Botox is the processed form of the toxin released by the bacterium Clostridium botulinum, known by its Latin name. This toxin is refined under laboratory conditions to make it therapeutically suitable for humans.
Our entire body is controlled by the brain. When we intend to make any movement, the movement commands emanate from the brain and are transmitted to the muscles through nerves. Botox halts the release of molecules that facilitate communication at the nerve endings, disrupting the communication between the nerves and the organs (muscles or sweat glands) they control. As a result, the commands from the brain cannot reach the muscles or sweat glands. The function of the affected organ, whether muscle or sweat gland, is thus inhibited.
In the field of medicine, Botox is utilized in various ways due to its mechanism of action. It is employed to prevent muscle contractions in paralysis patients, treat involuntary facial movements known as ticks, and correct strabismus. Aesthetic surgeons often use Botox to diminish dynamic facial lines that become prominent due to the movements of facial muscles, for excessive sweating treatment, and to alleviate migraine headaches caused by muscle tension.
Over the years, the repetitive movements of facial muscles lead to the formation of lines due to the folding of the skin above them. These lines, known as dynamic lines, result from muscle movements. For example, horizontal lines on the forehead, vertical lines between the eyebrows, crow's feet lines around the eyes, and vertical lines around the mouth are considered dynamic lines. Dynamic lines in the upper part of the face give a tired, aged appearance, while lines between two muscles may create a frowning, angry expression. When Botox is applied, weakening of the movements of facial muscles occurs, and the affected area becomes temporarily inactive. Due to the weakened muscle movements, the lines caused by skin movements gradually fade away. As a result, the face appears more youthful, lively, and expressions like anger, age, or weariness are eliminated.
Botox can also be applied to sweat glands. This interrupts the communication between the nerve endings that activate sweat glands, preventing them from functioning excessively. Many people experience significant discomfort due to excessive underarm sweating, especially during the summer months. If Botox is to be applied for underarm sweating, it is most suitable to perform the injection before the summer, particularly in April or May. I apply Botox to all my patients before the onset of summer. A person receiving underarm Botox injections in May will spend the entire summer without any sweating or odor problems. On the other hand, some individuals may experience intense sweating in the palms and soles of the feet unrelated to the season. Botox treatment provides highly successful results in individuals who consider their excessive sweating a social and psychological problem, effectively reducing sweating and eliminating the associated odor.
The impact of Botox on migraines was unknown until recently. The discovery that migraine attacks improved after Botox injections, which were initially applied for the correction of wrinkles in patients suffering from migraines, was made by chance. The underlying cause of a significant portion of migraine attacks is the tension in the muscles of the head. If the tension of the muscles causing migraine attacks is eliminated, i.e., if the muscles are relaxed, the factor causing migraine attacks is removed. Numerous pain-relieving drugs are used in migraine treatment. However, the most significant advantage of Botox is that it does not relieve pain but prevents the onset of pain. Approximately 80-90% of migraine patients benefit from Botox. The effect of Botox in migraine treatment lasts for about 4-6 months. In other words, the effect begins within 5-7 days after a Botox application and lasts for a pain-free period of 4-6 months. When the effect begins to diminish, a new injection is required.
Botox is administered as an injection and is a painless procedure. It is performed using a very fine needle. You may feel a slight pain due to the needle penetration at the moment of injection. The only pain you will feel is this, and it should not be taken seriously. If Botox is to be applied for migraine treatment, the injection should be made into the muscles causing tension. If correction of wrinkles is desired, the injection should be made into the muscles causing the wrinkles. If Botox is to be used for sweating treatment, the injection should be made under the skin in the area where sweating is a complaint. The entire procedure takes 5-10 minutes. After the application, there is nothing special you need to do or be careful about. You can continue your normal life immediately.
The effect of Botox reaches its optimal level one week after the injection application. The effect increases gradually every day. It stabilizes after one month. It remains at this level for about 2-3 months and then gradually starts to diminish. The effect of Botox applied for wrinkle correction and migraine treatment disappears after 5-6 months. For sweating treatment, the duration of Botox's effect is longer. It has been observed that this period can extend up to 11 months in some patients. When the effect of Botox wears off, it can be reapplied without any problems. The duration of the effect is longer in repeated injections.
Administering Botox is not a procedure that any doctor can perform just by holding a syringe. Unfortunately, it has almost come to that. However, this is not enough. It is crucial to determine the points where injections will be made accurately. Even a 3-5 mm deviation from the correct point can negatively affect the result. For example, injecting into a muscle with a diameter of 0.5 cm requires not only knowledge of anatomy but also special experience and skills. If the doctor cannot determine the injection points correctly or makes injections into random points with random doses, it may result in a stiff expression, an expressionless face, asymmetry, or various other issues. The reason you hear many negative comments about the results of Botox is because of this. Conversely, when injection points are determined carefully and administered by someone who is well-versed in the subject and experienced, excellent results are achieved, and a very natural appearance is attained. When people who know you look at your face, they feel a difference, a change, a sense of youth, but they cannot figure out where this difference comes from. The best part of the process is precisely this. With the beauty that comes to your face, it is not even apparent that you have had Botox.
Botox has no health-related side effects. There might be slight swelling, redness, or momentary bruising at the time of application. All of these are temporary and should not be taken seriously. There are no real negative side effects. However, since there is no definite information about Botox applications during pregnancy and breastfeeding, I do not recommend applying it to pregnant or postpartum women. Botox application is not recommended for individuals with neurological diseases, such as myasthenia gravis or Eaton Lambert Syndrome.
