The nose - seemingly so small and inconspicuous - can create big problems. This part of the body often plunges people into huge complexes. Therefore, it is not surprising that, if you do not take into account breast surgery, nose correction is the hit of plastic surgery. The solution to this problem may be hampered by the reluctance to engage in invasive procedures. But there are other ways too.
How can you reshape your nose?
Attention to the ideal shape of the nose stimulates the creativity of not only doctors, but also manufacturers of cosmetic gadgets that offer to improve their face in a non-invasive way. In Japan, nose straightening clips have been making a splash for several years now. This little thing must be worn from a few to 20 minutes a day.
An alternative to invasive aesthetic medicine procedures was offered by a New Jersey company that began selling Nose Secret flexible inserts. The plastic gadget can be worn at least all day, while providing yourself with a delicate, painless modeling. Although this insert does lift up the nose and constrict the nostrils, the effect is not permanent.
Much more useful in this sense are non-invasive procedures from the field of aesthetic medicine.
Correction without a scalpel
The nose, as the center of the human face, can either add self-confidence or take it away. To correct minor imperfections, including restoring its symmetry and eliminating irregularities, it is enough to use needles and appropriate doses of a properly selected drug. Previously, rhinoplasty was limited to surgery only. Currently, aesthetic medicine dispenses with the scalpel and offers much safer and simpler solutions.
Doctors have successfully used three drugs with which you can improve the shape of the nose, although not necessarily very noticeably - rather, delicately correct it. Depending on the needs, patients decide on injections of hyaluronic acid, calcium hydroxyapatite or botulinum toxin. With their help, you can, in particular, fill in the recesses and correct the bulges.
Raise the tip of the nose with Botox?
In the case of modeling the nose (which is supposed to look younger), they justify themselves well botulinum toxin injections to lift a slightly downturned tip of the nose. In turn, hyaluronic acid, which is equally popular in aesthetic medicine, is used to correct unsuccessful interventions by plastic surgeons, to level asymmetry and optical lengthening or reduction of the nose.
At the pace of lightning
Nose correction through the use of injections gives an instant effect. In addition, the procedure itself lasts up to 30 minutes and does not require a recovery period. The introduction of drugs, unlike invasive procedures, does not entail the risk of postoperative complications. But, despite the fact that after the injection, you can almost immediately return to your usual activities, only a good specialist should do it. The procedure is slightly painful and requires a certain level of skill, because the nose, due to its specific blood circulation, is at risk of developing complications. Therefore, it is important to put yourself in the hands of a specialist who will administer the drug properly.
The drugs used to correct the nose are substances that do not provoke allergies. Hyaluronic acid and calcium hydroxyapatite are well-known substances in aesthetic medicine used in the form of a gel-filler, so they should not present any “surprises”. Moreover, if you use them for nose correction, they retain their stability for a very long time. The effect lasts much longer than in the case of using the same drugs in other parts of the face. The practice of specialists shows that after non-surgical nose correction, patients can enjoy the results for up to 3 years.
beauty expert, director of VP AGENCY
For 25 years of existence, botulinum toxin, or, more simply, Botox has become the real king of cosmetology, which has never been replaced. The funny thing is that its capabilities are underestimated. In 15 minutes, you can not only become 5 years younger, but also undergo facial remodeling. But Botox can also become your psychologist: it is the facial muscles that help to convey our feelings and internal state to others. Sometimes anatomical features lead to the fact that the face does not express what we feel at all: Botox, like a conductor, changing muscle tension, makes our faces more friendly, thin, feminine and even intellectual.
Cosmetology is not only about beauty, but also about social recognition
There is such a thing in cosmetology as “tired type of aging” - that is, these are the first signs of wilting. The line of eyebrows, eyelids, lips begins to fall, the oval of the face “floats”, the radiance disappears, the skin around the eyes becomes thinner and dark circles and “bags” appear, furrows appear from the inner corner of the eye to the middle of the cheek, nasolabial folds deepen, mimic wrinkles ... The face looks tired and sad.
We see our reflection in the mirror and are sure that all this is due to poor work, place of residence, unhappy love, lack of sleep, ungrateful children, and so on. People around us see us with makeup, but (!) even in make-up, we look like we have forgotten what a taste for life is, although we have been sleeping at least 8 hours a day for a month and receive our salary and even sex on time. Obviously, the "tired type of aging" does not attract new friends and partners to us.
Love story
The cosmetic revolution of botulinum toxin therapy is based on the Nobel discovery of Henry Dale - research on the chemical transmission of nerve impulses (1936), which affect muscle activity and can cause "muscle weakness".
As a rule, it is enough to know the history of the drug in order to stop having vague fears about its safety. Botulinum toxin is indeed the most terrible poison in the world (stale sausages and canned goods are the reason for the discovery of the toxin). But! Like arsenic in homeopathy, purified botulinum toxin in microdoses is simply indispensable in aesthetic medicine. There are no drugs or creams that could turn off the signal transmission from the nerve ending to the muscle - only the toxin has such an effect.
