Nowadays, the most effective anti-ageing treatment for the face is injecting botox. Botulinum toxin, often called by its brand name, Botox®, reduces muscle contraction by acting at the neuromuscular level.

In 1973, Scott began using botulinum toxin during strabology procedures. Today, that means in case of serious strabismus surgery can be avoided in 80% of cases. The use of botulinum toxin for aesthetic treatments began in Canada in 1987. Jean and Alastair Carruthers, ophthalmologist and dermatologist noticed that patients treated for blepharospasm (permanent spasm of the eyelid) no longer had crow’s feet. And so began the use of botulinum toxin for aesthetic purposes by the reducing the tightness of the facial muscles that are responsible for facial expression. From that moment, millions of injection sessions have been performed to the extent that authorities in many countries have labelled botulinum toxin as safe. After retrospective studies approval has been granted to use botulinum toxin for removing frown wrinkles in: USA, Canada, Switzerland, France, the Netherlands, etc.

When botulinum toxin is injected it blocks the release of acetylcholine, which is important for muscle contraction. Everyone has two eyes, a nose and a mouth, and yet there are endless variations of unique facial expressions and shapes that are specific to each individual. This means that everyone possesses a different anatomical structure at rest and during movement. A doctor must carefully look at his patient to assess the position and dynamics of the muscles. These two factors allow the doctor to administer the botox in the right place. Knowledge of anatomy is, therefore, essential.

It is sometimes said that botox makes the face rigid and unnatural. This only happens when the injections are administered in a standardised way, i.e. each person is treated identically. Determining individual injection treatments to meet each person´s characteristics is technically challenging. Knowledge of anatomical structures and experience is required. Before the treatment, an explanation will be provided about botulinum toxin; the desired result will be discussed, and a follow-up consultation agreed. Sometimes it is necessary to perform a 2nd treatment after a month to even out small imperfections. However, during this time the face will carefully mapped out and future treatments will be easier and should not require a second visit.