin.

More recent indications include prominent muscle cords on the neck or wrinkles in the décolleté caused by muscle pull.

Safe use for newer indications is being tested.

What does the treatment with Botox (Botulinum) look like?

First of all, the patient and the doctor determine together which region should be treated and to what extent.

The injection is performed with precisely calibrated syringes and very thin needles. Temporary slight pain may occur.

To prevent small bruises from forming at the injection sites, the patient is then "compressed" for a few minutes (i.e., these sites are pressed firmly with a swab) and possibly cooled a little.

Can I go out with people right after the treatment?

Yes. The only thing that can be seen after a botulinum injection may be the small injection sites and rarely the smallest bruises, if fine skin vessels were injured. These changes can be easily made over if desired and will be completely gone after a few days at the latest.

When and how long does Botox (botulinum) work?

In most cases, the treatment effect occurs after 48 - 72 hours, the maximum effect is achieved after 1 - 2 weeks. Rarely, it may take longer for the effect to set in.

The blockade at the transmission point between the nerve and the muscle usually lasts 4 - 6 months. By then, the changes caused by Botox (botulinum) have regressed. The wrinkle-smoothing result of the injection remains for a correspondingly long time. If desired, the treatment can be repeated.

Can side effects occur during cosmetic application of Botox (Botulinum)?

Botox (Botulinum) injection is a very safe and well-tolerated method of gentle wrinkle smoothing when consulted by an experienced practitioner.

As a result of the injection, minor bruising or swelling may occur. Temporary discomfort, fatigue or headaches have been described (however, there are also many cases where pre-existing headaches improve after treatment). Extremely rarely, allergic reactions, itching or skin rash occur.

Extremely rare are also unpleasant complications such as temporary drooping of the eyebrow or upper eyelid, or short-term visual disturbances. In order to largely exclude these risks, the injection should be performed by an experienced, well-trained therapist.

All side effects - just like the effect of Botox (botulinum) - are limited in time.

Is there any experience about the long-term effects?

Botulinum toxin has been used for almost 30 years and in relatively high doses to treat pathological muscle spasms.

From this experience, it is known that botulinum does not cause any long-term side effects. Microscopic examinations have shown that after the effects of botulinum have worn off, there are no permanent changes in the nerves or muscles; everything looks the same as before.

Although the treatment of wrinkles with botulinum is a relatively new application for the drug, it has also been performed since 1989 without ever showing any evidence of long-term side effects.

If warnings are issued against the use of botulinum for wrinkle correction on the grounds that there is insufficient experience of long-term therapeutic effects, this is therefore incorrect.