For the first time, ophthalmologists and neurologists began to use the toxin back in the 50s - even for the treatment of infants. But it wasn't until 2002 that the FDA allowed a drug called Botox to join the cosmetologists' arsenal! Not every drug on the market can boast a 50-year history of clinical studies confirming its safety and effectiveness. For example, US plastic surgeons do not believe that pregnancy or lactation are contraindications for injections.
Botox was also introduced to the Russian market for the first time by neurologists. In 1994, Sofia Timerbayeva, an employee of the Scientific Center for Neurology of the Russian Academy of Medical Sciences, conducted the first training among her colleagues on the use of Botox for the treatment of certain neurological diseases.
Botulinum therapy (that's what doctors call it) requires a virtuoso knowledge of the anatomy of the face, so not every cosmetologist knows how to "smooth the forehead" and owns the methods described below.
Aces perform botulinum toxin therapy throughout the face and neck, injecting 100 units + to provide the desired lifting effect. The effect of the drug occurs on the second to fifth day after the injection. There are a number of botulinum toxin preparations on the market today, but Botox has already become a household name for this procedure. Although many have already tried Dysport, Xeomin, Lantex - their action is similar, but there are small technical nuances in the work for a cosmetologist.
So what does Botox do?
We turn up our nose
Non-surgical rhinoplasty of the tip of the nose (it is also called lifting of the tip of the nose) sounds like a fantasy, but it is a fact: with the help of Botox, you can lift the tip of the nose, make it more snub-nosed and visually shorter. Again, for some, by nature, the tip of the nose looks down ugly, and for many, this is a sign of age-related changes. From the inside, it looks like this: a muscle that is attached to the septum lowers the tip of the nose when you smile or talk. 2-4 units of Botox are injected into the transition zone of the nose to the upper lip (this place has a very funny name - columella), and as a result, the facial expression completely changes.
Another interesting manipulation is “modeling or widening the wings of the nose”, as well as getting rid of nervous twitching of the nose (yes, two effects in one). 5-10 units of Botox are injected into the middle of the wings of the nose - and voila, everything has changed!
"Opening" our eyes
Botox can make the eyes “more open and bigger”. Doctors call this “operation” not very beautifully - “expansion of the palpebral fissure”, but the effect is more important. In addition, the psychological capabilities of Botox are manifested here: if you squint your eyes ugly when you smile or other internal experiences, then in the end this habit can become permanent. Just 1-2 units of Botox need to be injected into the crow's feet area - and the eyes will become visually larger.
Take care of lips and a beautiful smile
Almost every woman once in her life thought about the procedure for lip augmentation. According to the gold standard of aesthetic medicine, lip contouring is performed using fillers based on hyaluronic acid, the effect lasts for about a year. But this is not a dress that you can hand over if it does not suit you. And given that the price of the filler, after the euro and the dollar jumped, began to approach 20,000 rubles per 1 ml, and if there are concerns, then you can “try on” new lips with the help of ... botulism toxin. Quick and affordable: the doctor cuts off the contour of the lips, they turn out slightly, “inflate”, for this only 3-4 units of the product are enough, which fits into the amount of about 2000 rubles. The effect lasts, however, no more than three months, but during this time you can understand whether you need such changes in appearance. An important point: this technique is not suitable for owners of naturally narrow lips, and it cannot correct asymmetry - only fillers with hyaluronic acid are suitable for such cases.
Including with the help of Botox, you can raise the lowered corners of the lips - for some this is an anatomical feature, but for the majority it manifests itself over the years. An eternally sad or dissatisfied look (although this may have little to do with the psychological state) can cause various life conflicts. The introduction of 4-8 units of Botox into the abdomen of each muscle that lowers the corner of the mouth leads to the fact that the expression on your face, like that of the unfortunate Pierrot, will leave you for at least 8 months. The effect of reinforcing this zone with injections of hyaluronic acid will enhance the effect: the skin will rejuvenate, thicken, and there will always be a slight smile on the lips.
If you dream of veneers to hide a “horse” or gum smile, as doctors call this flaw (this is when the gums are visible during a smile), then Botox will help to cope with it. And for this you do not have to sell half the kingdom, as is usually the case in the dental office. There are several reasons for the appearance of such a smile: excessive development of the upper jaw, too narrow upper lip or too large teeth. Look at pictures of Cristiano Ronaldo, Ben Affleck, Katy Perry, Keira Knightley at the start of their careers.
The muscular frame consists of elevator muscles (lifting tissues up) and depressor muscles (lowering tissues down). The two types of these muscles are interrelated and interact. If you slightly weaken the action of the muscles that lift the upper lip, then they will no longer raise the “curtain of your smile” too violently, as Shakespeare wrote. And you will need only (!) 1-3 units for this.
