Frown lines are the result of gathering or knitting the tissue between the eyebrows into a fold. These unattractive folds and furrows are caused by the repeated action of underlying muscles. Years of squinting and frowning leave deep wrinkles in the skin between the brows just above the nose (glabella) and on the forehead. On many people, frown lines produce an angry or sad look on the face that detracts from a pleasant appearance. Dermatologic surgeons can now remedy these lines without surgery and without scars by a simple injection of botulinum toxin.
Botulinum toxin Type A is a purified toxin and in large amounts, this toxin blocks the nerve signals from the brain to the muscle, causing a generalised paralysis called botulism. However by injecting tiny amounts into a specific facial muscle, only the targeted impulse of that muscle will be blocked, causing a local relaxation and weakness. In this way, botulinum toxin immobilises the underlying cause of the unwanted lines - the muscles that hold and fold the skin - and stops the "wrinkly" expressions. Thus, there is no change in the skin sensation after a botulinum toxin injection.
Botulinum toxin has been used since 1980 to treat many muscle disorders, such as lazy eye, eye ticks and uncontrolled blinking. Pioneered by Dermatologic surgeons in 1987, the use of botulinum toxin for cosmetic purposes is an "Off-label" use of an approved drug.
Botulinum toxin is injected directly into the target muscle to treat vertical lines between the eyebrows and on the bridge of the nose, the squint lines or crows feet at the corners of the eyes, the forehead horizontal lines and the platysmal muscle bands on the neck.
Once the muscle is weakened and paralysed, it cannot contract. Therefore, there is no way to make the undesirable facial expression.
Consequently, the lines gradually smooth out from disuse, and new creases are prevented from forming. Other muscles, such as those needed to raise the eyebrows, are not affected so natural expression is maintained. Botulinum toxin cannot be used on the smile lines around the mouth because the muscle action in this area is needed for expression and important functions, like eating.
BOTULINUM TOXIN INJECTION THERAPY
Treatment involves injection of small amounts of botulinum toxin into the underlying muscles to immobilise them. The actual treatment takes just a few minutes with no "down time" or prolonged recovery period and only minimal discomfort.
Botulinum toxin takes effect about 3 to 7 days after treatment. The improvement generally lasts about 3 to 4 months before the effect gradually fades and muscle action returns. With repeated treatments, atrophy (thinning) of the muscle may occur which usually produces longer-lasting results. It is anticipated that the average patient may require reinjection at various intervals. It should be noted that botulinum toxin injection therapy is a very different treatment approach than soft tissue augmentation using "filler" substances.
Side effects are minimal and typically relate to the local injection. Soreness or mild bruising, while uncommon, may occur around the injection site. Makeup may be worn after treatment, but care should be taken to avoid pressing or massaging the area for several hours. In rare instances, patients may develop temporary weakness of the neighbouring muscles, a temporary droopy brow or eyelid, or a headache. All of these possible effects are likely to be mild and temporary, and in most cases, are not significantly limiting to routine activities.