Botox (Botulinum Toxin) Treatment

What is it?

"Botox" is a brand name that has become the everyday name for this treatment; the active substance being described is botulinum toxin. When injected into a muscle, it temporarily reduces transmission from nerve to muscle and lowers that muscle's strength of contraction. The same substance also has non-aesthetic uses in medicine, which shows that the treatment is neither new nor untested.

The treatment has two separate areas of use, aesthetic and medical. On the aesthetic side the target is expression lines; on the medical side there are headings such as teeth clenching (bruxism) and excessive sweating. This page covers both, because most patients assume they are the same procedure.

Botulinum toxin is a substance that, when injected into a muscle, temporarily reduces the signal travelling from the nerve to the muscle. The muscle no longer contracts as strongly, and the lines formed by that muscle's constant contraction gradually become less pronounced. The distinction matters: the treatment does not erase the line, it reduces the movement that creates the line. That is why it works on lines that appear with expression (forehead, between the brows, outer eye area); on deep lines that have become permanently set in the skin and no longer relate to movement, it does not give the expected result. Lines of that kind need different approaches, and this is a limit that should be stated before treatment. The effect settles fully within one to two weeks and recedes over time; the muscle regains its former strength. Whether the result looks natural depends directly on the amount: the aim is not to remove expression but to reduce excessive contraction. An expressionless look comes not from the treatment itself but from too much of it. For this reason the amount is decided not by how much the patient asks for but by what the strength of the muscle requires; the two are not always the same number, and if the gap is wide, saying so is part of the assessment.

Jaw clenching (masseter) treatment is a separate matter

The chewing muscle at the edge of the jaw (masseter) enlarges in people who habitually clench or grind their teeth. Botulinum toxin is requested for this muscle on two different grounds: medically, to reduce complaints related to clenching, and aesthetically, for the lower face to look slimmer. These two grounds describe the same procedure but not the same expectation, and they should not be confused. Another point that is often confused is this: masseter treatment slims the muscle, whereas jawline filler defines a line. One reduces volume, the other adds it; they are not alternatives to each other, and in some people the intended look is achieved only by doing one and not the other. Which suits you depends on whether the volume of your lower face comes from muscle or from fat and bone structure; that distinction is made at the examination.

1. Injection: the substance is given into the target muscle in small amounts.
2. Settling: the effect does not start at once; it begins within a few days and settles fully in one to two weeks.
3. Effect period: the muscle's strength of contraction is reduced; lines formed by movement become fainter.
4. Return: the effect recedes over time and the muscle regains its former strength.

Treatment Areas

• Forehead lines — horizontal expression lines
• Between the brows — vertical lines
• Outer eye area — lines that form when smiling
• Masseter (the chewing muscle at the edge of the jaw) — teeth clenching and lower-face volume
• Excessive sweating — underarms and palms
• What it cannot do: deep lines set in the skin that no longer relate to movement

Procedure Steps

1. Assessment

   Facial expressions are observed, and it is established whether a line is related to movement or to the structure of the skin. If the treatment is not expected to meet your expectation, this is said at this stage.

2. Medical history

   Any history of neuromuscular disease, the medicines you take, pregnancy or breastfeeding, and previous treatments are asked about.

3. Planning

   Which muscle is treated, and with what amount, is decided. The aim is not to remove expression but to reduce excessive contraction.

4. Injection

   The substance is given in small amounts at the chosen points with a fine needle. The procedure is short.

5. Review

   The effect is assessed once it has settled after one to two weeks; if needed, a balancing adjustment is made. No decision is taken in the early period.

Duration and Longevity

One of the most common questions is whether there is permanent Botox. The short answer: there is not, and it is not something to wish for. The temporary nature of the effect is the most important safety feature of the treatment — a result you do not like does not stay with you permanently, and an overdone treatment corrects itself over time. How long the effect lasts varies with the person, the muscle treated, the strength of that muscle and the amount; for that reason it would not be right to give a single figure. A common mistaken expectation also needs correcting here: repeating the treatment does not make the effect permanent. Regular repetition means maintaining the effect; permanent weakening of the muscle is not an intended outcome. In people who have had regular treatment over a long period, it has been reported that the intervals can lengthen as the muscle gradually weakens; this cannot be presented as an expected benefit, because it varies from person to person.

Who is it suitable for?

• Adults aged 18 and over
• People bothered by lines that appear with facial expression
• People with complaints of teeth clenching or grinding
• People who come knowing that the effect is temporary
• People who expect a natural result that keeps their expression

Who is it not suitable for?

• Pregnant and breastfeeding people
• People with a neuromuscular disease (myasthenia gravis and similar conditions)
• People with an active skin infection at the treatment site
• People with a known hypersensitivity to the substance used
• People seeking a solution for deep lines set in the skin that no longer relate to movement — this treatment does not smooth those lines
• People who want their facial expression to disappear completely: this is not a technical goal and is not carried out even if requested; an expressionless face is not the success of the treatment but its overdone form.

Aftercare

• Do not massage or rub the treated area in the first hours.
• On the first day, avoid bending forward for long periods and lying face down.
• On the first day, stay away from strenuous exercise, saunas and steam rooms.
• The effect takes a few days to settle; do not judge by how it looks in the first days.
• If you notice asymmetry, mention it at the review appointment; in the early period it may be necessary to wait.
• In case of eyelid drooping, double vision or difficulty swallowing, contact the clinic without waiting.

Possible Side Effects

• Temporary redness and small bruises at the injection points
• Headache — may be reported in the first days
• Asymmetry — can be corrected with a balancing adjustment
• Temporary drooping of the eyelid or brow — rare, and resolves as the effect wears off
• After masseter treatment, a temporary feeling of fatigue when chewing in the early period
• What these side effects have in common is that, like the treatment itself, they are temporary.

Frequently Asked Questions