We smooth out fine wrinkles on the face ...
Like any injectable, botulinum toxin is administered using a variety of techniques. And not only intramuscularly, but also intradermally, as in mesotherapy, hence the name “mesobotox”. This method allows you to smooth out a fine mesh of wrinkles, while maintaining a lively facial expression. If you are worried about wrinkles above the upper lip, crow's feet, flabby wrinkled skin of the décolleté, then mesobotox will do a good job here. Several units of Botox in the right proportions are diluted with saline and cut off the problem area: you are provided with a lifting effect and smoothing fine wrinkles. At the same time, facial expressions remain alive and natural.
... and neck
Wrinkles on the neck can appear not only in older women, but also in young girls. This is again an example of anatomy and muscle attachment. Vertical wrinkles are formed due to the tension of the superficial cervical muscle with the beautiful name of platysma. How to discover it in yourself? Standing in front of a mirror, pull the corners of your lips down and say "yyy." You will see in this way under the lower jaw platysma. In some, by nature, it is not attached correctly, so it seems that there is no beautiful line of the lower jaw and the muscles pull the face down. As a rule, such problems bother slender thin women. Botox injections instantly tighten the oval of the face.
Horizontal wrinkles with the poetic name "rings of Venus" also smooth out beauty injections, and then the effect is fixed by fillers based on hyaluronic acid.
We emphasize the cheekbones
You can create the effect of "sunken cheeks" not only by removing Bish's lumps. Botox injections into the chewing muscles allow you to visually narrow the face. Dr. Levy came up with this technique and called it "Nifertiti Lifting".
If the doctor injects the toxin into the so-called Nifertiti points (flew), then the oval of the face will tighten. The most interesting thing is that this manipulation allows you to get rid of headaches and discomfort in the neck. But if age-related changes are already very obvious, like the “second chin”, then Botox will not help here.
Remove "cellulite" on the chin
For a long time I was sure that I had "cellulite" on my chin. But it turned out that this was an overstrain of the facial muscles. And a couple of units of Botox, it turns out, can relax them and smooth out the “bumps”, as well as “round off” the sharp chin and “square jaw”, which looks so beautiful in men, but definitely not in women.
Forget about excessive sweating
The treatment of complexes arising from excessive sweating should also be entrusted to botulinum toxin. Moreover, you can chop not only the armpits, but also the palms, feet and even the face. The procedure is expensive, but one of a kind: no deodorant can ever save a tarnished reputation.
We remove scars
Scars adorn a man, but not a woman. Botox injections “blow off” scars, they smooth out and accelerate healing. In addition, they stop itching and hurting, as the toxin blocks the nerve endings that have sprouted into the scar.
Including botulinum toxin, today it is used to treat acne, dilated blood vessels, and even hair loss. But this is experimental data, so for now we will simply indicate new horizons.
CEO of the National Beauty Company and creator of the Gen87 clinic network
“Botulinum therapy is one of the most popular procedures in the world. But some patients, under the impression of dubious accounts of “doctors”, do not realize how much this manipulation requires high medical qualifications.”
1. Botulinum therapy has the right to be carried out only by a doctor with a higher medical education and a separate state diploma with a specialization in cosmetology. Including he/she should have certificates for working with various botulinum therapy drugs, and in the best case, certificates of anatomical courses taken. Nurses and estheticians are not allowed to perform injection correction.
2. The upper third of the face is always easier to work with than the lower third. But think 10 times whether the savings are worth the following risks. Possible complications from unfortunate specialists: your mouth may not close or your eyebrow line will drop. In good clinics, they know how to correct the incorrect administration of botulinum therapy drugs. But it won't be instant either.
3. The doctor always asks the patient to make faces before botulinum therapy in order to identify areas of increased mimic stiffness and hypertrophy in order to determine the zones of influence. As a rule, the doctor marks the points with a special pencil or felt-tip pen, explaining to the patient what effect is expected. Experienced specialists recommend new patients to appear in a week and “pierce” to avoid trouble.
4. Ideally, the ampoule should be opened in front of you. It is recommended to request packaging for inspection: expiration date, integrity, country of origin. But many salons and clinics store open ampoules in the refrigerator, because they cannot, for example, find patients for 100 units in one day, which is not very good.
5. For botulinum therapy, special syringes and needles are used. The doctor must open the sterile package in front of you.
6. The doctor should put a cap on you, wash, wipe the affected area with an alcohol wipe, inject only with new disposable gloves, never inject with an open window in order to comply with all sterility measures.
7. Within a few hours after botulinum therapy, doctors do not recommend taking a horizontal position, tilting, warming up the skin (washing with hot water, baths, the beach, solarium, fitness, and so on), applying any “healing” or “lifting” creams, serums and masks, drink alcohol. It is also worth stopping taking drugs that change the composition of the blood (antibiotics, aspirin, paracetamol). The whole day you need to actively "grimacing" so that the drug "gets up" correctly.
