It is based on blocking nerve impulses entering the muscle fibers of facial muscles, as well as its general relaxation. The history of its appearance in aesthetic medicine has a typical beginning: ophthalmologists, treating strabismus and blepharospasm with special drugs, discovered an interesting side effect, expressed in the complete smoothing of crow's feet. They passed on their observations to cosmetologists, after which a revolution took place in aesthetic medicine, based on the advent of a “cure” for wrinkles - the drug Botox.
According to statistics and ASPS data, botulinum therapy is the most popular anti-aging procedure in the United States - it is performed more than 6,700,000 times annually throughout the country.
The principle of action of drugs for botulinum therapy
The botulinum therapy procedure involves a series of injections of drugs based on botulinum neurotoxin type A. The main component is obtained in the laboratory by extracting the protein complex of Clostridium botulinum microorganisms. The dosages of the substance present in preparations for botulinum therapy are safe for the human body.
Botulinum neurotoxin type A has an isolated effect on the facial muscles. It blocks the supply of nerve impulses to the fibers, inhibiting the neurotransmitter acetylcholine in the neuromuscular connections, and provides general muscle relaxation in the injection area. A decrease in the tone of the facial muscles, combined with a partial suppression of its innervation, leads to the smoothing of skin creases that arise from constant contractions of the facial muscles during laughter, smiling, surprise and other “vivid” emotions.
An age-related decrease in skin firmness and elasticity leads to the formation of wrinkles in areas of increased facial expression. Botulinum therapy stops the root cause of their formation. Many patients note the delayed effect of Botox, Dysport and Xeomin injections - a gradual adaptation of facial expressions to a calm, smooth and neutral state, preventing the appearance of wrinkles in the future. Botulinum therapy is unable to influence other aging mechanisms, such as skin dehydration, gravitational ptosis, photodamage, etc. It solves exclusively the problem of facial wrinkles, so one cannot rely on the procedure as a panacea for age-related changes.
Reviews from patients and doctors
Most girls are satisfied with the effect of the injection of hyaluronic acid, since reviews on the sites are mostly positive. Among the advantages are a quick and lasting effect, no harmful effects on the body, good skin hydration, disappearance of wrinkles, reasonable price compared to other anti-aging procedures.
However, if you try hard, you can find information about unpleasant experiences. The most common disadvantage is pain, despite the preliminary application of a local anesthetic. Bruising and swelling can last up to 5 days in some cases, and the results disappear quickly. Most likely, this is due to the individual characteristics of the skin.
Mostly girls rely on their friends’ stories about the procedure. But experts advise not to get hung up on other people’s experiences, since the body’s reaction to the same substance in different people can be unpredictable. The American Association of Plastic Surgeons compares the effect of hyaluronic acid injections to an inflatable frame that maintains facial tissue in tone. After all, as soon as you stop introducing fillers, the skin will sag again and wrinkles will appear. To avoid addiction, it is not recommended to start the procedure at a young age.
From all of the above, the conclusion suggests itself that hyaluronic acid is an excellent tool for the prevention of early age-related skin changes and wrinkles. It perfectly moisturizes, gives an inner glow to the face, and allows you to maintain tissue tone. But hyaluronic acid is not effective enough against deep wrinkles in women over 40–50 years old. For radical rejuvenation, the administration of drugs alternates with other procedures - botulinum toxin injections, lifting, laser resurfacing, the use of threads, implants and others.
Comparison of drugs based on botulinum neurotoxin type A
In Russian cosmetology practice, three drugs are used for botulinum therapy - Botox, Dysport and Xeomin. They all contain identical active ingredients, but differ in a number of parameters. Below is a comparative table of the three drugs, detailing the features, advantages and disadvantages of each.
