5 misconceptions about botulinum toxin (Botox©)

“No way! I don’t want Botox©, I want hyaluronic acid“, some of my patients tell me while pointing at the expression lines on their forehead and around the eyes.

Although hyaluronic acid can be used on this part of the face, it adds volume (to a lesser or greater extent) and does not act on muscular hypertonia, which causes expression lines (frown lines, forehead lines, crow’s feet).

The treatment indicated to relax the area around the eyes and forehead is indeed botulinum toxin (of which the trade names in France are Vistabel©, Azzalure©, and Boccouture©). Even though this molecule is perfectly known and controlled in medical aesthetics, many misconceptions and often false ideas persist on the subject of botulinum toxin. “Lips too big?  It’s Botox!“ “Swollen or puffy face? It’s Botox again!“ False!

And if I told you that targeted treatment with botulinum toxin at the correct dose goes unnoticed and that whichever area is chosen, only the benefits are visible: invigorated appearance, smoothed wrinkles, and even eyes subtly lifted, and this without altering the expression?

Here are 5 misconceptions about botulinum toxin.


#1 Botox© causes swelling

False! Social media and celebrities such as the Kardashians or starlets of reality TV, who all seem to be botoxed, undoubtedly have something to do with this. Admittedly, they have most probably had Botox© injections but this swollen look typical of these deceptively fresh faces is in fact due to an excess of hyaluronic acid injections.

To understand better the difference between Botox© and hyaluronic acid – and therefore their indications in aesthetic medicine – it is necessary to understand what Botox© is and how it works. Botulinum toxin is a neurotoxin produced by the bacterium Clostridium botulinum that at high doses, and if ingested, causes botulism (muscle paralysis). This paralysis is what we are interested in. Since the 70s, botulinum toxin has been used at low doses in neurology to treat no less than around fifty diseases: muscle spasms, strabismus, and urinary problems. Botox© is also used to fight muscle hyperactivity linked to multiple sclerosis, for example. Botulinum toxin blocks muscle contractions by preventing the release of acetylcholine, a chemical substance produced by the nerves that enables the muscles to contract.

So, botulinum toxin does not add volume and is not, therefore, responsible for disproportionate lips either!

Hyaluronic acid is the other star molecule in aesthetic medicine. This more or less thick, viscous gel is injected into the face to fill furrows and hollows (dark circles, tear trough), reshape the contours (chin, jaw), restore volume (lips, cheeks, temples…), or rectify shapes (nose with a medical rhinoplasty). It is an amazing ally to rejuvenate your face… if used properly! Successful hyaluronic acid injections, even if a lot of product is used, can be seen because our appearance is visibly better, not because we look oddly swollen. This is where the art of injections lies.


#2 My face will look frozen!

Used in aesthetic medicine and with optimum injections, Botox© is not designed to paralyse your face! There is a balance between the muscles in each face that have a positive effect (widen the eyes, lift the contour, lift the corners of the mouth) and the muscles that have a negative effect (make you look upset or mean by frowning, closing your eyes or pulling down the corners of the mouth making you look sour-faced).

The aim is to change the natural balance of the face by promoting the action of the muscles with a positive effect and, therefore, treating the muscles with a negative effect to decrease their action: frown lines (between the eyebrows), horizontal wrinkles on the forehead, the tail of the eyebrow for a subtle brow lift, the bitterness folds, and the platysma muscle of the neck.

The current trend is less is more, and the objective is to resolutely relax the face and make it more appealing: we will soften a sad, discontented, or anxious look. There is no question of totally freezing your facial features but targeting areas to maintain a globally expressive face while smoothing the wrinkles and fine lines and limiting the appearance of new ones.


#3 Botulinum toxin injections hurt

When the technique is fully mastered, botulinum toxin injections are not painful. To offer my patients greater comfort during the session, I use a “ botox pen“ , a small, extremely accurate injector pen with a very fine needle to inject the exact amount of product with unbeatable accuracy, even in difficult areas. This further reduces any pain and you will experience only a mild tingling sensation. As an added bonus, this accuracy reduces or even eliminates the need for any potential touch-ups a few days later.

Additionally, an anaesthetic cream is systematically applied before the session to make the treatment even more comfortable.

After the session and in the following days, you may have a mild headache and a feeling of tightness; this is normal and does not last.


#4 It will stay for life!

As with any aesthetic medicine procedure, the result is temporary! Little by little, the product will disappear and your muscles will recover normal functioning. In general, a botulinum toxin session is renewed every 4 to 6 months but this can be longer for some people. The effect will be visible within 7 to 10 days.

If it is your first time, I suggest a smaller dose to get used to the sensations post- treatment. Botulinum toxin can also be indicated preventively from the age of 25 or 30 years. “ Baby botox“  is ideal when we tend to frown a lot or have a powerful forehead to prevent the early appearance of fine lines.


#5 Botox is incompatible with surgery

On the contrary, aesthetic medicine is ideal after aesthetic surgery. After the recovery period, botox injections, as well as hyaluronic acid treatments (injections or mesotherapy) help maintain your natural beauty and the results of your procedure over the years.


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Rajao in Paris? Contact our team; we are at your service.

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