Thus, everything in life is harmonious. Poison can be medicine and eternal youth. Usually poets give such comparisons to a feeling called love. Needless to say, Botox is the true love of patients and patients all over the world.
Entering the warpath with old age and winning sounds like the announcement of a science fiction movie. Meanwhile, for more than 20 years, cosmetologists from all over the world have been fighting for our youth and holding a very confident victory. Their main weapon is Botox. We decided to find out if it is safe, how it works and what it actually is, and asked for help from experts in the field of cosmetology and aesthetic medicine.
History of the toxin
It is usually enough to know the history of the drug to stop having vague fears about its safety. Deeper knowledge about the origin of the botulinum toxin, on the contrary, is more frightening than encouraging. That's right, Botox is the strongest organic poison known to science of organic toxins and one of the most toxic substances. But, like arsenic in homeopathy, purified botulinum toxin in microdoses becomes a magic wand in the hands of aesthetic medicine.
Neurologists first began to use the toxin in the 1950s to relax muscle spasms, and later in the 1970s they were joined by ophthalmologists who used Botox to treat blepharospasm. Botox came to cosmetology only in 2002, when the FDA (US Food and Drug Administration) finally allowed a drug called Botox Cosmetic to replenish the arsenal of cosmetologists. From that moment on, the triumphant march of the toxin across the planet began: now it could officially be used to eliminate facial wrinkles on the forehead and around the eyes.
It is worth noting that not every drug on the market can boast a 50-year history of clinical studies confirming the safety and effectiveness of the formula. It is also interesting to note that US plastic surgeons do not consider pregnancy or lactation to be contraindications for toxin injections.
How Botox Works
This cosmetic revolution is based on the Nobel discovery of Henry Dale, who was awarded the prize in 1936 for his research on the chemical transmission of nerve impulses. This knowledge led to the fact that botulinum toxin began to be used in medicine and later in cosmetology. How are these two things related to each other? To understand this, you need to know what our saving toxin is. Botox is a protein that can disrupt the transmission of impulses from the nerve ending to the muscle, thereby causing temporary paralysis. As a result, the muscle stops contracting.
The question immediately arises, why would a woman (and a man) purposely cause paralysis of the facial muscles. The answer, as always, lies on the surface - to get rid of hated wrinkles. To clarify the process, let us clarify a few points. Firstly, the action of Botox is aimed at blocking individual facial muscles. Secondly, let's take a look at the causes of wrinkles themselves.
Where do wrinkles come from
Wrinkles are of two types: those resulting from the destruction of collagen (they cannot be corrected with Botox) and due to spasm of the subcutaneous muscles (this toxin is exactly what they need for them). The latter are folds of skin that appear at the site of muscle contraction.
In youth, when the skin is elastic, such folds disappear almost immediately after muscle relaxation, but with age, this process can slow down and accumulate, forming more and more visible skin creases. Similar folds appear in places where our facial expressions are especially active. The task of Botox in this case is to relax the muscle, then the wrinkle will magically disappear from the face, as the contractions will stop.
The advantage and, at the same time, the disadvantage of Botox is that such a freezing effect does not last long, on average 4-6 months, after which the mimicry is restored again.
We also note that there are no other drugs (not based on botulinum toxin) or creams that could turn off signal transmission from the nerve ending to the muscle - only the toxin has such an effect. By itself, it cannot improve the quality of the skin, like, say, hyaluronic acid. But, as we have already said, it is in his power to turn off the facial muscles and thereby smooth out the skin fold that forms during their contraction.
What and how can be corrected with Botox
Karina Musaeva, chief physician of LazerJazz, specialist in botulinum toxin injections, tells.
Working with botulinum toxin requires a virtuoso knowledge of the anatomy of the face, so not every cosmetologist who knows how to “smooth the forehead” knows the methods described below. There are a number of botulinum toxin preparations on the market today, although Botox has already become a household name. So, there are several methods of introducing a toxin into the skin, and each of them solves its problem.
1. Fine mesh wrinkles
Like any injectable drug, botulinum toxin is injected with different techniques. And not only intramuscularly, but also intradermally, like meso-cocktails. The latter method allows you to smooth out a fine network of wrinkles, keeping facial expressions alive. If you are worried about purse-string wrinkles above the upper lip, crow's feet, flabby wrinkled skin of the decollete, then mesobotox will do a good job here.
2. Small eyes
Botulinum toxin can open up your eyes. Doctors call this manipulation not very beautifully "expansion of the palpebral fissure", but the effect is more important, isn't it. In addition, the “psychological capabilities of Botox” are manifested here: if you squint your eyes ugly when you smile or other internal experiences, then in the end this feature can become a permanent mimic habit that will lead to the appearance of “crow’s feet”. By getting rid of the latter, you will notice how the eyes become visually larger and more attractive.