A drug | Compound | Number of units for each zone | Duration of action | Specific characteristics |
"Botox" (Botox), produced by Allergan (USA) since 1989 | Botulinum neurotoxin type A, human serum albumin, sodium chloride | Forehead – 10-30 units. Between the eyebrows – 5-25 units. Eyelids – 5-15 units. (or 10-30 units on both sides) Eyebrows (raising) – 3-5 units. Nose / bridge of the nose – 5-10 units. Jaw – 35-60 units. Neck – 25-50 units. | 6 months for the first session, up to 7-8 months for subsequent sessions | The most studied and popular botulinum therapy drug with an ideal price-quality ratio. Requires small dosages, works stably for six months, is used for various purposes, including medicinal |
"Dysport", produced by the Ipsen concern (France) since 2004 | Botulinum neurotoxin type A (concentration almost 2 times lower than in Botox), human serum albumin, lactose | Forehead – 30-90 units. Between the eyebrows – 15-75 units. Eyelids – 15-45 units. (or 30-90 units on both sides) Eyebrows (raising) – 9-15 units. Nose / bridge of the nose – 15-30 units. Jaw – 105-180 units. Neck – 75-150 units. | 4-6 months | The first European competitor to Botox. It has a lower concentration of the active substance and a lower cost per unit. It is characterized by rapid diffusion in muscle tissue, therefore it is recommended for emergency correction of facial wrinkles (for example, 1-2 days before an important event). For the same reason, it requires more caution and skills from the cosmetologist. |
"Xeomin" (Xeomin), produced by Merz Pharma (Germany) since 2005 | Sterile Lyophilized Botulinum Neurotoxin Type A | Forehead – 10-25 units. Between the eyebrows – 20-25 units. Eyelids – 10-15 units. (or 20-30 units on both sides) Eyebrows (raising) – 5-7 units. Nose / bridge of the nose – 5-15 units. Jaw – 45-50 units. Neck – 30-50 units. | 4-5 months | The safest drug available. The likelihood of any unwanted complications with the introduction of Xeomin is 7.4% lower than with the introduction of Botox. “Xeomin” is also notable for preserving natural facial expressions in full. |
According to new research, the drug Botox can be somewhat addictive, and therefore cosmetologists advise varying the drugs from time to time. If you notice a decrease in the effectiveness of Botox injections, you are recommended to alternate them with Xeomin or Dysport injections.
Indications for botulinum therapy
Indications for botulinum therapy are facial wrinkles of any location and severity. Typically, the following areas of the face are treated with botulinum neurotoxin type A:
- Forehead (horizontal “wrinkles of surprise”);
- Between the eyebrows, or glabella (vertical “wrinkle of anger”);
- The bridge of the nose (horizontal folds formed when laughing);
- Periorbital and temporal zone (“crow’s feet”);
- Jaw line (wrinkles in the dimple area of the cheeks);
- Neck (horizontal “rings of Venus” on the front).
In addition, the drugs raise eyebrows when they droop with age.
The healing properties of hyaluronic acid for the face against wrinkles
Hyaluronic acid for the face against wrinkles not only provides deep hydration to the skin, but also has other properties:
- Accelerates the healing of wounds on the epidermis. Regeneration processes are accelerated, minor damage to the skin is quickly healed, which prevents infectious agents from penetrating into the deep layers of the dermis.
- Smoothes out existing wrinkles. Hyaluronic acid increases the level of elasticity and firmness of the skin, making facial wrinkles less noticeable. How effective procedures using a substance will be depends on how it penetrates into cells - injections are considered the best choice.
- Provides antioxidant protection to the skin. If the skin is well moisturized, then it is almost not exposed to the harmful effects of free radicals, and it is not afraid of photoaging.
- Creates a protective barrier on the surface of the epidermis. This helps the skin retain moisture within its cells, even if the person is in a hot room or in direct sunlight. The barrier reduces the harmful effects of environmental factors - wind, low/high air temperatures, dry air, which only accelerate the formation of wrinkles.
How is botulinum therapy performed?