3. Thin lips ("fitting" plump lips)
Surely every woman once in her life thought about the procedure for lip augmentation. According to the gold standard of aesthetic medicine, lip contouring is performed using fillers based on hyaluronic acid, the effect lasts for about one year. But this is not a dress that you can hand over if it does not suit you. If there are concerns about how your face will look after, then you can “try on” new lips with the help of ... botulinum toxin. Quick and affordable: the doctor cuts off the contour of the lips, they are slightly everted, “inflated”, for this manipulation only 3-4 units of botulinum toxin are enough. The effect persists, however, no more than 3 months - during this time you can understand whether you need such changes in appearance. An important point: this technique is not suitable for owners of naturally narrow lips, it cannot correct asymmetry - only fillers based on hyaluronic acid are suitable for such cases.
4. "Gumy" smile
Just a couple of units of the toxin allows the owners of a “gingival” smile to forget about their complexes forever, or, to use the expression of folklore, a “horse” smile (when the upper lip does not cover the gum). There are several reasons for this feature: excessive development of the upper jaw, too narrow upper lip, or too large teeth. A tiny amount of toxin, injected into the muscle that lifts the upper lip, leads to a miraculous transformation: the lip expands and gently closes the gum.
Including with the help of such injections, you can lift the lowered corners of the lips. The effect of reinforcing this zone with the help of injections of hyaluronic acid will enhance the effect: the skin will rejuvenate, thicken and there will always be a slight smile on your lips.
5. "Dangling" tip of the nose
It sounds like fantasy, but it's a fact - with the help of Botox, you can lift the tip of the nose, make it more snub-nosed and visually shorter. Again, for some, by nature, the tip of the nose hangs ugly down, and for many, this is a sign of age-related changes. What does it look like from the inside? A muscle that is attached to the septum lowers the tip of the nose when smiling or talking. 2-4 units of Botox are injected into the transition zone of the nose to the upper lip (a very funny name in your piggy bank - columella), and as a result, your facial expression completely changes.
Another interesting manipulation is "modelling, or expanding the wings of the nose", as well as getting rid of nervous twitching of the nose (yes, two effects in one). 5-10 units of Botox are injected into the middle of the wings of the nose - and voila, everything has changed!
4. Sunken cheeks
How often do owners of fundamental faces with a square jaw dream of beautifully sunken cheeks. Beauticians after examination can diagnose "masticatory muscle hypertrophy", which leads to a change in the contour of the lower jaw. Toxin injections disable these facial muscles, allowing you to have a sexier and more feminine face. If the doctor injects the toxin into the so-called Nifertiti points - points along the edge of the lower jaw (flews), then the oval of the face will tighten. The most interesting thing is that this manipulation also allows you to relieve headaches and pain in the neck.
5. Wrinkles on the neck
Vertical and horizontal wrinkles on the neck can bother someone from a very young age. This is again an example of anatomy and muscle attachment.
Vertical wrinkles are formed due to the tension of the superficial cervical muscle with the beautiful name of platysma. How to discover it in yourself? Pull the corners of your lips down and say "yyy" while standing in front of a mirror. Thus, you will see platysma under the lower jaw. Some people have a naturally incorrect attachment of this muscle, so it seems that there is no beautiful line of the lower jaw, the muscles pull the face down. As a rule, such problems bother slender thin women. After injections with botulinum toxin, a miraculous lifting of the zone occurs, which, it would seem, cannot be corrected by anything.
Horizontal wrinkles with the poetic name "Rings of Venus" are also smoothed out by Botox injections, and then the effect is fixed by fillers based on hyaluronic acid.
6. Sweating
The treatment of complexes arising from excessive sweating should also be entrusted to botulinum toxin. Moreover, you can chop not only the armpits, but also the palms, feet and even the face. An important element of self-confidence during business negotiations or on a romantic date. The procedure is expensive, but one of a kind: no deodorant can ever save a tarnished reputation.
7. Scars
Scars can not only beautify, but also greatly interfere, especially if it is a keloid or hypertrophic scar. Toxin injections "blow off" them and speed up healing. In addition, after the injection, the scars stop itching and hurting, as the toxin blocks the nerve endings that have sprouted into the scar.
8. Much more
Including botulinum toxin, today it is used to treat acne, dilated blood vessels, and even hair loss. But this is experimental data, so for the time being we will just indicate new horizons.
On a note…
There are many myths and legends around Botox. We have selected the 7 most common opinions about the toxin and briefly talk about whether this is true or not.
- Botulinum toxin is a terrible poison. Yes, that's right, we wrote about it above.
- Botox can make your lips look bigger. In certain cases, see above.
- Botox is addictive. No, Botox is not a drug.
- Over time, the effect of Botox may be less pronounced. In rare cases, then you just need to take a short break from the injections.
- Botox distorts facial expressions. Yes, if you have a non-professional beautician.
- Botox injections are very painful. Depends on your pain threshold, but in general, no.
- Botox causes muscle atrophy and nerve damage. No, it causes temporary paralysis, that is, it does not allow the muscles to contract.
This cosmetic defect is characterized by excessive exposure of the gum line when smiling. A gingival smile is most common in people with a small distance between the base of the nose and the Cupid's bow, as well as in those with a prominent nose and underdeveloped chin. Often these same people can observe pronounced nasolabial folds. The effect of a gingival smile is the result of the work of the muscles that raise the upper lip and the complex of the upper lip and the muscles of the alar nose.
In addition, patients with a gingival smile often have an everted upper lip, making them unsuitable candidates for lip augmentation with fillers. The ideal option for them is a combination of filler injections and botulinum therapy. To match the ideal proportions of the face, the upper lip should cover the upper third of the central incisors. It is to achieve this effect that botulinum therapy of the gingival smile is aimed.
Injections are made symmetrically on both sides of the nose with the patient's maximum tense smile. BTA is administered intramuscularly above the periosteum. The first point of BTA injection is the body of the muscle that lifts the upper lip and the wing of the nose at the border of the junction of the nose and cheeks. The second point is about 2 cm closer to the bony edge of the orbit, in the muscle that lifts the upper lip (Figure 11).
BTA should not be injected too close to the zygomatic eminence to prevent penetration of the toxin into the zygomatic major muscle. The initial recommended dose for each side of the face is 2 units. Botox® or 5 units Dysport®. After 15 days, the result is evaluated and, if necessary, additional injections are made.
Figure 11. BTA insertion points for gingival smile correctionComplications: The most common complications are asymmetry and drooping of the upper lip. The asymmetry is eliminated with the help of 25% of the initial dose of BTA with the evaluation of the result in a week. The drooping of the middle of the upper lip may be the result of too much toxin action and excessive activity of the zygomatic major muscle.
Commentary by a cosmetologist, dermatovenereologist, MD, professor, head. Department of Dermatovenereology and Cosmetology, State Budgetary Educational Institution of Higher Professional Education "GSMU of the Ministry of Health of Russia":
- The goal of gingival smile correction is to reduce the contraction of overactive muscles responsible for exposing the gums, and, accordingly, to reduce the "breadth" of the smile. Muscle relaxation leads to harmonization and aesthetic appeal of the smile. The scheme and technique of injections depends on the presence of deep nasolabial folds. To assess the condition, the patient should be asked to smile as widely as possible. Exposing the gums without the formation of deep nasolabial folds: a rather deep injection into the center of maximum activity in the caudal zone of m.levator labii superioris. If the exposure of the gums is associated with a deepening of the nasolabial fold, the injection is made in the region of the labial part of m.levator labii superioris alaque nasi into the bulge in the upper part of the nasolabial fold. In this place, the muscle is located literally on the surface; injection depth should not exceed 3 mm. Dose of the drug: 2 units. drug Dysport.
nose tip
The tip of the nose is an important component of its aesthetic appeal. With age, the tip of the nose drops, which emphasizes the convexity of its back. The drooping of the tip of the nose in young patients is associated with increased activity of the muscle that depresses the nasal septum during the process of smiling, which is also often accompanied by a shortening of the upper lip. The same phenomenon is observed in owners of a prominent nose and underdeveloped chin.
Before making a decision on the introduction of BTA, the length of the upper lip and nasolabial angle of the patient is assessed. There are 2 ways of administering injections to the depressor septum muscle: percutaneous and intraoral. The latter method is quite difficult to perform, so we will only consider the method of introducing BTA through the skin.
Due to the special sensitivity of the nose to external anesthetics, it is recommended to use ice compresses to reduce pain. BTA injection points are located on both sides of the nasal septum at the base of the medial pedicle (Figure 12).
The BTA preparation is administered superficially at a dosage of 1-2 units. Botox® or 4-6 units Dysport® per point. The dosage may vary depending on the desired degree and duration of the correction, the proportions of the face, the observed muscle activity and the work of the adjacent muscles.
Complications: In general, complications in the correction of a drooping nose tip with BTA preparations are extremely rare. Among the side effects, patients most often mention pain. Too strong action of toxins on the depressor septum muscle can lead to ptosis of the upper lip.
Wrinkles in the perioral region
With age, the lips undergo a number of changes, including a reduction in the lateral part, an increase in the skin part of the upper lip, a thinning of the red border, and the appearance of many vertical wrinkles around the mouth. These wrinkles, also called smoker's wrinkles, can be the result of exposure to sunlight, smoking, hereditary factors, and hyperactivity of the orbicularis oculi muscles, such as in musicians. There are several ways to eliminate wrinkles on the upper lip, including filler injections and various anti-aging procedures. Botulinum therapy is also used to correct age-related changes in the perioral region, especially in the presence of deep static wrinkles.