Botulinum therapy is the introduction of a series of injections into strictly specified points of the face responsible for the facial activity of a particular area. The procedure is relatively painless, but for patients with a low pain threshold it requires preliminary anesthesia. In this case, a lidocaine-based cream “Emla” is applied, applied to the skin in a thick layer and placed under a film for 20-25 minutes. Botulinum neurotoxin type A preparations are injected into the surface layer of the skin using ultra-thin miniature needles. The bottle with the solution is opened in the presence of the patient. The cosmetologist marks out the treatment areas in advance and injects the drug into the points of maximum innervation of muscle fibers (they do not always coincide with the actual points of wrinkle formation). Next, the cosmetologist performs a gentle manual massage of the skin for optimal distribution of the drug. The patient is asked to grimace (frown, raise his eyebrows, smile broadly) for the next 2-4 hours - this will contribute to a better effect of neurotoxins. To avoid neutralizing the effect, you should avoid drinking alcoholic beverages, staying in a solarium or in the sun, or visiting baths and saunas for the next week.
Use at home
Filling wrinkles with hyaluronic acid at home without the involvement of a specialist is impossible. Without introduction into the subcutaneous layers, the substance does not fully reveal its properties. But it is permissible to use gels and creams based on it as preventive agents against early skin aging.
Masks
Masks containing hyaluronic acid should be applied to cleansed skin of the face, neck and décolleté, avoiding the area around the eyes and lips. The duration of the procedure is 15 minutes, after which there is no need to wash off the product.
- Mix hyaluronic acid (1 g) and nicotinic acid (30 g) in powder in one container. Dilute with a small amount of warm water until thick.
- Mix hyaluronic acid powder (1 g) with oatmeal (40 g) ground into flour. Add 1 tbsp. l. lemon juice, 2 - 3 beaten egg whites and stir the mask well. 15 minutes after application, rinse with warm water.
- Mix 4 drops of acid in ampoules with 1 chicken egg yolk and 1 tsp. grapefruit pulp. Apply to skin and rinse with warm water after 20 minutes. If a burning sensation occurs, the procedure should be completed earlier.
- Mix 5 drops of liquid acid with 2 tbsp. l. fat kefir. Apply to skin using a brush and rinse off after 20 minutes.
Crema
The easiest way to use hyaluronic acid prophylactically is to add it to face cream. It is recommended to maintain a proportion of 1 part acid to 200 parts cream.
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You can also prepare the product yourself:
- Dilute 500 mg of liquid hyaluronic acid with 10 ml of water, stir until completely dissolved. Add 1 tsp. chopped parsley, knead and apply to face. The duration of the procedure is 15 minutes, after which the mass must be removed with a towel soaked in water. This anti-wrinkle cream with hyaluronic acid has very good reviews, and is especially effective for dry, flaky skin.
- Dissolve 500 mg of acid in 10 ml of water. Add 8 g of zinc paste, which can be purchased at the pharmacy. Apply with gentle movements, wait until absorbed. You don't have to wash it off.
- Dilute the hyaluronic acid in the proportion indicated above. Add 10 ml of steamed olive oil and apply to skin with a brush. After 20 minutes, rinse with warm water without soap.
- Mix 20 ml of water, 500 mg of acid and 20 g of coconut oil. Stir until smooth. Apply with gentle massage movements, wait until the cream is completely absorbed.
- Combine the components in one container: 20 ml of water, 500 mg of hyaluronic acid, 20 ml of almond oil. After obtaining a homogeneous mass, it can be applied to the face with a cosmetic brush. The cream helps well against wrinkles on the forehead and other problem areas.
- Prepare a chamomile decoction (1 tbsp of dried crushed flowers per glass of boiling water), separate 20 ml from the total volume. Mix the decoction with 500 mg of acid in ampoules and 20 ml of peach oil. Apply to face along massage lines using a brush.
Possible complications
Botulinum toxin therapy procedures practically do not cause unwanted complications if performed in a reputable clinic by a qualified cosmetologist. When performing injections at home or in other makeshift conditions, as well as in violation of the technique of administering drugs, the following complications may develop:
- Facial asymmetry;
- Ptosis (drooping of the upper eyelid);
- “Face-mask” effect.
Also, complications of botulinum therapy can be expressed in allergic reactions, nausea, skin paresthesia, dyspepsia, respiratory failure (if the permissible dosage is significantly exceeded).