Treatment of the orbicular muscle of the mouth with BTA preparations is carried out with extreme caution in order to achieve the effect of reducing wrinkles and not affect the normal functioning of the oral region. In addition, the introduction of BTA near the corners of the lips is unacceptable. Otherwise, relaxation of the muscles that lift the corners of the lips under the influence of the toxin will lead to ptosis of the lips and salivation. The introduction of BTA over the middle of the upper lip will lead to a smoothing of the cupid's arch, which is an undesirable effect from an aesthetic point of view.
In general, 1-2 injections are made in each quarter of the perioral region. In order to avoid dysfunctions of the oral region, it is recommended to administer BTA preparations in very small doses. With the introduction of toxin 5 mm from the border of the red part of the lips, a secondary aesthetic effect of a slight eversion of the lip is achieved. (Figure 13).
Complications: An overdose of BTA preparations will result in lip dysfunctions such as inability to roll them into a tube, difficulty pronouncing plosives, and difficulty in eating and drinking. For this reason, botulinum therapy of the perioral area is recommended to be started with minimal doses and repeated as needed.
- When performing BTA injections in the perioral area, it should be remembered that the muscles located around the lips are involved in the implementation of important physiological functions. Therefore, the correction of this zone must be carried out very carefully. In the circular muscle of the mouth, the marginal part (pars marginalis) and the labial part (pars labialis) are distinguished. BTA injections into the labial part make it possible to turn the lips somewhat, which creates the effect of increasing their area and volume. Injections into the marginal part of the circular muscle of the mouth are performed in the presence of purse-string wrinkles. Dividing the skin portion of the lip in half and stepping back from the columns of the filtrum and from the corners of the mouth at least 5 mm, subcutaneous injections are usually carried out at 2 points on each side at a dose of 2-5 units. Dysport.
Vertical wrinkles from the corners of the lips to the chin
Deep wrinkles from the corners of the lips to the chin can give the face a disgruntled, sullen, and sometimes even dismissive expression. The reason for the formation of such wrinkles lies in the combination of several factors at once: a reduction in the level of collagen, atrophy of adipose tissue, the presence of excess or saggy skin. All these factors can be corrected with the help of plastic surgery and filler injections. In some cases, the depth of wrinkles from the corners of the lips to the chin may increase due to increased activity of the depressor muscles of the mouth, which, when attached to the skin, can pull the corners of the mouth down. Then, by relaxing these muscles with BTA preparations, it is possible to ensure that the large zygomatic and lifting corners of the mouth muscles return the corners of the mouth to their normal position. In some patients, an increase in the depth of wrinkles from the corners of the lips to the chin is promoted by the activity of the platysma muscles intertwined with the lowering corners of the mouth. Then the action of BTA preparations should be directed to both muscle groups. Sometimes the best result can be achieved by combining BTA preparations and dermal fillers, with the former enhancing and prolonging the effect of the latter.
To determine the position and grope for the declining angles of the mouth muscles and platysma, the patient is asked to make a grimace and expose a set of lower teeth. Usually, BTA is administered intramuscularly at 2 points on each side. The first of them is the muscle that lowers the angle of the mouth, and the second is the bands of platysma attached to the lateral part of the circular muscle of the mouth. The introduction of BTA near the corners of the lips or the middle of the lower lip is not recommended in order to avoid relaxation of the orbicular muscle of the mouth and the muscles that lower the lower lip.
The first point is easy to detect by palpation, it is usually located on the continuation of the nasolabial folds on an imaginary vertical line located at a distance of 1 cm from the corners of the lips. The second point is located a little closer to the outer border of the lower jaw (Figure 14).
Some authors propose to inject one BTA injection on each side at a distance of no more than 1 cm above the lower edge of the lower jaw on imaginary parallel lines drawn through the corners of the lips. The recommended initial dose is 2-5 units. Botox® or 10 units Dysport® per insertion point and is subject to adjustment depending on the patient's muscle mass.
Complications: Too much dose of BTA or its injection near the corners of the mouth can cause asymmetry or disturbances in the functioning of the oral region, such as salivation or difficulty pronouncing certain sounds.
Comment by a cosmetologist, dermatovenereologist:
- The muscle that lowers the angle of the mouth is the most superficial muscle in the lower third of the face, therefore, in our experience, it is more rational to administer BTA subcutaneously: the needle is inserted into the skin at an acute angle almost parallel to the surface. Thus, we control the depth of injection and exclude the diffusion of the toxin into the underlying muscles - the square and lowering lower lip. In our experience, the introduction of 6-8 units. Dysport is enough to achieve a pronounced effect.
Dimple on chin
The dimple on the chin is formed as a result of contraction of the mental muscle. The BTA preparation is injected into one or two symmetrical points located approximately 1 cm from the line dividing the face in half directly above the chin protrusion. It is not allowed to introduce BTA closer than 1 cm from the lower lip. Since the mental muscle is located deeper than the rest, intramuscular injection is recommended to the periosteum, below the dimple. This will avoid spreading the toxin into the orbicular muscle of the mouth. Some authors argue that, despite the deep location of the mental muscle, good results can be achieved with superficial injections. (Figure 15). The recommended total dose is 2.5-8 units. Botox® or 2.5-20 units Dysport®.
Complications: Subject to restrictions on the introduction of BTA near the lower lip, this procedure does not entail any complications, except for bruises and hematomas.
Bands of platysma
Age-related changes in the skin are associated with excessive skin laxity, loss of elasticity, double chin formation, lipodystrophy, prolapse of the submandibular glands, and bone resorption. The subcutaneous muscle of the neck can become hyperactive, lose tone or exfoliate - all this leads to the formation of the effect of the so-called "turkey neck". Horizontally and vertically located platysma bundles become noticeable with increased contraction.
Botulinum therapy of the neck area is aimed at reducing the external manifestations of platysma contraction. In addition, relaxation of the platysma bands has a positive cosmetic effect on the oval line and wrinkles from the corners of the lips to the chin. The best candidates for neck botulinum therapy are patients who demonstrate active platysma contraction during conversation.
BTA preparations are administered to a patient in a sitting position with maximum tension of the platysma in the direction of the cords. Depending on the length of the cord, BTA is inserted into 4-8 points located at a distance of 1.5 cm from each other, with the cords being captured by the non-dominant hand (Figure 16).
Complications: Often, bruises remain in the neck area after injections of BTA preparations. It is recommended to avoid the introduction of BTA into the pharyngeal area due to the risk of exposure to the underlying muscles toxin, which can lead to difficulty swallowing, weakening of the neck and dysphonia. Botulinum therapy is also not suitable for the correction of horizontal wrinkles on the neck. In addition, due to the large number of injection sites for BTA preparations, the procedure for anti-aging neck correction is quite expensive.
In rare cases, complications may occur after the procedure:
- Various respiratory infections.
- Frequent bouts of vomiting and nausea.
- The face turns into a completely immobilized mask.
Such complications arise in case of excessive enthusiasm for botulinum toxin injections or referral to an illiterate cosmetologist.
Tips for removing Botox from the body after an unsuccessful procedure can be found in.
Description of the action of injections, photos before and after
To the neck
With age, under the influence of aggressive environmental factors, the skin of the neck loses its elasticity. Having lost elasticity, the skin forms folds on the neck and décolleté. Explicit sagging and creases in the neck area are very aging, look unattractive and create a feeling of discomfort for their owner.
Botulinum toxin injections reduce the activity of the neck muscles, but do not disrupt blood circulation in the treated area.
Result
What does the face look like after?
The nerve impulse ceases to flow to the muscle fiber, and the muscle comes to a relaxed state. Prolonged rest and relaxation contribute to the straightening of skin grooves and creases on the face.
After an injection of Botox, the face acquires a healthier and toned appearance.. The skin becomes firm and elastic. Increases its resistance to aggressive environmental factors.
Read about how long the Botox effect on the face lasts and when you need to prolong the action.
Around eyes
The skin around the eyes is very delicate and sensitive. There are almost no sebaceous glands in this zone, so it is most prone to sprains.
With age, the muscles lose their elasticity, small wrinkles form around the eyes.
the effect
We offer you to watch a video about the use of Botox in the forehead:
From "crow's feet"
Wrinkles that extend from the edge of the eye in long thin rays are called "crow's feet". Such wrinkles are very visible on the face and indicate age. Therefore, most people try to get rid of them. All kinds of creams, masks and traditional medicine recipes are used. But when there are many wrinkles and they are pronounced, only Botox injections can help.
The drug blocks the muscles in this area. But, at the same time, a person will be able to blink, close and open his eyes. To eliminate crow's feet, you need about 10-15 units of the drug.
The amount of the drug is calculated by the beautician, depending on the number and depth of the creases. The pronounced effect of the injection occurs a day after the procedure and lasts for about 6-8 months.
Appearance of injection victims
Before making any injection, you need to choose a competent highly qualified specialist. This will help to avoid negative consequences and complications. An illiterate approach of a cosmetologist can turn a patient into a victim of Botox.
Excessive passion for botulinum toxin procedures can disfigure the appearance. The Botox victim's face looks like a wax mask. It is difficult for such a person to express his emotions with the help of facial expressions, since the face is practically unable to move. The face looks swollen and unnatural. The oval of the face changes its structure and shape.
Conclusion
A large amount of injected botulinum toxin will lead to complete paralysis of the facial muscles. And insufficient volume, on the contrary, will not give the desired effect.
So the injection must be carried out by a qualified specialist. To enhance the result of the procedure, you should follow all the recommendations. Only in this case the result will be positive.
